HomeMy WebLinkAboutOccupancy Correspondence 1995-12-18
.d. 3S""
DEVELOPMENT SERVICES DEPARTMENT
OCCUPANCY INSPECTION APPLICATION
225 flFT.H STREET
SPRINGFIELD, OR 97477
. (541) 726.3753
FAX (541) 726.3689
CITY OF SPRINGFIELD
BUILDING DIVISION
_======_==_============c=======================~=c===================~~16;~==
DATE: 12/18/95 JOB NUMBER: '1"~~~
ADDRESS OF INSPECTION: 512 Harloli Rd.
OIlNER: Glenn M. Kotara , """
/Oh{o .,.y, to. H//!-aLI'a....> Ve- '
OIINER'S ADDRESS: .-,+-"~,,. fl... Albi'lnv. OR
PHONE NUMBER:
q71?1
APPLICANT: Brian Cuff
Church of The Harvest
APPLICANT'S ADDRESS:
626 Archie St., Eugene, OR 97402
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 689-0389
Da~G=aaaaaaaaa====a======================================================0======
PROPOSED USE:
Church
"
A S35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPE~ ---;-,
~/J/Z I~
,SkGNATURE Of PROPERTY OWNER
,',.
--------------------------------------------------------------------------------
FOR OFFICE USE ONLY
--------------------------------------------------------------------------------
DATE PAID: I J_ )z.,<K I q s
RECEIPT NUMBER: 01 q q 10
DATE OF INSPECTION:
DATE OF CERTtFICATE OF COMPLIANCE:
.....-..'.. .
.DATE OF REPORT:
M"' ,>',"
'.'
COMMENTS:
. ....,
, ...........
",' .',
" . . .,'-.';-.. !:;l;;~ll~"
~
,',..,.. . .-
.' ", ~. .
..
.'
.,' '. ",
, .'
"