HomeMy WebLinkAboutAffidavit of Legal Interest V1C�iE ]DIAN- AFFIDAVIT OF LEGAL INTEREST
APPROVED
DATE: 0824/22
FILE NUMEERstiry'05
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(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 1 grant my
permission to:
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(name) (address) 83L i%
to submit the accompanying application(s) pertaining to that property.
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.
1 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 day of Jj. l 20 Z Z
(Sign
SUBSCRIBED AND SWORN to before me the day and year first above written.
STATE OF -T�PL& ) ss)
COUNTY OF MT ) y
This record was acknowledged before me on / - l - Z° Z Z (date) by
(name of person signing form).
VITALIY YAKIMYUK
COMMISSION NUMBER 69179 t�ofN.,
NOTARY PUBLIC /
State of Idaho My Commission Expires: 17 ZDZ�
My Commission Expina Ot/t 7/20Y3
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