HomeMy WebLinkAboutAffidavit - Hatch (Lot 19)·Affidavit of Legal Interest
35 North 1" East
Rexburg, ID 83440
State of Idaho
County of Madison
www.rexburo.oro
City of Rexburg
Phone: 208.359.3020
Fax: 208.359.3022
CITY OP
REXBURG ~---
Ammali,.,.,,, ~
I, Caleb R. Hatch or Jacob B. Hatch or Kimberly,Hatch ___ 6_1_5_S_o_ut_h_S_t. ________ _
Name Address
Deforest Wisconsin _________________ ,
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: Mitchell Smedley 5624 Sorrel Dr, Pocatello, ID 83202
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 ~cation.
Dated this ,6 ,() (, • J day of 0 ~ l'X , 20_2......_1, __
1
Signature
Subscribed and sworn to before me the day and year first above written.
I' C,,(..N\ S1 fl
Residing at: 3/ 5? f:.a/cJ,r,,H /J(
My commission expires: Jqnc, ~, 2.JJ2 °I