Affidavit of Legal Interest - signed V1A—IFF'WAVI' OF LEGAL RMUST
STATE OF EDAK®COUNTY OF ADA
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(name) (address)
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(city) (state)
being first duly sworn opm oath, depose and say;
l That I am the record owner of the property described on the attached, and I grant my
pertnissi®nt®; 2590 N. EAGLE RD. MERIDIAN, ID. 83646
JEFF LIKES - ALC ARCHITECTURE 1119 E. STATE. ST. STE. 120. EAGLE, ID. 83616
to submit the accompanying application(s) paining to that property.
21 I agree to indemnify, d@fend and hold the City of Meridian and its employees harmless
from any claim or liability resulting frmn any dispute as to the sta moats contain@d
herein or as to the ownership of the property which is the srtbjoat ofthe application,
31 I hereby grant permission to City of Meridian staff to enter the subject property for the
purpose of site htspeetioos related to processing said application(s),
mated this 4day of 0 Gm _ , 20;kj—
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SUBSCRIBED AND SWORN to before the the day and year first above written
�► (Notary l�bl )
ding at;_
y ca�lsslan Expi ,
D R. Bro4dway Alms, SWO 103 • I+ oddim IdPAe 83642
Dime, (208)1874211 9 foosifftilo; (208) 687=1297 0 wsbsite: www,meridiwitymp
CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202
YSee Attached Document (Notary to cross out lines 1-6 below)
❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary)
Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any)
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document
to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
Countyof .540 7),;�5o
01
DANIEL D. SPONSELLER
U ' ` COMM. # 2360805
.. NOTARY PUBLIC . CALIFORNIA +�
- SAN DIEGO COUNTY n
• „ COMM. EXPIRES JUNE 11, 2025-
Place Notary Seal and/or Stamp Above
Subscribed and''''orn to (or affirmed) before me
on this day of G� 20�,
by Date Month Year
(1) %
(and (2)
Name(s) of Signer(s)
proved to me on the basis of satisfactory ence to
be the person(s) who ap�d be me.
Signature
Notary Public
Vr 1IVIYF►L
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Documen`tC _ c /
Title or Type of Document: A/ !!AVI � OT
Document Date: ` �K Z I Number of Pages:
Signer(s) Other Than Named Above:
= 2019 National Notary Association
M1304-08 (09/19)