HomeMy WebLinkAboutAFFIDAVIT - 05-00379 - 109 S Hidden Valley Rd - New SFR-q 4
AMERJ FAMILY OMMUNITY 19 E. Main (PO Box 280) Phone: 208-359-
Ibur, Idaho 83440 Fax: 208-359-3024
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Affidavit of Legal Interest
State of Idaho
County of Madigan
Ct V, i
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Name Address
City State
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, slip to B)
A. That I am the record owner of t property described on the attached, and I grant my
permission to g V V V
Name
Address
to submit the accompanying application pertaining to that property.
B. Y agree to inde=ify, defend and hold. Rexburg City and its employees harmless from any
claim or liabflity resulting from any dispute as to the statements contained herein or as to
the ownership of the property 4�-high is the subject of the application.
Dated this20day of
Signature
Subscribed and sworn is before me the dad and year first above written.
Notary Public of Idaho
Residing
at. -
My commissionx firesF