HomeMy WebLinkAboutDPI Green - Affadavit for Rexburg CityAffidavit of Legal Interest4`�"°R
`�� 1�..y CIT_ S" OF
Submit by E-mail City of RexburgREXBURG
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35 North Is' East Phone: 208.359.3020America'sFiamid Community
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Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
State of Idaho
County of Madison
I, Devin Durrant
Name
Provo
City
2000 N Canyon Road
Address
Utah
State
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, slap to B)
A. 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 22 day of September —2021
t
Signator
Subscribed and sworn to before me the day and year first above written.
NAary Public oflL_J46ko 1 kj-c!J-�_
NOTAPY PUBLIC Residing at:
Amy L Morris
714749 �U2
MY COM1411$s]fJN EXPIRES
10/16/2024 My Commission expires:
STkTE OF UTAH