HomeMy WebLinkAbout899971STATE OF WYOMING
COUNTY OF TETON
AFFIDAVIT
RECEIVED
,' U- CLERK
COMES NOW, Arield Shane Wasem, whose address is P.O. Box 11865, Jackson,
Wyoming 83002, who beipg duly sworn on oath according to law, does hereby make the
following statements of facts and affirms:
That he is an owner of the land described under the Certificate of Surveyor on the
plat titled, "FiNAL PI,AT BLAZE ESTATES WITHIN THE N½NW'A SECTION
23 T35N R119W LiNC£ LN COUNTY, WYOMING", dated 11 November 2003, as
revised.
2. That he has reviewed said plat.
3. That he has read and tmcerstands the provisions of the Certificate of Owner thereon
and th e implications th'srcof.
4. That this affidavit is si~ed in the stead of and has the same effect as if the original
mylar of said plat had been sigmed.
DATED this 3Oda3: of
Arield Shane Wasem
2004.
The foregoing instrument was acknowledged before me by Arield Shane Wasem this
~0 dayof ~t4)Yi [~ ,2004.
Notary Public
Commission Expires: a~ ' t ? - 0 5~