HomeMy WebLinkAboutOccupancy Application 1983-1-25
EXISTING BUILDINGS
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BUILDING DEPARTMENT
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
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APPLICANT: ;::5;f\r. V\ =/-O!~ I<,\^ 'PII ~
APPLICANTS ADDRESS: .3 )()<ltJ edae/;J /LL RMlrl ~~,
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"',FOR ACCESS TO PROPERTY - PLEASE. INCLUDE TELEPHONE NUMBER: " ')4{Q-4413
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\ - \': . A $24.00 INSPE QN FEE IS REQUIRED AT TitE TIME .-
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THIS APPLICATION FOID1 ~ruST BE SIGNED BY TOE TH~PRO RTY TO BE
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,DATE OF INSPECTION: DATE OF CERT, OF COMPLIANCE: "
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DATE: \~~~~-
JOB ADDRESS: \~I /J5""' ~
OWNER: '(j Jlt;;~ O.M.XI
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NUMBER, OF UNITS:
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DATE OF REPORT:
RECEIPT NUMBER:
REMARKS:
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