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HomeMy WebLinkAboutOccupancy Application 1992-1-22 . . OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIEW BUIWING DIVISION ================================================================================ DATE: /- J-d..-Cf? ' JOB NUMBER: ct 2J!if32- mlNER: =-- ~ ',-", r II l' /7;;;"'0 So~ It. I} .c,71'c<T (J;~) g~h~/J :::J ~/r)'-' w PHONE NUMBER: 3'"r;J..-I/;A / ADDRESS OF INSPECTION: mINER'S ADDRESS: w} ;:U-.>;;1o H"~/</,'" f!/~r) Ei-Cr..a...... ' APPLICANT: .4 5/;.<7 AA7:i~-r,..... S/cc./_ /"O"J. XJVC-, :;w,,~ l<i""'I';:''^'- c.,../"s ):{VI~io'I~""t.(5-r.....~ 11/1'1 APPLICANT'S ADDRESS: n;;;..o S,-')~7l../7 o/,.<~ FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 7?-6'- gl-f>3 ================================================================================ Wv.~-r 70 b",c-I< ;:) bv..;ld;")'\,v wr,'':' '" kdc.-- ...iu ,t1 ,"- v / sce:: 1--'- s7:r/ ~)'c....,t-J,... ~ ,; PI Ie. . ,/ I"::r PROPOSED USE: 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. !i:.~~~h' SIGNATUaevOF PROP~ OVNER FOR OFFICE USE ONLY DATE PAID: /-:-U/-C(L..-r RECEIPT NUMBER: ~q ---.,,;,/ DATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: .