HomeMy WebLinkAboutOccupancy Correspondence 1980-8-25
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OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
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CITY OF SPRINGFIELD
BUILDING DEPARTMENT
DATE: ~r2~((> )/-{ (S f<J
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JOB ADDRESS: 91 ') l~1'//I"J~ 4/-
OliNER: 12t(~'~I) ~~A"&,t-f
ADDRESS:
NU~IBER OF UNITS:
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APPLICANT: 1 (
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ADDRESS:
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FOR ACCESS TO PROPERTY - TELEPHONE: 7?/;"'-I,f/3.
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A $20.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FOro~ MUST BE SIGNED BY THE
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OWNER OF THE PROEPTY TO BE INSPECTED
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SIGNVURE O/ERTY OWNER :
FOR OFFICE USE ONLY
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Date of Inspection:
Date of Cert. of Compliance:
Date of R~port:
Receipt Number:
REMARKS: .
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