HomeMy WebLinkAboutSpring Creek AffidavitSubmit by E-mail
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State of Idaho
County of Madison
Name
Affidavit of Legal interest
City of Rexburg
,PDC Af G LI- o
city
Prone: 208.359.3020
wwvw.rexburg.org fax: 208.359.3022
Being first duly sworn upon oath, depose and sac:
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REX.EURG
A?tterica' wdy Cottorwa:
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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 me
permission to: A ry1-lr-S C. E t-1) 3b 6QLL-E CSFAVE-
Name -Wdress
to submit the accompanying application pertaining to that property.
B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from am-
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 L day of _a �� 0 d 1l ?0
4ature
Subscribed and sworn to before me the day and Bear first above written.
,R BRI/V�--
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Residing at: U
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N1c comm ssion expires: 2
d 1N"'�. No. 202?�$� •O ``�
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