HomeMy WebLinkAboutAFFIDAVIT - Dustin Hegsted - 21-00621 - Rexburg North - 1371 N 2nd E - AnnexationAffidqvit of Legol lnlerest
Phone:248359.3020
Fax: 208.359.3022
Name
State of Idaho
County of Madison
5 l"l 5 \./v. "LLlo O .a-,
(- o.tAr'\ L-
Address
iJ +q h
City
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
A. That I am the record owner of the properry described on the attached, and I grant my
OermiSSiOn tO. Kindi M@sman 225 W Navigator Dr., Suile 21O, Meridian, lD 8392
to submit the accompanying application peraining to that property.
B. I agtee to indemni$r, 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 properry which is the subiect of the application.
Dated this l tu duy of /4- t,, Sl ,20-!-l-,---_-J-
Subscribed and swom to before me the day and year first above written.
NOTARY PUBLIC
.IANIE MCBEE
6S7002
'OMM|SSION
EXPIRES
SEPTEMBER 13,2A21
$tfr}E OF UT4H
Public o-fJdnho(}lqh
Residing r,, Tlcrx 2 lCo r , t*ah
Mycommission expires' Cq
\ t3 il frt t
Submit by E-mail
35 North Ist Eosf
Rexburg. lD 83440 www.rexburg.org
CITY OF
ruXBURG_,-...-.... a\,r.-
A merica\ t:amily Co m munity