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CITY OF DELRAY BEACH# FLORIDA
REQUEST FOR
NEW ADDRESS OR CHANGE OF ADDRESS
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NAME ct d � ,- laj
,re 'o rn�n ADDRESS �l7 3l �� ---`k ------
PHONE N0. lIC 6- -),Do C' & L �_c �� ✓L 33yys- ''
`.,OCAT I ON
LEGAL DESCRIPTION
3UD- �p� , r,on\r PCt( � BLOCK LOT
DATE Ja`��o i I SIGNATURE
--------------------------------------0------------------------------------
THE FOLLOWING ADDRESS HAS BEEN ASSIGNED TO THE ABOVE:
(0 Sw 6
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APPROVED BY '/'�`� fa /�30 lql
C UNITY IMPR EMENT DEPT. DATE
---------------------------------------------------------------------------
COPIES TO:
POLICE DEPT ADMIN PUBLIC LIBRARY
UTILITY BILLING POSTMASTER
ENVIRONMENTAL SERVICES 911 NGMT
FIRE DEPT SO BELL
CITY CLERK WASTE MANAGEMENT
PLANNING Community Development
CODE ENFOFC-EMENr
REQUEST FOR l a q3 V� 820 N 03 COb G'
NEW ADDRESS OR CHANGE OF ADDRESS
---------------------------------------------------------------------/-----
AME �Ve op-,1-1 ,,+- ADDRESS CIO l G /
t l,7-1 �LCt�S d
HONE NO. � 02_ GO'
OCATION V pc T
LEGAL DESCRIPTION
- n� to ���� BLOCK LOT
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)ATE �3 I -"01
SIGNATURE
---------------------------------------------------------------------------
CHE FOLLOWING ADDRESS HAS BEEN ASSIGNED TO THE ABOVE:
(19
APPROVED BY � Cti-�a�t �� -
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COMMUNITY IMPROVEMENT DEPT. DATE
---------------------------------------------------------------------------
COPIES TO: WQS �ccrylal( un� pr-
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POLICE DEPT ADMIN PUBLIC LIBRARY S�
)2 y3 Vb
UTILITY BILLING POSTMASTER �n4s
ENVIRONMENTAL SERVICES 911 NGMT
FIRE DEPT SO BELL
�-
CITY CLERK HASTE MANAGEMENT
PLANNING Community Development
CODE ENFOPtT
�Y
RECEIVED
FEB 2 7 M CITY OF DELRAY BEACH, FLORIDA
DELRAY BEACH REQUEST FOR
FIRE DEPT
NEW ADDRESS OR CHANGE OF ADDRESS
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NAME n _
��i4�ri.. s t Y f"l1 ADDRESS s f ll ilia
PHONE NO. cI 7e- 9(s Se b �&lY'yI� �t r LQ +
LOCATION A e�'' -�- w ►�.
o�-� N F c a,-Y.
ovr-e v
LEGAL DESCRIPTION
SUB BLOCK LOT
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DATE a 3 pD SIGNATURE i
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--------------------------------------------------------------------------
THE FOLLOWING ADDRESS HAS BEEN ASSIGNED TO THE ABOVE:
i
APPROVED BY LT
DELRAY-BE-CH- -FIREDEPARTMENT DATE
------------
-------------------------------------------
COPIES TO:
POLICE DEPT ADMIN PUBLIC LIBRARY r
UTILITY BILLING POSTMASTER
PUBLIC UTILITIES 911 MGMT
BUILDING (2) SO BELL
L,-'CITY CLERK
ENGINEERING
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See Lot 15 for Agree/Deed dated 12/27/72
See Block 1, Lot 1, for Agree/DEED dated 12/22/70
" 1, Lot 1, for Agreement for deed dated 12/22/70
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