HomeMy WebLinkAboutOccupancy Correspondence 1982-11-3
.
-I...
'.
OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
OWNER:
U. S, DEPT, OF HIJD
: OWNERS ADDRESS:
520 S, W, Sixth AVerrue
Pot!tland';>rOr. 97204
APPLICANT:
STATE Rea1tv Lane County Area Manager &oker for HIJD
APPLICANTS ADDRESS:
143 Madison
lligene. Or. 97402
FOR ACCESS TO PROPERTY -' PLEASE INCLUDE TELEPHONE NUMBER: 686-1971
IUD Lock Box. on Property
A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION '
THIS APPLICATION FOID1 ~ruST BE SIGNED BY THE 'OWNER OF THE PROPERTY TO BE
INSPECTED.
STATE~ty A,M,B, for HIJD
~ ---, ---
;-- ~,-- c~..cE.... ~.
SIGNATURE OF ~TY OWNER
LD, W, Haase, &oker
FOR OFFICE USE ONLY
----------------------------------------------------------------------------
DATE OF INSPECTION:
DATE OF REPORT:
REMARKS:
. DATE OF CERT. OF COMPLIANCE:
RECEIPT NUMBER:
B9~
."