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APPROVED
DATE: 08/23/22
f I!E HUMBIR Psa-zo 1-1
STATE OF IDAHO )
COUNTY OF ADA )
AFFIDAVIT OF LEGAL INTEREST
name) (address)
(city) (state)
being first duly sworn upon, oath, depose and say:
That I am the record owner of the property described on the attached, and I grant my
permission to:
The Land Group, Inc.. 462 E. Shore Dr., Ste.100, Eagle, ID 83616
(name) (address)
to submit the accompanying application(s) pertaining to that property.
2. I agree to indemnify, defend and hold the City of Meridian 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.
3. I hereby grant permission to City of Meridian staff to enter the subject property for the
purpose of site inspections related to processing said application(s).
Dated this 1W141 day of ,/G�--� 20 c9c—)-
(Signature)
SUBSCRIBED AND SWORN to before me the day and year first above written.
(Notary Public for Idaho)
Residing
My Commission Expires:
(Rev 05/29/20)
CUEIDI� IAy
APPROVED
DATE 08/23/22
FILE NUMBER: Psaz=z 003
ACKNOWLEDGMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document
to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of i aS AO-Q. ,AF S
—. 1 ��.PT� .�^c �J 1�y 1)I. CAS' �t T,�C�il rl�
On TAw►� -I o . 7? Lbefore me,
Date Here Insert Name and Tilde of the Officer
personally appeared svp�,� a n20-,Sn;
Name(s) of Signers)
who proved to me on the basis of satisfactory evidence to be the personts�whose nam is re subscribed
to the within instrument and acknowledged to me that I&e he/they executed the same i his er/their
authorized capacity., and th t b his er/their signatures) on the instrument the person or the entity
upon behalf of which the person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
KATHLEE, DONLON paragraph is true and correct.
Notary Public - California ■■
• Los Angeles County S
commission # 2358826 WITNESS my hand and official seal.
My Comm. Expires May 24, 2025
Signatur
Place Notary Seal and/or Stamp Above Signature of Notary Public
Vr- I IVIVW6
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer is Representing:
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
F1 Other'
Signer is Representing:
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02019 National Notary Association