HomeMy WebLinkAboutOccupancy Housing Code 1982-6-17
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OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
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,- ---rOB ADDRE~ --!L~~ / ~~ . Nill1BER OF UNITS: J r ~_
'OWNER: {CLI!J:1 (} 0//'1 l/l n r .
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OWNERS ADDRESS:
APPLICANT:___t .. k~ !"," 8 (') I,'#) A
APPLICANTS ADDRESS: '7 R r~ . 1-1 t1 NV'l.'- r4-~1I C;~
FOR ACCESS TO PROPERTY -'PLEASE INCLUDE TELEPHONE NUMBER:
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A $2l:. 00 INSPECTIQN 'FEE IS-REQUIRED AT THE TINE
OF APPLICATION
THIS APPLICATION FOffi1 MUST BE SIGNED ~Y THE 0 &R' THE PROPERTY TO BE
INSPECTED. . .' :2: .' .
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FOR OFFICE USE ONLY .
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DATE OF INSPECTION:
DATE OF REPORT:
REMARKS:
DATE OF CERT. OF COMPLIANCE: .'
RECEIPT NUMBER:
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