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- FORM G <br /> • CITY OF EVLRr.TT <br /> • Sno:iomish County, Vr�H5I11Rb�011 <br /> UNSAFE BUILDINGS REEERLPvCE NO. ^;_; _�,., <br /> STf.TL OF IVPSHINGTO�� ) <br /> SS <br /> CGUATTY OF SIv'OHO�SISII ) AFF'DAVIT OF SI�RVIGT, <br /> Tlic �tadersigtihc?, Ucin� first dnly- sv:orn on oatn, dcposc, anu sa}'�: <br /> 1, That iu and derir.g all times herein mentioned, affian2 was and nu�v <br /> is ovci tiie zgc oi t�ventt^one years, a citizen of t�ic U�iited S!ates, a resident . . , <br /> of thc Siate o£\tiasLington and cornpetent to be a �ritness herein, <br /> 2. That affiant served a :ull, true, correct duplicate oririnal copy <br /> of thc follo«�ing described document: (Cross out inap};licable no:ices) <br /> (a) NOTICE OF UiiS�'1FE BUILDID'G(S) <br /> {':vT_nT�^�rr�x-.a�--�T_.�z- oo��'�.�,_.�mT_�ii 9�?�.LtiT�.� �;G - <br /> n�rrrrnr r>rnr-•,c-• m:Y-S�T�'-{-rF-�.+i+rF:F-i� ^O?� <br /> �4?d 6i�B��_^, _ <br /> . 1�---AA�-9T' r-r�r—� r'-�=`IbI�-BRD�:_: <br /> A eopy of ��•Lich is attached l:ereto and b�- this rcfercr.ce <br /> made a part herein as t�ioc��'i set for[h :n iull hc:cir. <br /> upon each oi the following Ias . I:no�vn o"�ncr(s) oi <br /> record of tne buildin�(s), or structure(s), or po:tiou(s) <br /> thereof described in said documcnt by the mani.er sec <br /> forth hc±-cinaftcr: <br /> rn) YEP�SO\�L SEI:\'iGF� <br /> }3y� dclivcrin� and lcaving sa:d copy with sairi o�encr(s} <br /> at the place and time set forth hercinUclo�v: <br /> O�vner Name Address S^rved Date Se�•��ed <br />