HomeMy WebLinkAboutOccupancy Correspondence 1994-1-26
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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OYNER'S ADDRESS:
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JOB NUMBER: C\4DOet)
DATE:
ADDRESS OF INSPECTION:
OYNER:
PHONE NUMBER: q)5 ..(,/ if
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APPLICANT: t\JG"W 0F,(;;i1I.lNINhS (' L (.
APPLICANT'S ADDRESS: 170, ( F $.,,- SPltlAi J:'lfEl,O otR- <7N;l'
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: (50 3Y q77 -"-.tL-r- -< I
AI-So CllL./... /Sol) CAREt( @ 7"f.,-65Sg 01( M~'f.'17(2 €' lM'-'f C,"TS""'- 741o.J(-I-Z-O
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PROPOSED USE: C \1\JRCi;-\ ~ALL '
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OYNER OF THE PROPERTY TO BE
IN SPEC D.
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S~ 'NATURE OF PROPERTY OYNER
FOR OFFICE USE ONLY
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DATE PAID:
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RECEIPT NUMBER:
\,1401/
DATE OF INSPECTION:
DATE OF CERTiFICATE OF COMPLIANCE:
DATE OF REPORT:
COMMENTS:
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