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HomeMy WebLinkAboutOccupancy Housing Code 1994-6-3 . \~D~~'.)\ 00ldD HOUSING INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- DATE: 6' /~/q4 ADDRESS OF INSPECTION: JOB NUMBER: 9101?2~''Z- //219 h:"(/(~lJ Dr. ffCf3 OWNER: Be~jl S~'4v4-71~""~r4v PHONE NUMBER: 7d-b2b::S OWNER'S ADDRESS: //:::2..t:J h/r{/r~/IJ Pro .::;t:'43 ;;r~'bjJJl tJv APPLICANT: J?e--Uoi/-il g;,//~ /' APPLICANT'S ADDRESS: ff~ h,:V6'r~r" Dr_ ~/f3 c;oj-r~bff. a /',:9' - FOR ACCES:; TO PROPERTY - TELEPHONE NUMBER: 72.h - b~ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- 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. ~0/Z ~~ d~ ~F'tOPERTY ~ -------------------------------------------------------------------------------- FOR OFFICE USE ONLY -------------------------------------------------------------------------------- DATE PAID: /:~ /..z. /5'.,L /( ::..( " DATE OF INSPECTION: RECEIPT NUMBER: /.2../5'/ DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: