HomeMy WebLinkAboutOccupancy Housing Code 1996-11-27
.
.
HOUSING INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
================================================================================
DATE: //-27'~
ADDRESS OF INSPECTION:
'::l\,' ('lhrtr\"Yv"",r~<...
JOB NUMBER: ~/~~~
*,,\",u,9A\
~
C'c.-\\ QS,-\ 'd.~'-\O
PHONE NUMBER: ~ (,\I-loY {,3
01JNER: \', """ ~ C\. \ r. ~ ,(' ~"=-C _to<--\-\-
01JNER'S ADDRESS: ~ I, \ ----u 't.o..;)(Vv-, 0 rt.\. '" ~r"l..\ .. 0 r~ '
G
APPLICANT:
("")l ,-"\r\. f- r-
APPLICANT'S ADDRESS:
FOR ACCESS TO PROPERTY .. TELEPHONE NUMBER: "1'--\ {- leY lo '>.,. ~~ y .. d-. ;, Y T\ '\ ':l..l~" \ ~ \~
=============================================================================~c=
A $35.00 INSPECTION FEE IS REQUIRED AT.THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE 01JNER OF THE PROPERTY TO BE
INSPECTED.
D.r,,~q ~~!r~~-ri-.
SIGNATURE OF ~~')!RTY--01JNER
--------------------------------------------------------------------------------
FOR OFFICE USE ONLY
--------------------------------------------------------------------------------
DATE PAID: //-2'7'5JC
RECEIPT NUMBER: ..::?3~e::C;
4?
. ,
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: