HomeMy WebLinkAboutPermit Housing Code 1991-4-26
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BOUSINGINSPECl'ION APPLiCAnON .
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CITY OF SPRINGFIELD
'BUILDING DIVISION
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, ;JOB NUMBER:
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DATE:
ADDRESS OF INSPECTION:
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OYNER: ;tBv, M"eeis
PHONE NUMBER: 7.;2~ -J.(9 / S-
OYNER'S ADDRESS:
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APPLICANT: -:i) I 0 /1 J i "-,
APPLICANT'S ADDRESS: :171 I (.., ~+
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: /-IEL€/V rh'~/2Pc::- 7~t. -3,:<, 70
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OYNER OF THE PROPERTY TO BE
INSPECTED. -
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SIGNATURE OF PROPERTY OWNER
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FOR OFFICE USE ONLY.
DATE PAID:
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RECEIPT NUMBER:
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
ceMMENTS: