HomeMy WebLinkAboutAFFIDAVIT - 25-01288 - Diaz (Birch Property) - Approx 301 S 12th W - Comp Plan change fr LR to IRSubmit by E-mail
35 North 1,1 East
Rexburg, ID 83440
Affidavit of Legal Interest
State of Idaho
County of Madison
City of Rexburg
Phone: 208.359.3020
www.rexburg.org Fax:208.359.3022
i
Name �o
City
Being first duly sworn upon oath, depose and say:
State
(If Applicant is also Owner of Record, slip to B)
CITY OF
REXBURG
Ow—
Amed&s Family Community
A. That I am the reco d qwner o the property described on th attached and I rant my
percussion to: U0101 U)44D / 0 O
Name Address �t�l g-300
to submit the accompanying application pertaining to that property. l c�'"��C)Y- do
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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 9 A'nL day of �/1 e U Q� Q> 20 Z _5
Signature
Subscribed and sworn to before me the day and year first above written.
MY 111
7��i����/ Notary Public o If dahU
`aOoPYP�e��c
s Residing at:Qd�-�
MY COMMISSION
EXPIRES 1-15-2027
• = My commission expires: 1' % '5 z-b Z-7