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APPLICATION FOR HOUSE NUMBER <br />Date — _BL2 1964 — <br />Name _City Radiator Sus <br />Street Ruin_ <br />Number Assigned <br />Phone 252-7�— <br />Present Address -- <br />Legal Description of Property <br />Lot�6�ok 769 Plat of verett <br />PR __�— <br />CITY EVER Issued by -- .., <br />ENGINEERING <br />DEPERING DEPARTMENT <br />FORM NO. 435001 F. __— <br />