HomeMy WebLinkAboutOccupancy Correspondence 1991-11-12
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: /0L-/'i'/
ADDRESS OF INSPECTION: ))8 1"'14-/~ ~.,..
JOB NUMBER: ~./"3J72..
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OIlNER:
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PHONE NUMBER:
OIlNER'S ADDRESS: /3 B 1'1 A-,.:. ~ 1'" .
APPLICANT: '\-1, Ut"'c.-c""eL.. ~..J. ~<>". -( LA--Jt!' -G,. ]:AJc;,
APPLICANT'S ADDRESS: 70 >' .s, ~f'''''e~... S 1- 'A<6Cffil. Ol/t.- <; ? q ,,>../
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FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: ,'/ 5"-1} .~-1' :) ,... ....~
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PROPOSED USE:/'f""", r",,,,'-(i lr...o.....'/~
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OIlNER OF THE PROPERTY TO BE
IN~_~~~~~D~ AA~-
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?1GNATURE orl'ROPERTY OIlNER W~ f1s-
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FOR OFFICE USE ONLY
DATE PAID: /;.../~., / RECEIPT NUMBER: 00 '3/9'~
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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