HomeMy WebLinkAboutAFFIDAVIT - 4U Development - 22-00102 - Pine Brook DIV2 Blk6 Lots 16-24 - Comp Plan Map change from Rural to LDR1-MDR1yrs yMIR11-4
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APY- -
35 North I v East
Rexburg, 1D 83440
State of Idaho
County of Madison
Affidavit of Legal Interest
Uy of Rexburg
Phone: 208.359.3020
www.rext+urg.org 'tax: 208.359.3022
CITY of
aY.,,BUR(.......___......._
Afneriall &13164T i,L4^Tfi?ad
I? C11,07�n
7 r_
Name Address
— wl�e3 �t I
city ,
13eing first duly sworn upon oath, depose and say:
Stare
(If Applicant is also Owner of Record, skip to B)
A. 'nat him the record. owner of the Pr -)Per = descri )ed onxhe atr.ached, and I grAnt 11y
La
permission to:
Nance �lddress
to submit the accompanying application pertaining to that property.
B. I agree to indemnif r, defend and hold Rexburg City and its employees hwrn-�tess from any
chum or liability resulting from. any dispute �Ls to the statements contained herein oras t« the
ownership of the property whiClh is the Subject of the applicarion.
Dated this day of
S(pulturc
Subscribed and sworn to before me the day a�car above wri
DAYNA L-• EN NO 4ERSELL
9820
COk4 SIO
NOTARY PUBLIC Notary Public of :rho
S -'ATE OF IDAHO
MY COMMISSION EXPIRES p4123125
Residing at: �V .
Nly conrrz ssion expires: 4- Z�'ZS