HomeMy WebLinkAboutAFFIDAVIT - 23-00950 - Chip Cookies - 505 N 2nd E - SignAffidavit of Legal Interest
City of Rexburg
35 North 70 East Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
State of Idaho
County of Madison
Name
Ply l,!/1
City
Being first duly sworn upon oath, depose and say:
Address
:T—b
State
(If Applicant is also Owner of Record, skip to B)
C IT Y OF
REXBURG
America's Family Community
A. That I am the record owner of the property described on the attached, and I grant my
permission to: Sign Pro 2274 W. Heritage Cir., Idaho Falls, ID 83402
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.
Dated this / / day of 6- C--� 120
Subscribed and sworn to before me the day and year first above written.
VICKI WEEI<ES
Notary Public
State of Idaho
Commission #65053
Expires - 03/08/2027
Notary Public of Idaho
Residing at: D
My commission expires:
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