HomeMy WebLinkAboutAFFIDAVIT (INCOMPLETE) 4.13.22 - 22-00254 - Davis Home - 215 E 3rd S - Lot Line Adjustment - NOT NEEDEDAffidavit of Legal Interest ;6�}LI'U�Cr4 C_:Y or
Submit by E-mail City of Rexburg
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35 North 1,1 East Phone: 20& 359-3020
Rexburg. 1D 83440 www.rexborg.org Fax: 208.359.3022
State of Idaho
County of Madison
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Narne
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City
Being first duly sworn upon oath, depose and say:
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Address
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State
(If Applicant is also Owner of Record, skip to B)
That I am the record owner of the property described on the attached, and I grant my
permission to
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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 Z day of Y. , 20 ZZ-
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Signature
Subscribed and s,,vorn to before me the day and year fust above written.
Notary Public of Idaho
Residing at:
My commission expires: