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APPLICATION FQR HOUSE NUMBER <br />Date 11 Aor. 67 <br />Name <br />Present Address <br />Legal Description af <br />Robert Bether <br />New Residence <br />Sheet (=rant Dr� ve <br />Number Assigned <br />East 150' Lot 6 Block 3 <br />Plat of Beverlv Park <br />Phone <br />CITY OF EVERCTT Ron EVer�$t <br />ENGINEERING DEPARTMENT Issued by— <br />,,,C��.., <br />FORM NO. 435-001 Q�-�^�^ <br />