HomeMy WebLinkAboutAFFIDAVIT - 23-00170 - Rexburg 10th Ward LDS MeetinghouseSubmit by E-mail;
35 North 11t 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
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CITY OF
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Americas Family Community
I� David Forbush 50 East North Temple Street, COB 12th Floor
Name Address
Salt Lake City Utah
City State
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 I grant my
permission to: BHD Architects 65 East Wadsworth Park Drive, Draper Utah 84020
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 T� day of l L , 20 Z3
Signature
Subscribed and sworn to before me the day and year first above written.
Lo"
D. TODD EVANSNotary Public, State of Utah
Commission # 713439
My Commission Expires On
_ September 06. 2024
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Public of Idaho
Residing at: ✓ l(�� `O ��
My commission expires: `y�