HomeMy WebLinkAboutOccupancy Correspondence 1992-5-7
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: ,') / -; / ~ L-
ADDRESS OF INSPECTION: /j.f I'U~--r:.~ (r-
JOB NUMBER: q Z~ J
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OIlNER: tvlJ/r f) r'lrt--V,)
PHONE NUMBER: 7 q {'-A hf, Cj
OIlNER'S ADDRESS:
APPLICANT:/Ptf/l//Y 4Ll&1//4
~ I J to - [, 7 q.l Or 7 <{ 7:3 702-
APPLICANT'S ADDRESS: ? J /.. M"",,,_-,..,,, I'r-- r ,P',.c-"""" t:J r?
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FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 7C/h' - at: & </
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PROPOSED USE: C:::r Z:-u/J /71fi:H/ct--1"71f,~7,'O" r
(}(e~us...fl JIv SJ;:> ~--L .K'I '?;~O({::,A1I'6- - i.1f/:.-ft-92
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY JH~ER OF THE,PROPERTY TO BE
c&~4& 'D(Y,p~~f' l~ ~ I~,
I'4$'!GNATURE OF PROP1;:RTY OWNER ~
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FOR OFFICE USE ONLY
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DATE PAID: h.J2 --?) 2---- RECEIPT NUMBER: iff;::) '1 L-i
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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