Affidavit of Legal InterestM
AFFIDAVIT 0'FLE(___1'1AL INTEREST
STATE OF ID:\I10 )
COUNTY OF ADA )
1 P45Z6/e-- oo S S41) rc Zoo
(address)
�ov� T i F✓L
(city)
being first duly sworn upon, oath, depose and say:
07<
(state)
I. Teat I ain the record oNvrner of the property described ar7 the attached, and I grant my
Peril ission to:
Larson Architects
(name)
210 Murray St., Boise ID 83714
(address)
to submit the accompanying application(s) pertaining to that property.
2. I agree to indemnify, defend arid hold the City of Meridian arid its employees han-n1ess
from any claim or liability resulting from any dispute as to the statements contained
herein or as to the ownership of the property w1l1ch is the subject of the application.
3. 1 hereby grant
pern issioii
to City
of Meridian
staff
to enter the subject property for the
purpose of site
inspections
related
to processing
said
application(s).
Dated this 5 T-A. day of MA rL-wc-oH , 20 2 1
(Signature)
SUBSCRIBED AND SWOR1\1 to before me the day and year first above written.
m ELISSA FUji0KA-BURNZ
Notary Public, State of Idaho
Commission No. 201$-04D1
My Commission Exo;rG� 03/02/2024
oPublic for Idaho}
Residing at:
My Commission Expires;
z D
(Rev 05�29/20)