HomeMy WebLinkAboutOccupancy Housing Code 1996-1-9
HOUSING INSPECTION APPLICATIPN
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: C~N~' .~ JOB NUMBER: 0Ce153Lf /
ADDRESS OF INSPECTION: 7/2 /i//Y7 W'~ /~ CO~Z::~
OYNER: 6-r. JlJcf'YJrr l::>e PA-tk_ SoC-l~ PHONE NUMBER: ~7-C;8'2D
OYNER'S ADDRESS: 70S S. Sc:N~ It EuC;~. (J;e CJ'746z-
,
APPLICANT: ~e
APPLICANT'S ADDRESS:
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: ~-~~4r~
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A $35.0q INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OYNER OF THE PROPERTY TO BE
INSP/:iD. 1 / / //
/ /kc~4 A{/// -;e/Zj2L( uJe8s-rErL I ~~?
,;SIGNATURE OF PROPERTY OYNER
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FOR OFFICE USE ONLY
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DATE PAID:
I - Gj-1v
RECEIPT NUMBER:
0200 I ~
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: