HomeMy WebLinkAboutAFFIDAVIT - Freddys - 21-00773 - 18 N 2nd E, 220 Ricks, 227 E Main - Rezone from CBD to CBCAffidavit of Legal Interest
City of Rexburg
35 North jar East Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fox: 208.359.3022
State of Idaho
County of Madison
)
Name
city
Address
State
CITY QT
REXBURG
Amerka_z Famih, C:<tavar�aza�rrty
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 property described on the attached, and I grant my
permission to: City of Rexbur 35 N 1 st E, Rexburg, ID 83440
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 rth�e, property which is the subject of the application.
Dated this " 1� day of ° , 20
Signature
Subscribed and sworn to before me the day and year first above written.
L ao� w�'-46tam e'" —
ry Public of Idaho
REBECCA NIERODZINSKI Residing at: 4 A4L t
COMMISSION #49872
NOTARY PUBLIC My commission expires:
STATE OF IDAHO
MY COMMISSION EXPIRES OA/22/2027