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CITY OF DELRAY BEACH, FLORIDA
REQUEST FOR
NEW ADDRESS OR CHANGE OF ADDRESS
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NAME / _t r L + &r b 0 rCX. JGt rJ S ADDRESS /t/,-v ( yf
PHONE NO. QT-1 & 3 7 3 rC `�
LOCATION !n ct l ��-
LEGAL DESCRIPTION
SUB (�1.4 BLOCK
LOT
DATE
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THE FOLLOWING ADDRESS HAS BEEN ASSIGNED TO THE ABOVE:
R/2- 0
APPROVED BY v 'L
C —MMU ITY WRGVFAENT DEPT. DATE
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COPIES TO:
POLICE i,tE,PT ADMIN PUBLIC LIBRARY
UTILITY BILLING POSTMASTER
ENVIRONMENTAL SERVICES 911 NGMT
FIRE DEPT SO BELL
CITY CLERK WASTE MANAGEMENT
PLANNING Community Development
CODE ENFOFC-F2Elr
Lot 11, Bk. 2 for W/D dated 4/10/72
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