4 Affidavit Of OwnershipAFMAV IT OF LEGAL INTEREST
STATE OF )(_ AR0 �
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COUNTY OF ADA )
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(name} — — w
(city) - -
being first duly swam !goon, oath, depose and say:
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(state) —
"'at l a;n the record Owner of the properly dmribed on the attacbed, and I gant niy
permission to:
(name} (address)
to submit the accompanying aM1icationfs) pertaining to that propeM,
- I Vrc-a to indc[r[mfy, defend and bold the City of Nkridian mid its cmploy"s harmless
from araim or liability resulting from any dkpale as to the titaaements contained
herein on- clr m to the cm mermip of tho propeny w1lich is t€te subj= of the appl imdon-
I he rchy grant permission to City of Meridiwi staff [O enter tiro subject property for tltc
purpose of site insp=tions related 10 proD sing said appiicat iojt s).
]?arod this I _-yof_Ta�
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UBSCIBI l] ANL D Sv4'{lRN to before me and yet rst above written.
D&MMI L. SAYRE
OOMu MiON #30074 (Notary Public, fop- Idzt )) —
NOTARY Pk.OU
STATE OF IDAHO R siding at- _ _ ResidingIn, Kura, ID
My COMMi lON EXPIRES OG�2&= oFI7fCtlS$tt3f1 Ex„�Ifes: D�
My Commission lExpires= .
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