HomeMy WebLinkAboutMiscellaneous Application 1982-05-13CITY OF SPRINGFIELD
COURTESY INSPECTION APPLICATIO}I
(RENTER REQUEST)
BUILDING DIVISION
DATE ffI
OI\NER
3 t9(ADDRESS OF INS PECTION 5 a5
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PHONE NO.
740 j
ADDRESS
PHoNE No. 1/
RENTER
SIGNATURE OF OCCUPANT (RENTER)
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER a47-oa4
TYPE OF DWELLING: SINGLE FAMILY x'DUPLEX D MULTIPLE t]
BRIEF DISCRIPTION OF MAJOR PROBLEMS:
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FOR OFFICE USE ONLY
Date of InsPec tion
CourtesY Let ter Sent
Notice and 0rder Issued To Owner
Date For ComP liance
4.7 -saa 4
Compliance Obtained - Date
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INVOICE
SEPTIC TANK & SEWER SERVICE
P.O. BOX rOO93 EUGENE, OR 97440
Ollica:'l719lryiog R{d 666'4531 ' 746'6331
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instsllations 4repairs t/
estimates
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WORK DONE:
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TIME
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FOLLOW UP
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SIZE
LOCATION
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SIGNA R
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THIS lS YOUR lNvOlCE o PAYMENT lS EXPECTED UPON COMPLETION OF JOB
C
CITY 0F SPRINGFIELD, OBXI0N
Department of Pub1ic I'Iorks
225 North 5th Street
JOB ADDRESS:32{-/ua4>
BUILr- -'{G II{SPUCTION DIVISI'ON
JOB NIJ}4BER:
DATE:#\
TO
NOTE
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INFOR}{ATIOII:
INSPECTION:
7 26-37 53
726-37 69 CALL FOR REINSPECTION
INSPECTOR:
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