CC - Legal Interest Affidavit AFFIDAVIT OF LEGAL INTEREST
STATE OF IDAHO )
COUNTY OF ADA )
(!'7
(name) (address)
(city) (state)
being fast 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 IC, day of
(Signature)
SUBSCRIBED AND SWORN to before me the day and year first above written.
NANCY HALE LAROQUE �— ublic for
..,.� :;.,. tI
"'' NOTARY PUBLIC-STATE OFUTAH
coMMISSION 696540 Residing at: '_�K
Spa l _c_
COMM.EXP.',08-18-2021 My Commission Expires: g -mac,;
33 E.Broadway Avenue,Suite 102 • Meridian,Idaho 83642
Phone: (208)887-2211 • Facsimile: (208)887-1297 • Website:www.meridiancity.org