HomeMy WebLinkAboutSpecial Inspection Building 1986-8-19 (2)
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COURTESY INSPECTION APPLICAT10N
(RENTER REQUEST)
'CITY OF SPRINGFIELD
BUILDING DIVISION
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ADDRESS (J Po /SOY: 71, 1-dl Cu.J, Ol?
RENTER I~ '&~dJev, PHONE NO.
SIGNATURE OF OCCUPANT (RENTER) Y0 Q~ .~, ~OJ:J.A('~
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER ~
DATE
ADDRESS OF INSPECTION 5;2 If 0 111~, f}l'f. II
OWNER
PHONE NO.
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TYPE 'OF DWELLING: SINGLE FAMILY [] DUPLEX ~ MULTIPLE []
BRIEF DISCRIPTION OF MAJOR PROBLEMS:
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FOR OFFICE USE ONLY
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Date of Inspection
Courtesy Letter Sent
Notice and Order Issued To Owner
Date For Compliance
Compliance Obtained - Date
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