HomeMy WebLinkAboutAFFIDAVIT - Wayne Erickson - Erikson 40 Acres - 1040 W Main - Lot Line AdjustmentAffidavit of Legal Interest
35 North 1st East
Rexburg, ID 83440
State of Idaho
County of Madison
www.rexburg.org
1, W(A:i n:e., [ric.J.son I Name
City
Being first duly sworn upon oath, depose and say:
City of Rexburg
Phone: 208.359.3020
Fax: 208.359.3022
Address
State
(If Applicant is also Owner of Record, skip to B)
CITY OF
REXBURG ---c_,---
Americas Family Community
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.
i -11.. Dated this ___________ day of_�/)-���------,, 20 .2 /
Subscribed and sworn to before me the day and year first above written.
esiding at: / cl<J} £Rt5wn_,,J)-g _
My commission expires: g-)D · J5
Bron Leatham 2535 Little Town Dr, Rexburg, ID