HomeMy WebLinkAboutAffidavit - Don Heinz (2)Submit by E-mail
35 North 1,1 Eost
Rexburg. ID 83440
Affidavit of Legal Interest
City of Rexburg
State of Idaho
County of Madison
I Don Heinz
Name
Rexburg
city
Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3022
Being first duly sworn upon oath, depose and say
750 Hillside Drive
Address
Idaho
State
CITY OF
RE"URG
CW--...__._.
Ani,Hc , Family famrnunity
(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: St.ne'a EVM88 Luce s Car Wash LLC (Mash lu,"[a a) 615 S Yellowstone Highway, Rexburg, ID 83440
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.
application.
Dated this day of ' " ch" , 20
Sign
Subscribed and sworn to before me the day and year first above written.
ALISON BANTA
Notary Public Notary Pubhc of daho
State of Idaho
Commission #21444 Residing at: Residing in Rt Anthnny, ID
Commission Expires 11-30-2029
My commission expires:
Docusign Envelope ID; 064EBOFB-003E-40AC-A226-F1268ABF3447
EXHIBITA
Legal Description of Property
Parcel RPRXBCA0362416
Owner: Heinz Family LLC
Owner: Don Heinz
Legal: Rexburg City Acreage N2 Nw4 Less Tax 42 & W2 Tax 46; less Tax 124, 726 West of Hwy, Madison County, Idaho
EXHIBIT A Buyer's initials CZ— l__.
(_) Seller's Initials( �B ) 411.