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APPLICATION FOR HOUSE NUMBER <br />9/16/1964 <br />Date <br />,1ack Heath <br />Name <br />New Residence <br />Present Address <br />Legal Description of Property <br />D1v. S <br />CITY OF EVERETT <br />ENGINEERING DEPARTMENT <br />FORM NO. 435-001 Q ��— <br />Street —�Lermore -- <br />421 <br />Number Axsigned — <br />Fhone <br />Lot 11, 12 & N 10' of Lot 13, Block 105, Plut of <br />Issued by Rowland Robb <br />.,�q.,. <br />