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I DATE k81"c4143 19931R4 CtIF PAGE: 1005
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TIME 08:37:11
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CITY OF DELRAY BEACH, FLORIDA
REQUEST FOR
NEW ADDRESS OR CHANGE OF ADDRESS
--------=-------------------------------------------------__-rr---------------
NAME g-�I, 14 ,FIoc: CC., Par-4 re '� ADDRESS ���' .T o duS rr,'c'-1
PHONE NO. `73b '33 (4 n 4 Bn pe ac.`I 3 ac/2Z
LOCATION S E Co c ner� i ��i sew 10 C S 15+5�` `� S S�� A,LEGAL DESCRIPTION
SUB BLOCK &O LOT , Z ► 3
DATE SIGNATURE -` /
--------------------------------------------------------------------------
THE FOLLOWING ADDRESS HAS BEEN ASSIGNED TO THE ABOVE:
/ O c E Soh ve,
APPROVED BY O
C01*1UNITY I&VtOVatENT DEPT. DATE
---------------------------------------------------------------------------
COPIES TO:
POLICE DEPT ADMIN PUBLIC LIBRARY
UTILITY BILLING POSTMASTER
PUBLIC UTILITIES 911 MGMT
IRE DEPT SO BELL
IZCITY CLERK WAS"rE NIANAGEMEN'r
ENGINEERING
CODE E NFORCE MaU
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lorence R. M. Smith died January 22, 1953 and her will wp
probated in the County Probate Court leaving the property to hr.
son, John Morrison Smith
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CITE' OF BELR14V BEACH
BUILDING DEPARTMENT
(305) 278-5770
PROPERTY CHANGE
A F F I D A V I T
Before me, the undersigned authority, personally appeared the OWNER of
the described property: ROBERT W. HAYES
(Property Owner's Name)
who, being by me the first duly sworn, on oath deposes and says:
1. That he is the fee simple OWNER of the following described property:
197 S.E. 5th AVENUE TOWN OF DELRAY
Number Street Subdivision
LOT 10 BLOCK 110 Type Of Structure 5-UNIT RESIDENTION
2. That he intends to: DEMOLISH ; or
(Describe Change)
is MOVING Building(s) , leaving �_ building(s) on this property; or will MOVE
(Number)
- - - - building(s) ONTO this property.
(Number)
3. That he has appointed '� LJ� 'L.1 - � ''y I"C- to act as AGENT
(Name)
I his behalf to accomplish the above.
SIGN: v� �t
OWNER F RE D
BU NG OF IAL: �f,Q SWORN TO & SUBSCRIBEDD BEFORE ME THIS
,,Y� 2,: ��� �-c & DAY OF �/4 ri�rrc�' c� 19
gnatur Date
A�
COPIES: P.B. County
City Clerk Notary Public,, State of Florida At Large.
Utility Billing ��.��
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REQUEST FOR NEW ADDRESS OR
,/x TH/ Utz Z . E�/ECy��=/' r �l� moo/ S- �. 6 �/�
(NAME) (ADDRESS)
(PHONE N0, )
LOCATION: 6cvf e
LEGAL DESCRIPTION: 17,
(SUB—DIVISION) (BLOCK NUMBER)
,
(LOT NUMBER)
CATE
-----------------------------------------------------------------------------
THE FOLLOWING ADDRESS HAS BEEN ASSIGNED TO THE ABOVE:
(NUMBER) (STREET NAME)
APPROVED BY :
Copies To:
Utility Billing
Arlene Eubank, Public Utilities DELRAY BEACH FIRE DEPARTMENT
Donna Quinlan, Building Dept. (2)
City Clerk DATE
Steve Ford, Engineering
Police Dept. Administrative Div.
Police Dept. Staff Services
See Lot 18 for Pers . Rep. Deed dated 6/20/77
Date July 1, 1974
TO: OFFICE OF CITY TAX ASSESSOR
Your attention is called to a building change at
174 SE 6th Ave. Edward Galli
(No. ) (Street) (Owner
SID 110
Block
Lot 18
REASON:
1. Fire doing damage in amount of approximately
2. Building or Buildings moved from property, leaving
one buildings on property.
(number)
3. (number) Buildings moved onto property.
Remarks: One building demolished and all debri cleared
from area.
Signed
Department Chief Building Official