HomeMy WebLinkAboutOccupancy Housing Code 1996-5-29
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HOUSING INSPECTION APPLICATION
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CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: W/atAl zq, tqq If/ . ' ' \ ' JOB NUMBER: -Elf07.2.L-
ADDRESS OF INSPEbTION: lL/tJ vJt~ Gft1.flA1Y1 i CI I
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OIlNER: &rr:l fJO~
OIlNER'S ADDRESS: JelLf /1/ r~.
APPLICANT: ~CJ.:wld \\\/~O\
APPLICANT'S ADDRESS: U sl lIvlllJq) '+>+-
PHONE NUMBER: 7'1Y-C-:7 S,g...-
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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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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FOR OFFICE USE ONLY
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DATE PAID:
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RECEIPT NUMBER:
Q175L(
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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