HomeMy WebLinkAboutOccupancy Application 1992-4-1
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRinbr~ELD
BUILDING DIVISION
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DATE: -JL-/ - 72....
JOB NUMBER: '72""''S"<~
ADDRESS OF INSPECTION: 3"2 <.) ~....... -tt. /4" J1,.{.
OlmER: Fn5!nl- f A,.,c:LeJ-::S"tD1 PHONE NUMBER: 71../-7- S"69 b
OlmER'S ADDRESS: /:~,"~.' ll"??t.. '7 C::;;;-e...~..;U_',,_....J. OrY"':"'" L e.0'?64-J 97LJ-ff1
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APPLICANT: r=:-~-A' E An,JJE!krl'S>1
APPLICANT'S ADDRESS: Y''l'?6'7 GJ.....e/'}~c/ ~ /e~..I4~ "1'7'f-~
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 74t-?-s D 'Y C ~... 8'9/'-5 [14- Q
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PROPOSED USE: r-~""A;~-,L,_ ~ -t:.~", ..d:>_.r<: ~~..-/ ,","~~r-~
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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
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SIGNATURE OF PROPERTY OWNER
FOR OFFICE USE ONLY
DATE PAID:
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RECEIPT NUMBER:
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: