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HomeMy WebLinkAboutSpecial Inspection Occupancy 1991-10-1 -,,:;---,""'''' ~- . .. OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION ================================================~~~---------===================== DATE: 1/)..-1~1 JOB NUMBER: 9////.0 ADDRESS OF INSPECTION: .::lk'h4 - '0 fY'u1)9 ~ SQJ'd,.. ()r?P fAr/Y'l Cf7<.{7b ('.ta.M V3 db !'MtJ-t). . , '=-Y-'. mINER: ~4-1Q.AI~ll );\~ PHONE NUMBER: ~ OIINER'S ADDRESS: "!'J77 S IO(llti R..aft/ SPf<tlJ&f=/E.J..f).-alfJJVl Q7l/7'i APPLICANT: ~ kklPJlOtl e..1\ ::::::.::=-~~:::;!:q.~~~_.~- !I a: CV'Lw AY\o/T\ t ) i.J PROPOSED USE: () J 1m ~ G...il...pn lL1.L(pY' (Ofl /lP A"'n> /~/Hr,.~ //)(c:.~t.->Z;~;;:;:>. 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 INSPECTED. <<111. J ; { dc'iMI ) SIGNATURE OF PROPERTY OYNER --------------------------------------------- FOR OFFICE USE ONLY -------------------------------------------------- DATE PAID: /tf/~ /J~,/ RECEIPT NUMBER: -:2 /5/</ DATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: