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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: