HomeMy WebLinkAboutAFFIDAVIT (INCOMPLETE) - 22-00203 - KTRI Farms, LLC - 1025 S Yellowstone Hwy - Lot Line AdjustmentAffidavit of Legal Interest
City of Rexburg
35 North P, East Phone: 208,359.3020
Rexburg, ID 83440 www.rexburg,org Fax: 208.359,3022
State of Idaho
County of Madison
Nan e '
City '
Being fust duly sworn upon oath, depose and say:
C I T Y O F
REXBURG
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Address
Vl--7't
State
(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:
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
%.off the property which is the subject of the application.
Dated this I D day ofJ��,&F?Jfi20
Subscribed and sworn to before me the day and year first above written.
Notaq Public of Idaho
Residing at:
My commission expires:
Description of Attached Document
Title of Type of Document AFFIDAVIT OF LEGAL INTEREST
Document Date 2/18/2022 Number of Pages 1
Jurat
State of UT
Count § SALT LAKE
y of
Subscribed and sworn to before me on this 18 of FEBRUARY in the
year 2022 by TYS O N J. C I C 4b S month
year name of document signer
Witness my ha nd official seal.
ry Signature
AFCU Form #747 09/16
°a JETXHAFOLLI (seal)
5 NOAIRrP=•StATEOFUTAN
COMAMSSION NO. 700759
COMM. EXP. 0608!!022