HomeMy WebLinkAboutSpecial Inspection Occupancy 1996-2-8
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD * BUILDING DIVISION
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DATE: 2~f ~q U ' JOB NUMBER: q Ceo '-7((
ADDRESS OF INSPEGTION: ..,., ~ /M14~ ~-I- "'p-L"....,k-t"".,,(r' fly '" -l({.,';:i '
J 702'-S3C-1/ 0 10-0 ~I'Z."t40t.:eJr J .
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OVNER: 1I...,,-;~ "''l' 1 l ~IA J.I"( PHONE NUMBER: 1tfc( -I~n
OVNER'S ADDRESS I S I ~l /'(lAiN S 1, s ~ &lnLGI \ Hl2..~.Q}:: en ~ 1K
APPLICANT: fg(t,-IA 1-1-"...+ /
APPLICANT'S ADDRESS:.J..k..2.c.. r;,~ r'l~ ~ '1 ')t{ar I <N Cz~<,,';vLcu... .
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: I 4 q _ (q ~ ') " <N c.::;l~.- q, l>5{
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PROPOSED USE: ~~<;.\.I...~
A $35.00 I~SPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OVNER OF THE PROPERTY TO BE
IN ECTE -
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FOR OFFICE USE ONLY
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DATE PAID:2~ --1&
RECEIPT NUMBER:
DATE OF REPORT:
o ;:J() 33 I
DATE OF INSPECTION:
DATE OF CERTifICATE Of COMPLIANCE:
COMMENTS:
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