HomeMy WebLinkAboutOccupancy Correspondence 1993-11-18
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE:J !! ! .\(11'/~ JOB NUMBER: ~31.~~7
ADDRESS OF INSPECTION: -4-.q C; I:/-IJJl 10 IA/ /20 zx- lJ <; .f (I/JV C f;.f ZJ
OWER:. Y"V\] G- Ti PHONE NUMBER: 746~72.7L
OIlNER'S ADDRES;: 4-'tS-I100.r(OW 'At( (Ptt'}f.{:"Ic( OR. '174. 7/
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APPLICANT:~AtV ,fit> dV/jK-GC PI')' 7.
APPLICANT'S ADDRESS: J.r s / (( /l. fll/-IwolJd.
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FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: b (g'
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PROPOSED USE: V {")-t-O--\,lVCl,,:d-
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWER OF THE PROPERTY TO BE
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p"""'O) S@NATldh 00 PROPf1;RTY OIINER
FOR OFFICE USE ONLY
DATE PAID:
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RECEIPT NUMBER:
DATE OF REPORT:
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DATE OF INSPECTION:
DATE OF CERTiFICATE OF COMPLIANCE:
COMMENTS: