HomeMy WebLinkAboutOccupancy Correspondence 1997-6-9
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DEVELOPMENT SEll VICES DEP/1RTMENT
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FAX (54!) 726,3689
OCCUPANCY INSPECTION APPLICATION
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CITY OF SPRINGFIELD
BUILDING DIVISION
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ADDRESS OF INSPECTION:
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OWNER: (J.J ;- / ) ~_eN' c.,
OVNER' S ADDRESS: --,3. c;, Gc.: y- L...-::H...;
APPLICANT: U...)J~!/ /J{.,.ftl/S
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APPLICANT'S ADDRESS: 3, ~0 G/? /<:!"/) 1/':''1''/_..( 1/7>(
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: /t..-/ ;':'-7/(/L.-j
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JOB NUMBER: ..i.L / . 1:/- '
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DATE:
PHONE NUMBER: J7?,1~-7~~j
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PROPOSED USE:, ~ a J 1 U7'r?JvV\
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED. ~----
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FOR OFFICE USE ONLY
DATE PAID: q r....h'A--I7e.. 91
RECEIPT NUMBER: dJlo/O,.;2,
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DATE OF INSPECTION:
DATE OF CERTtFICATE OF COMPLIANCE:
,DATE OF REPORT:
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COMMENTS:
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PROPOSED FLOOR PLAN REQUIRED AT TIME' OF APPLICATION