HomeMy WebLinkAboutAFFADAVIT 2 - 23-00026 - Tropical Smoothie Café - RemodelSubmit by E-mail
35 North Ist East
Rexburg, ID 83440
Affidavit of Legal Interest
City of Rexburg
State of Idaho
County of Madison
Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3022
I, E u.,c' M� ,
Name
City
155 2!9
Address
0
State
CITY O F _.
REXBURG
OW
America's Nmily 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 Irant my
permission to:-[L�� 2 1� p
Nara J W �M R�fy rOI1( IM Address � d [a t_ V �
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 U day of , 20 Z -Z>
Sign tore
Subscribed and sworn to before me the day and year first above written.
VICKI WEEKES Notary Public of Idaho
Notary Public _
State of Idaho
Residing at:
Commission #65053
Expires • 03/08/2027
My commission expires: