HomeMy WebLinkAboutAFFIDAVIT - 22-00716 - Riverwalk Condos - 4 Plex - Bldg 2Affidavit of Legal Interest
Submit by E-mail City of Rexburg
35 North 1St East Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
State of Idaho
County of Madison
I Bron Leatham
Name
Rexburg
City
2535 Little Town Drive
Address
ID
State
CITY OF
REXBURRG
ow
America's Family Community
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, and I grant my
permission to: Scott Page 2428 Little Town Drive Rexburg, ID 83440
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 22 day of , 2022
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission expires: