Legal Interest 001 (002)STATE OF IDAHO )
COUNTY OF ADA )
AFFIDAVIT OF LEGAL INTEREST
ki,
(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:
(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.
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 _ _day of Qb6k' 1'' , 20 19
SUBSCRIBED AND SWORN to before me the day and yrar first above
A�R�iy�.•.
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Public or Idaho)
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• ♦ Residing at:
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i'b"MxPt rl•. evelopment ■ Planning Division ■ 33 E. Broadway Avenue, Ste. 102 Meridian, Idaho 83642
Phone: 208-884-5533 Fax: 208-888-6854 w w.meridiancity.or- piam,iL
www.meridiancit .or ublic works/autocad standards/index.as
(1) Disk with electronic version of the conceptual engineering plans in the format specified
above.
STATE OF IDAHO )
COUNTY OF ADA )
AFFIDAVIT OF LEGAL INTEREST
ki,
(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:
(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.
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 _ _day of Qb6k' 1'' , 20 19
SUBSCRIBED AND SWORN to before me the day and yrar first above
A�R�iy�.•.
/"Vh
�F 0.
-/ � �v
Public or Idaho)
—1 • SOS
• ♦ Residing at:
JQ'
�'•.,��sj� °�'�0��•`� My CommissionLpires:q/(�)M 1 14
TE 0'V
i'b"MxPt rl•. evelopment ■ Planning Division ■ 33 E. Broadway Avenue, Ste. 102 Meridian, Idaho 83642
Phone: 208-884-5533 Fax: 208-888-6854 w w.meridiancity.or- piam,iL