HomeMy WebLinkAboutAFFIDAVIT - 23-00697 - Chip Cookie - RemodelSubmit by E-mail
35 North Is' East
Rexburg, ID 83440
Affidavit of legal Interest
City of Rexburg
Phone: 208.359.3020
www.rexburg.org Fax:208.359.3022
State of Idaho
County of Madison
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Name
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City
Being first duly sworn upon oath, depose and say:
( I r Y o f
REXBURG
OW
Amends Family Community
2� Do
Address
State
(If Applicant is also Owner of Record, slap to B)
A. That I am the record owner of the property described on the attached, and I grant my
permission to: Joshua Sommers 1609 N 2200 E. Hamer, ID 83425
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.
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Dated this I 1A day of a �� , 20
>ignarure
Subscribed and sworn to before me the day and year first above written.
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``01t11i 111J. o Notary Pubbc of Idaho
�P KE"WS' �L�eS� �� Residing at:
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My commission expires:
OV13 9
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