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PROPERTY OWNER ACKNOWLEDGEMENT
COMMUNITY DEVELOPMENT – PLANNING & ZONING – 205 S 6TH AVE, CALDWELL ID
I,_____________________________________________ , the recorded owner for real property addressed
as ___________________________________________________________________, Suite #_________,
City ________________________ State _________ Zip ____________, am aware of, in agreement with,
and give my permission to ___________________________________________________, to submit the
accompanying application(s) pertaining to this property.
1. I agree to indemnify, defend and hold the City of Caldwell and its employees harmless from any claim
or liability resulting from any dispute as to the statement(s) contained herein or as to the ownership of the
property which is the subject of the application.
2. I hereby grant permission to City of Caldwell staff to enter the subject property for the purpose of site
inspection(s) related to processing said application(s).
Dated this _______________ day of _______________________________________, 20______________
__________________________________________________
(Signature)
CERTIFICATE OF VERIFICATION
STATE OF IDAHO )
) ss.
)
I, ________________________________________________, a Notary Public, do hereby certify that on this
___________ day of ________________________, in the year, ___________, personally appeared before me
_________________________________, known or identified to me to be the person whose name is subscribed
to the foregoing instrument, who, being by me first duly sworn, declared that he/she/they signed the foregoing
document, and that the statements therein contained are true.
_______________________________________
NOTARY PUBLIC FOR IDAHO
Residing at ______________________________
My Commission Expires ___________________
TRIPLE DOT DEVELOPMENT LLC
THE CHARLES - TBD LAKE AVE & KARCHER RD
CALDWELL ID 83607
UPLAND ENGINEERS
4TH APRIL 25
Authentisign ID: 851079F7-7011-F011-90CE-00224822F75A