HomeMy WebLinkAboutSpecial Inspection Miscellaneous 1993-7-7
· \ I OJ. 3Lf:SL{ - 0'00
HOUSING INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
--------------------------------------------------------------------------------
---------------------------------------------------------------------------------
DATE:
J /"7/C; ~
ADDRESS OF INSPECTION:
b3(J
A1A'l,.
JOB NUMBER:
( sfr cI)
0~loo)
~ ./
PHONE NUMBER: 7V6- Ycc.o
~
P1ol1"-k Ollld ~SfJf~
~'C j)i~-~
. Yf
~9SS TO PROPERTY - TELEPHONE NUMBER: 'It.{)'-- '7lo{..., / .
~~;~=i[==~~~=======================================================
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
OIlNER: YV1 e ( WJ~SO,,\
OIlNER'S ADDRESS: C/O ~ Ar/#VW'J r
~....r RJf? /S-IO
APPLICANT: N GOLD - -.h",,,, Hvl:J ~;"J.
APPLICANT'S ADDRESS: "7 t ~ /JI10r'/ rue
THIS APPLICATION FORM MUST BE SIGNED BY THE OIlNER OF THE PROPERTY TO BE
"en' \ rJfrv- ~ 1J;.d 1r1 ~
IGNATURE OF PROPERTY OIlNERiJ'" ~
FOR OFFICE USE ONLY
DATE PAID:
1 -q -1 ~
RECEIPT NUMBER:
q~5Z-
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: