HomeMy WebLinkAboutAFFIDAVIT - 22-00536 - Madison Amory - 870 N 2nd E - SignAffidavit of Legal Interest
City of Rexburg
35 North I" East
Phone:
208.359.3020
Rexburg, ID 83440
w .rexburg.org
Fax:
208.359.3022
State of Idaho
County of Madison
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City
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Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
A. That I am the record owner of the property described on the attached, nd I g�iant m II
permission to: A1C Sn V s 2 a 2�.(Ma �r—i-alo�p0 i11S
Name `T 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 prope which is the subject of the application.
Dated this ZZ day of JAA,,Z 20
Signature
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Subscribed and swom to before me the day and year fust above written.
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Nota Public of Idaho
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PUBLIC i ? Residing at:
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No, 'eo:,p� F My commission expires: