HomeMy WebLinkAboutBuilding Application 1995-07-24t70fi52'/ ^blIO
COI'RTBSY INSPECTION APPLICATION
(RENTER REQUEST)
CITY OF SPRINGFIELD BUILDING DI\ISION
DATE:2_t JOB NUMBER:q
ADDRESS OF INSPECTION:
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oWNER : V[-(r.-,'r,.- (r rOll\)
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"PHONE NUMBER:
orrNER,s ADDRESS,MT*u sis r- 1.+q < , (' oe-92 r77
RENTER: iILr-r-r0.-,-,-. +(1 t--r \\-,\-,r\ er--..PHONE NUMBER:
srGNATr.rRE 0F OCCUPANT (RENTER):JU*r vo-.\*.e 'fi* U
ACCESS TO PROPERTY - TELEPHONE NUMBER:
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TYPE OF DI,IELLING: SINGLE FAHILY I I DUPLEX I I MULTIPLE IYI
.,BRIEF DBSCRIPTION OF MAJOR PROBLEMS:
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FOR OTFICE USE ONLY
DATE OF INSPECTION:
COI.IRTESY LETTER
NOTICE AND ORDER IS
DATE FOR COMPLIANCE:
COMPLIANCE OBTAINED - DATE:
YOU WTLL BE GALLED TO SGHEDULE AN INSPECTION
WITHIN 5 Ui'ORKING DAYS
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