HomeMy WebLinkAboutPermit Application 1997-06-17SPIi.NGFIELO
,'.:'Ittili:-l!t"!!
: ;l'l I ING i'' ll:1.D, Ol 1'J i't i i
(!;4t)726 37s3
FAX (541) 726-368s
OCCI'PANCI INSPEGTI,ON APPLICATION
CITY OP SPRINGFIEIJ)t 70135 3l o',/ffD
BUrr.DrNG Dr\EsroN
C,'TY OF OFEGOA'
DATE:
ADDRESS OF INSPECTION:
JOB NUMBER:
OTINER: U),L l/+rvl -f rCLI F-F PHoNE NuMss{:Jifl ) ?JS'ds"'--
OI.INER' S ADDRESSI
APPLICAI.IT:{,e I TAxTo)
APPLICAT'IT' S ADDRESS :
FOR ACCESS TO PROPERTY - TELEPHONB NUMBER:
PROPOSED USE:
A $35.00 rNspEcrroN FEE rs REQUTRED AT THE TrME 0F APPLICATTON
THIS APPLICATION TORM MUST BE SIGNED BY THE OIINER OF THE PROPERTY TO BE
INSPECTED
FOR OFFICE USE ONLT
DATE PAID:RECEIPT NUMBER:
DATE OF REPORT:DATE OF INSPECTION:
DATE OF CERTIFICATE OF COMPLIANCE: '"
COMMENTS:
PROPOSED FLOOR PLAN REQUIRED AT TiME OF APPLIGATION
t)l \./l_l-( )lrlyll. I'l I :;i./il'/r".1:.'; I )1. l'itl i I it
rrr! I L tq?7
/ f/)' ./r*t d r,et ,
,z - ?oo/
n C)
I
$urtLflorerD
ilsr
lkil!-
\
N
lio
"r+P sl
r\ \ \ \ \ \\\\\\\\\\,\
-