HomeMy WebLinkAboutAFFADAVIT - 21-00586 - Just4Kids Pediatric Urgent CareAffidavit of Legal Interest
City of Rexburg
35 North I,f East Phone: 208.359,3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359,3022
State of Idaho
County of Madison
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Name
City
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Being first duly sworn upon oath, depose and say:
A.
CITY OF
aXBURG
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Address
State
(If Applicant is also Owner of Record, sldp to B)
That I am the record owner of the property described on the attached, and I grant my
permission to:
Name Address
to submit the accompanying application pertaining to that property.
B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from any
claim or liability resulting from any dispute as to the statements contained herein or as to the
ownership of the property which is the subject of the application.
Dated this -Z t day of -TN of , 20
Signature (5Cnval C uv�`5+1 ���is a THfL-
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Subscribed and sworn to before me the day a year •
firs(above written.
AMYYLIAMS
COMMISSION NO. 30589
NOTARY PUBLIC
STATE OF IDAHO
MY COMMISSION EXPIRES 0510625
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Notary Public of Idaho
Residing at: I w t ° R///S
My commission expires: � may
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CITY OF
XBURG
mAmeriwsFamily Community
PROPERTY LINES
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Each site plan that is submitted to the City of Rexburg for the Building Permit process requires that property lines
are shown accurately. Itis the Developer's responsibility to correctly identify on the site plan the location of these
lines in reference to the public right-of-way, other adjoining property lines, the street, other structures and all
utility lines. The Developer should find property pins that are still available at the lot in question. If these pins do
not exist or have become unrecognizable then a new survey should be performed.
Accurate property line information is a must for a timely review. In addition to finding existing property pins,
legal descriptions should be checked. The best way to identify property line location is with a land survey. The
City of Rexburg has aerial photos and a parcel line layer that can be checked, but they are only tool and are not
guaranteed for accuracy. This information is available at madisonrexburg.org. If you want to requesta copy of
your lot iniormation, contact the Community Development Department.
I have read and understand the above requirements.
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Signature Date
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Printed Name
InspecCion Hottlne-(208)3722344 shauna.eatonprecburg.org Permi@Technician'. (208)372.2160