HomeMy WebLinkAboutOccupancy Correspondence 1992-6-23
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE:
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JOB NUMBER: ~'2~
ADDRESS OF INSPECTION: 110
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OIINER: (2.0 bPrll.. .., '( _ 11M In L
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OlJNER'S ADDRESS: 1'12'5: w. 3lftrf/h/r,
PHONE NUMBER: '3f~'.9bk_
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APPLICANT: k!.~ r- L. TIt,fol/
APPLICANT'S ADDRESS: :S'~ (;;
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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PROPOSED USE: () ScQ:\ (l M (Co '(
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
TH~PLICATION FORM MUST BE SIGNED BY THE OVNER OF THE PROPERTY TO BE
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FOR OFFICE USE ONLY
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DATE PAID:
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RECEIPT NUMBER:
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: