HomeMy WebLinkAboutAFFIDAVIT - Andrew Wells - 21-00995 - Lot Line Adjustment - Evergreen Blk3 Lot 11 & Starlite Add. Blk 1 Lot 2Affidavit of Legal Interest
City of Rexburg
35 North I'' East Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
State of Idaho
County of Madison
I At'tdr(P,A) w�115
Name
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City
Address
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State
CITY OF
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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 cad the property described on the attached, and I grant mi���
permission to`��'Q��1 k{Na` --q
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
wf�k dayof 0eCeV41&y- 20—?=�_
signature
Subscribed and sworn to before me the day and year first above written.
ADAM SNARR Notary ublic of Idaho
COMM NO.2017-0786
STATENOTAO IDAH Residing at: 6 �^� f c.t-x 110N'ry,
STATE OF IDAHO
COMMISSION F,CPIRES 10123123
My commission expires: l O /Z3 /Z;