HomeMy WebLinkAboutPZ - Affidavit of Legal Interest AFFIDAVIT OF LEGAL INTEREST
(name) (address)
e, J Cj(Z
(city) (state)
being first duly sworn upon, oath, depose and say:
I . That I am the record owner of the property described on the attached, and I grant my
pernussio� to:
C. s
(name) (address)
to submit the accompanying applica.tion(s) pertaining to that. property,
24 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 processingsaid application(s).
Dated this � L day of / ` �� Cl 20�
(Signature)
SUBSCRIBED AND SWORN to before me the day and year first above written,
STATE OF ) ss)
COUNTY OF W .— )
This record was acknowledged before me on �Vl (] � : Li��/�tl (date) by
d�ln �d n (name of person signing form) .
OEEICIALSTAMP 1 h
NATALIEAKINCAID Signature of otai•y ;ublic
NOTARY PUBLIC - OREGONN@01
COMMISSION NO, 1024536 f'^
MY COMMISSION EXPIRES MAY 15, 2026 My Commission Expires;