HomeMy WebLinkAboutOccupancy Correspondence 1991-7-26
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE:
7.26..91.
JOB NUMBER:
q I 0 ggo
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ADDRESS OF INSPECTION: .2t}S. MAIN: SDrine:field. OR
OlINER: r....,nnTJi 11 T nnl1s t:,.~ I'"'' n. of T .I'lne Count'7
PHONE NUMBER: 345-1801
OVNER'S ADDRESS:
R"5 Sf!m>ca Road, E1.~gene. .OR 9UiQ2
APPLICANT: n",ni 011 M.Qlalyn
APPLICANT'S ADDRESS:
?nO~ F.. 17t:n 4~',
....lgene, OR 9740:1
~L.. ~_ "L.. 71
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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PROPOSED USE: ,..,.,,,,. (L..) _ nno. ,",otl"'nnm "'r",.rmpt;"r,,:
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OVNER OF THE PROPERTY TO BE
INSPECT~D. ..., / -
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SIGNATURE OF PROPERTY OVNER
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FOR OFFICE USE ON,LY
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DATE PAID:
1- :L(O-'11
RECEIPT NUMBER:
'2-02\'7
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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