HomeMy WebLinkAboutOwnerAck_Mino'Akasub_V1,. U nn , e 14,. Wf h",*s, {( , the recorded owner tbr real property addressed* 4bof 5. F/ori,la- Ave , ,Suite#-.
ciry Cr, lJ utel I zip f 3b O {,am aware of, in agreement with,
PROPERTY OWNER ACKNOWLEDGEMENT
COMMLINITY DEVELOPMENT _ PLANNING & ZONING 205 S 6THA\T,, CALDWELL ID
State
and give my permission to to submit the
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. Ihercby grant permission to City of Caldwell staffto enter the subject property for the purpose of site
inspection(s) related to processing said application(s).
Datedthis t5+L day of 20 2{
CERTTTICATE OF VERIFICATION
sTArE OF rDAHO )
) ss.
)
I,aNotary Public, do hereby certiff that on this
Aanne L known or identified to me to be the person whose name is subscribed
to the foregoing instrument, who, being by me frst duly swom, declared that he/she/they signed the foregoing
document, and that the statements therein contained me true.
, in the y"ur,lAL{ , personally appeared before me
Residing " (ae,vw konla
My commission Expires fLl ZZI tA f-8
KACEE ROGERS
Notary Pubtic - State of ldaho
Commission l{umber 20225805
i y Commi$sion Expires Dec 27 , 20VB
accompanying application(s)to this property.
day of