HomeMy WebLinkAboutPermit Application 1988-05-11CITY OF SPRINGFIELD
Departrnent of P
Building
225 NorSpringfiel
726-3753 (sus
and Dr pment
Di vi s r,in
Streetgon 97 477
-3769 (lnsp.)
lanning
Safetyth 5thd, 0re.) 726
DATE:\\*8
JOB AD
OWNER.:
DRESS
OWNERS AD
APPLICAI{T
DRESS:
-rt ,
-fr
I
APPLICANTS ADDRESS:
HOUSING INSPECT}U
APPLICATION
SPRINGFIELD
A $35.00 INSPECTTON FEE rS REQUTRED AT TI{E Til.IE OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY TI{E OhTIER OF THE PROPERTY TO BE
INSPECTED.
S GNATURE OF PROPER.TY OWNER
FOR OFFICE USE ONLY
DATE OF INSPECTION
DATE OF REPORI:
DATE OF CERTIFICATE OF COMPLIANCE:
RECEIPT NU}{BER:
DATE PAID:
CO}O{ENTS:(
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