HomeMy WebLinkAboutOccupancy Housing Code 1994-4-4
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HOUSING INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: if- y~ 9'V
JOB NUMBER: ~,/'o y)" c>
ADDRESS OF INSPECTION:
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OWNER: OAf;: )r6r//1'V-
OWNER'S ADDRESS: ?2~ /" 2( pC1( ,
PHONE NUMBER: ? r?-6 5' S' / ~
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APPLICANT: C)"t/Me'r tUft-Ltc ~//1r.5
APPLICANT'S ADDRESS: fSe~lk - ...4/1: 1i-c ~~k ~I(.h
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS PLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
IN EC D.
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FOR OFFICE USE ONLY
DATE PAID:
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RECEIPT NUMBER: / "2/u~ ~7-> ~
DATE OF REPORT:
DATE OF INSPECTION:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: