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HomeMy WebLinkAboutSpecial Inspection Occupancy 1996-2-8 'I.~ ~ \ . . OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIELD * BUILDING DIVISION ---==-==========-=----------=----=-- =---------=--=-====--==--==---------- --- - - ---------- ---- -- --------- -- - -- -- ---------- 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 . , ' 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{ ===================================================================~==== 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 - -------------------------------------------------------------------------------- FOR OFFICE USE ONLY ------------------------------------------------~------------------------------- DATE PAID:2~ --1& RECEIPT NUMBER: DATE OF REPORT: o ;:J() 33 I DATE OF INSPECTION: DATE OF CERTifICATE Of COMPLIANCE: COMMENTS: ~ -f1^- - '- ... _.~....... -. . ...... '.