HomeMy WebLinkAboutMiscellaneous Miscellaneous 1994-8-26
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HOUSING INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: 1JA-~:26 /f'9.<J JOB NUMBER: tt4J?Xf1
ADDRESS .OF ~SPECTION: ~dS~ ~ rOdC'3 IhtlA u-f~ i.l?d
OIlNER: -c;~':'4 r t/~~W M PHONE NUMBER:~'Y1-~
OIlNER'S ADDRES~: 7C<-:J S-n---L-1'5-7 5A~, c:;;.,r:J~ )lsL~
APPLICANT:~~_7 (kM~( ~ ~
APPLICANT'S ADDRESS: '1b~ ~7Sr ~~ C;//Ct!:-z-<-(' 77'Vcf~
FOR ACC~SSTO PROPERT~ - TE:EPHONE NUMBER: hh.-~c) /
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OIINER OF THE PROPERTY TO BE
INSPECTED.
M1tti~R~~~~
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FOR OFFICE USE ONLY
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DATE PAID: S - 21., .Jj<-/ RECEIPT NUMBER: , L[ L{ g /
DATE OF INSPECTION:
DATE OF CERTIFICATE OF COMPLIANCE:
DATE OF REPORT:
COMMENTS: