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APPLICATION FOR HOUSE NUMBER <br />Datc <br />Namc�--- <br />Present Address <br />Le9al Description of Properry <br />Street ---- ----� <br />Numher Assig�e'i -- - —� -�- <br />.. Phone —. -- <br />r <br />1 : <br />CITY OF EV6RETT Issued bY --- <br />ENGINEERING DEPARTMENT ..�:':�' <br />PORM NO. 435-D01 �•.:��"...- <br />