HomeMy WebLinkAboutOccupancy Housing Code 1993-8-9
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HOUSING INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: J}/,(LJ 9 , /9~~
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ADDRESS OF INSPECTION: 70 ~
JOB NUMBER:
q~1177
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OI./NER: r: ~L.t'>. li -?~ It-
OIlNER'S ADDRESS: .LS!2...1J 9 ~--o.............
PHONE NUMBER: 3~2-- 2.-8'PO ~
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APPLICANT:
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APPLICANT'S ADDRESS:
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FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
7;:1, /,- '2-~ 0
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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
INSPECTED.
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SIGNATU -O~ rROPE~~~ER
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FOR OFFICE USE ONLY
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DATE PAID:
q .-1 .Lj 7-..,
RECEIPT NUMBER:
qct61
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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