achdSTATE OF IDAHO )
COUNTY OF ADA )
AF�'IDa vIT Or' LEGAL INTEREST
(name)
tci�)
being fast duly sworn upon, oath, depose and say:
(address)
: "0
1. That I am the record owner of the property described on the attached, and I grant my
permission to:
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(name) (address)
//0 S/ LAA MO�Y �.a�e • Esc-,. .d
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 applications}.
�` 20 ZC�
1�ated'this .�� day of JIZJ�.J.t ,
LAURA LANDRET'H
Notary AubNc -State of Idaho
Commission Number 20201911
My Commission Expires May 26, 2026
e(1`Iotary public for �daho�
Residing at° G� �' f L
My Commission Expires: 2-�io
33 E. Broadway Avenue Suitc 142 •Meridian, Idaho 83642
Phone: (208) 8$7 2211 • Facsimiles (20$) 88?-129? • Website: www.meridiancity.org
.,A�,��'IUA.'V��' of LEGA.� l���tES'I'
sTA�� oar m�xo }
COUNTY OP' ADA, )
z, �p�G ��r����
(name
r(citY)
being fu�st duly sworn upon, oath, depose and say:
�.5� ��'' �iU
{address) ..
�� � ���
(state)
1. That I am the record owner of the property described on the attached, and I grant my
ermission to:
/ Q (/name) %��f��. (address} Q � -y� (�
�l � C7 l � r r �'4.z,�7� V�LVO�.J 1�� r d...�n��.1 ���� �-+�-' /�� /
to submit the accompanying appl�cation(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 resuating 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'ttiis _�! - i � day of c.,� li � � , 24���_._._
1• _ s��ic��7���>fa7
Phone:
(Signature}
�e me the day and year fast above written.
Qr��
G''
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4
�`� ���~
Residing at:
l!
(Notary Public for Idaho)
� �C�F tO�' �'��
�`���I111111 � � NOTARY PUBLIC ��s.
State of Idaho
My Commission Expires 14J24J2r724
33 E. Broadway Avenue, Sulte l02 • Mcrldie<t, idalio 83642
(248} 887-22! 1 Facaimilc: (2i�$) 88?-i2�7 Wabsite: www.mcridianciry.org