HomeMy WebLinkAboutAffidavit TSCSubmit by E-mail
35 North 10 East
Rexburg, ID 83440
State of Idaho
County of Madison
I Eric Isom
Name
Idaho Falls
City
Affidavit of Legal Interest
City of Rexburg
Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3022
Being first duly sworn upon oath, depose and say:
1568 E 17th Street
Address
ID
State
(If Applicant is also Owner of Record, skip to B)
O�pE%B URC
CITY Of
J� REXBURG
ny
AmericA Faintly Community
A. That I am the record owner of the property described on the attached, and I grant my
permission to: 3D T Holdings, LLC 3540 Wheeler Road, Suite 309 Augusta, GA 30909
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 Z O day of Su„ V 4 7 20 2 LP
e-
Signature
Subscribed and sworn to before me the day and year first above written.
NI�30719 Notary Public of IdaLICHO���n l i1EM
S 1010612028 Residing at: (�(� (J
My commission expires: 10-Q&'211)20