HomeMy WebLinkAboutAFFIDAVIT - 23-00214 - Hernandez Hot Rods and Customs - 905 Jet Stream Dr - SignAffidavit of Legal Interest
City of Rexburg
35 North PO East Phone: 208.359.3020
Rexburg. ID 834/0 waw.rexbarg.oT Fax: 208.359.3022
State of Idaho
County of Madison
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Being first duly mom upon oath, depose and say:
(If Applicant is also Owner of Record, sldp to B)
A. That I am the record canner 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 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
owaetship of the property which is the subject of t/hh��e apphcation.
Dated this�I day of 17� 20._ 02 D7
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Subscribed and sworn to before me the day and year fust above written.
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"' susrvu�a Residing at hl l/ aor .()X)dSj e&
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My commission ezpizes: �