HomeMy WebLinkAboutSpecial Inspection Occupancy 1994-6-6
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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ADDRESS OF INSPECTION:
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OYNER:
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OVNER'S ADDRESS:
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PHONE NUMBER: 7'-11- '-Ie, 7(,
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FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 7'-1/- '-It, 7~ f).(+.>. r~.;r-;:;; M.,~\vt:)
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PROPOSED USE: N(l~frt/,~t.b'c/ (O","W1<..Y:J :5- 'I 5t'f7~-L
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OVNER OF THE PROPERTY TO BE
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SIGNATURE Or-PROPERTY OVNER
FOR OFFICE USE ONLY
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DATE PAID: \C) ......\.0 -ct RECEIPT NUMBER: _1.;:5Z-.-z......!
DATE OF INSPECTION:
DATE OF CERTiFICATE OF COMPLIANCE:
DATE OF REPORT:
COMMENTS:
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