HomeMy WebLinkAboutAFFIDAVIT - 21-00814 - 2943 W 3800 S - Strong Shed with Living SpaceAFFIDAVIT OF LEGAL INTEREST
PLANNING & ZONING DEPARTMENT
134 E Main Suite 208 Rexburg ID 83440
Phone(208)359-6259
Fax(208)356-6308
State of Idaho
County of Madison p✓ 0
Name )Address
City
Being first duly sworn upon oath, depose and say:
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State
(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 grand my
permission to:�ce)yc�rw, nm>�� Q2540 A) 161-6 z LWAI �et-bt.rvd7 n' `63[140
Name Address
to submit the accompanying application pertaining to that property.
B. I agree to indemnify, defend and hold Madison County and its employees harmless from
any claim of 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 6u day of 6(Aolner 20 2.I
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Publ&- f Idaho
ANGELA MORGAN
Notary Public -State of Idaho Residing at:
t Comm. No. 53772
My Comm. Expires December 29, 2026 ! n
My commission expires: L19 Ue