HomeMy WebLinkAboutSpecial Inspection Fire Damage Report 1992-8-8
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COURTESY INSPECTION APPLICATION
(RENTER REQUEST)
CITY OF SPRINGFIELD
BUILDING DIVISION
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ADDRESS OF INSPECTION: WiD~,'" (J" -:iJ L../
OWNER: fA - L.Nf'2\+ ~C\('.J...-S-\. Pf ();)
OWNER'S ADDRESS: l)(=' li\SL:\-CL_
PHONE NUMBER: C]2,i:'- l..f1<:o
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RENTER: l\>n.'Jn:rCl furN'\ PHONE NUMBER: r;L/4-"2(<,7(hO~)
SIGNATURE OF OCCUPANT (RMUJ;K): L} R~-(i)/,&. ~
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: f)2.G -.:sICa' (,.y,}<fL/-cl"<"',
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TYPE OF DIlELLING: SINGLE FAMILY 0 DUPLEX 0 MULTIPLE tiQ1
BRIEF DESCRIPTION OF MAJOR PROBLEMS: r o?\', nc; ;" k:::n.~h room
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FOR OFFICE USE ONLY
DATE OF INSPECTION:
COURTESY LETTER SENT:
NOTICE AND ORDER ISSUED TO OIlNER:
DATE FOR COMPLIANCE:
COMPLIANCE OBTAINED - DATE: