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HomeMy WebLinkAboutOccupancy Housing Code 1996-5-29 """ '" ..... . ., HOUSING INSPECTION APPLICATION ~-' '".;, CITY OF SPRINGFIELD BUILDING DIVISION =~=~=======]A=,======.========r=~=============7============================~======'(' DATE: W/atAl zq, tqq If/ . ' ' \ ' JOB NUMBER: -Elf07.2.L- ADDRESS OF INSPEbTION: lL/tJ vJt~ Gft1.flA1Y1 i CI I . , ;' 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: , ==========================~==================================================~== 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. - . (-J)- / ' -_::~===~~~~~~~:~~~~------------------------------------------- FOR OFFICE USE ONLY -------------------------------------------------------------------------------- DATE PAID: 5'-~I~q(p RECEIPT NUMBER: Q175L( DATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: .'