affidavit of legal interestversion of the
in the format
AFFIDAVIT OF LEGAL INTEREST
O r�0
STATE 0F4D*li&j
�' S
COUNTY O jr�t
I, Sic Oke -n ` ` ,416r , k2ko e Pow,rJ i e,,j Aq-t—
A A (name) (address)
(city) (state)
being first duly sworn upon, oath, depose and say:
1. That I am the record owner of the property described on the attached, and I grant my
permission to:
(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 'L -Yd day of �a 41 V OL f , 2019
(Signature)
SUBSCRIBED AND SWORN to before me the day and year first above written.
STAMP
TAYLOR LOREN t:ASTUN
NOTARY PUBLIC -OREGON
COMMISSION N0.OMM
MY SON t7tPtRES NOVEM ER 26, 2MI
Orot-40k6lic fo
Dr.�vn
Residing at: /;2g= _Se.(W1a
My Commission. Expires: _Z4111 (46,6Z 4
Community Development • Planning Division ■ 33 E. Broadway Avenue, Ste. 102 Meridian, Idaho 83642
Phone: 208-8845533 Fax: 208-888-6854 ww-%v.meridianciw.org/planning
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