HomeMy WebLinkAboutOccupancy Application 1991-7-12
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OCCUPANCY INSI'ECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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ADDRES$ OF INSPECTION: ~.s; N.C'., -r>:: 's..~. 5;u."T'F. ..c...'
OIINER: \...\\LLI"-"" :C-. \<......,,~'--\l=~
OIINER'S ADDRESS: .3,2'7 S' ~"j\,,'n.1."" 'W1\7
PHONE NUMBER: '\l!.4-"1~
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APPLICANT: fJt7AJA IJJ c:r )./L / PFE'L
APPLICANT'S ADDRESS: j/.? '9 Cr.L.5~_:7"nJo<.1..Jj)ltl ~/V/(jGF IEL//, O/<
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 717.2::zt (J
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PROPOSED USE:
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED. ----
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SIGNAT~OF~RTY OWNER
FOR OFFICE USE ONLY
DATE PAID:
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RECEIPT NUMBER:
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: