HomeMy WebLinkAboutAFFIDAVIT - 21-00589 - Madison Armory - 870 N 2nd E - Indoor Gun RangeAffidavit of Legal Interest
City of Rexburg
35 North 10 East Phone: 208.359.3020
Rexburg, ID 83440 w .rexburg.org Fax: 208,359.3022
State of Idaho
County of Madison
I, J illi'M (S V"olI('0
Name
Ni� b,,
City
Being first duly sworn upon oath, depose and say:
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Address
State
C I TY O F
REXBURG
(14
America's Family Community
(If Applicant is also Owner of Record, skip to B)
A. That I am the record owner of the property described on the attached, and I grant my
permission to: �<.(y Acly. /con cc (�h s ),rc ,.� 6 bF \Is $3Yo j
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 wch is the subject of the application.
Dated this day of ,4 6 20 1
Signature
Subscribed and sworn to before me the day and year first above written.
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dr My commission expires: