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IF IN THE U6.B.
DATE oF APPLrcArohr A I+ nZ
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ADDRE39 PIJONE:
PROCEDI.JFE FOR INSFECTICt.I REGI..IEST,
C,\YS 12".'163 (FECORDER ) gTATE YOIJR CITY DE9IGNAT=D JO3 NLJI'Ig=R, JO3 ADDRESS,TTPE OF
INgPECTIOT.I REAUEgTED AD IIHEN YOU TUILL BE READY rcR N9F,ECTIOIiI, COI{TRACIOR9 OR OIINER9 NAFIE lJ.]D
PHoNE NI.T.1BER REALIEgTS RECEIVED BErcRE \O@ /fr,I]JILL BE I1ADE Ti.{E 9A1E DAY, REOJE9TS /FT:.-R 1,OO
A}.,IUJILL BE T1ADE THE NEXT I.IJORKING DAY
EXISTI}.IG ELIILD INC FERi1 lT No. r IF lEl ICABLE )
*YOTJR CITY DESIGI.IATED JO3 NO."f nzl l21gEE BOOK
FEAUIRED IN9PECTION9 gIDEIUALK / DRI\GVJAY
FOR ALL CONCRETE PAVING IUITiIIN
THE gTREET RIGI]T OF IUAY, TO 3E
I'1ADE AFTER AL EXCAVATING
19 COHPLETE AJ\ID FORI1 IIJOR<
AID S,I,Jts-BA9E I1ATERIAL 19
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AFTER FOB19 AR= ERECTED
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FEE9: SIDEUJALK9
TOTAL FERlltT FEE'
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OF I1JALK
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COXI"IERICAL DRI\GIIJAYS SHALL
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I A/.G CAREFdLLY EXAYINED iHE COI1PLETED APPLICATIOI.I FOR PERiIT,, AD DO i]ER=BY CERTIFY TIIAT ALLINTSIATIOt{ }IEREON 13 TBJE A\D CORR=CT, A\D I RJRTII=R CERTIFY 'l'llAT ANY A\D ALL UiCR< PERFOS1ED9i-iALL BE DONE lN AccORDANcE UJITH TltE oRDtNANCEg G Ti.tE ClTy G SPRINGFIELD, AND T|IE LALIT9 G TI-.IESTATE oF OR=6ON PERTAINING TO TI{E UJORK DE9CRIB=D HER=I\, AND ]-;]AT NO OCCUPA\CY UILL BE I1ADEf ANY STRTJCTU= II.JIT}{OJT PEB1IS9ION G TH= BUILDING D lvl9 r of'l'@r.rc:{E.rTjoNTRACTeRS
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