HomeMy WebLinkAboutOccupancy Application 1995-8-17
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: _~/J1./95--- JOB NUMBER:<1S J35d.-
ADDRESS OF INSPECTION: Cj 9 ~ S".,J-t tl
("b,et "?~~f ~.
OIINER: _~~~Xl'J_o.n_cl L...,.._~T- PHONE NUMBER: '*"~'~Cl..5~1
OIlNER' S ADDRESS: .2.C'-.~S::'3_7ro..i-""-i-~ tZDo..d J C. ....~.:t_n~ cy '_4-_02._
APPLICANT: m.,'b ; !!\S_:b_O_c.. .
APPLICANT'S ADDRESS: "720 W; (SO'Y)-I-("'s--en~-. Cil.. Ct1.Y.o_~
FOR ACCESS TO PROPERTY - TELEPHONE NurIBER:.s $ '1_3 -~.9_"Z, I
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PROPOSED USE:
A $35,00 INSPECTION FEE IS REQUIRED AT TEE TIME OF APPLICATION
SIGNED BY THE OIlNER OF THE PROPERTY TO BE
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XSIGNATU!(E OF PROPBRTY O\IN~V
FOR OFFICE USE ONLY
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DATE Pi\ID:
<6...-- 17~ <1'5
RECEIPT NU~IBER:
OI(S'7L9
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COHPLIANCE:
COHHENTS:
P L eM e CJo(ll'f\-C I
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46$ ~ 3Lfb
'Sa. $I <;;,-pec.-H ~