HomeMy WebLinkAboutAFFIDAVIT - 22-00280 - 795 S 5th W - Annexation and Rezone from RR1 to MDR2Affidavit of Legal Interest �4�x,��<:ka
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City of Rexburg
REXBUR
35 North Is' East Phone: 208.359.3020 d>>�<ric:a:'ssraasis'y t.;vn+�r�unrty
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
State of Idaho
County of Madison
Name Address
P, arI ,
City
Being first duly sworn upon oath, depose and say:
Tcto 11 113
State
(If Applicant is also Owner of Record, skip to B)
A. That I am the record owner of theproperty described on the attached, and I grant my
permission to: �?�% ;i I k U:,<n 4� 19hrLD4 S l 4-ya C e _ SC L r U-1
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 ZD71^
Signature
day of /-'1wl ( , 20 ZZ -
Subscribed and sworn to before me the day and year first above written.
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:•�.iY? "G'•.• Notary Public of Idaho
W COWASSION Residing at: l J iz i�
EXPIRES3-21-2028 r g Y y.�1 Or i��x�, ., T �, ;�1 �L
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Of My commission expires: 3 I Z i
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