HomeMy WebLinkAboutOccupancy Correspondence 1979-6-4
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"CUPANCY INSPECTION APPLICATIt'
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EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING lJEPARH1ENT
DATE: ;:}-UA.-Ir r -j97~
JOB ADDRESS:g t, '? I-AU/l.;J. 5"..... NUMBER OF UNITS: J
OWNER: LY&JDJ/Z WfL,bi:r. ADDRESS: t:,(,.I.2-.-i.....lLJlJlJ.... LAiJlr-~61.p~.
APPLICANT:-1L1. tJe:j:t,~.i:J./t-Pr ADDRESS: :L?J'...9.. J~L.-L.IJ LcJA.'Y-)Q~'D.
<if.t 7'4 A-~RfI,y~6 7/AE
FOR ACCESS TO PROPERTY - TELEPHONE: 7y? -h '//{) IIG WI'-'- )I.dlSET' ~.
.(.LJNII;::P';//>/J o;q EX/oS77&:;' IIc",~ h> O;r;:v~c: r~
A l?E7?1/I- I v)l;t8=C ~Rb
A $20.00 INSPECTION FEE IS REQUIRED AT THE THIE OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROEPTY TO BE INSPECTED
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S~ATUREOF PRorfu'rY O~ER
FOR OFFICE USE ONLY
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Date of Inspection:
Date of Ccrt. of Compliance:
Date of Report:
Receipt Number:
REMARKS: