HomeMy WebLinkAboutAFFADAVIT - 23-00026 - Tropical Smoothie Café - RemodelSubmit by E-mail
35 North 1 East
Rexburg. ID 83440
Affidavit of Legal Interest
City of Rexburg
State of Idaho
County of Madison
Phone: 208.359.3020
www.rexburg.org Fox: 208.359.3022
I, L,L.,1M. Wl ��✓�' ,
Name r n_
vt
CitV
Being first duly sworn upon oath, depose and sav:
CITY OF
REXBURG
C%i
Anicriais Family C4)mnmNty
Address
FD
State
(If Applicant is also Owner of Record, sldp to B)
A. That I am the record owner of the property described on the attached, and I grant my
permission to:
Name
Address
to submit the accompanying application pertaining to that property.
B. I agree to indemnih-, 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 I� � day of Ott , 20--c2:-�
Signa
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
SEBASTIAN PLUMMER j - 7
Notary Public - State of Idaho Residing at: III /
Commission Number 20214016
My Commission Expires Aug 23. 2027 � 23
My commission expires: t