HomeMy WebLinkAboutOccupancy Correspondence 1982-1-7
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OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
DATE:
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NUMBER OF UNITS:
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JOB ADDRESS: 1/70 C057VQ7 N/1C/
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OWNER: 3 L./9C~.:S ~ /? e / 7 R'D J
OWNERS ADDRESS: . //70 ~v S'/(j/?? Wfl-y
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APPLICANT:
APPLICANTS ADDRESS:
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FOR ACCESS TO PROPERTY -' PLEASE INCLUDE TELEPHONE NUMBER: 7 ~ ~ ~ 7 ~ S S
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A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER 'OF THE PROPERTY TO BE
INSPECTED.
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SIGNATURE OF PROPERTY OWNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
DATE OF REPORT:
REMARKS:
DATE OF CERT. OF COMPLIANCE:
RECEIPT NUMBER:
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