HomeMy WebLinkAboutOccupancy Housing Code 1981-12-2
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OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
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DATE: 1)e.c,;t, /81,
JOB ADDRES S: 2. (f!3(p f,...r4VR..A 9r., S p./-lcJ .
OWNER: VIRa.:./.Ji'\- l(1..~S'-ekJ .
OWNERS ADDRESS: o~ Cl.-bou-e-
. APPLICANT: ~DV\..Qs.~ H. Sbi pe...k
APPLICANTS ADDRESS: "38 s:cr E. AMa. Jon
NUMBER OF UNITS:. 1..
*
FOR ACCESS TO PROPERTY -' PLEASE INCLUDE TELEPHONE NUMBER: 484 - ~'6 II <.port.
7;Lb-/170 h.OM.e
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A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER'OF THE PROPERTY TO BE
INSPECTED.
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SIGNA7URE OF PROPERTY OWNER
------------------------~Q~-Q~~!g;-Q~;-Q~~y---------------------------------
DATE OF INSPECTION:\~-~E\\ DATE OF CERT. OF COMPLIANCE:
DATE OF REPORT: RECEIPT NUMBER:-,-~ llCO~)c\QC' AlI6.L
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REMARKS:
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