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HomeMy WebLinkAboutOccupancy Application 1993-12-23 . . \ 1rJL-?:/L?f2- O\2f1) OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION ;=======================~======================================================= DATE: 1:1;;'1>/'1.3 l//(1..'/ JOB NUMBER: q31~~D' ADDRESS OF INSPECTION: ~ maU'L~~_~ I-i'~ - OlJNER: fJ1 T I I kc.- PHONE NUMBER: ?1P7 -Sl)", OlJNER'S ADDRESS: Ptr~ U99 /5ttLt.nt. 0lZ 91~tf7 - APPLICANT: lL2.w,(f.1\ B"/l.f\ltVG l1nlACTS - ClI~15 /l1A.~TOtV hU;-117B) APPLICANT'S ADDRESS: 4r=jPJc( HOUI{ Sr SPN.JGtltLf'l DR T7V79-> I , FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: BOA)/ylf Ail kef! - R Rok (;1( =======~=======================================~~:7=:=L7J2~=================== PROPOSED USE: WA~f/bA<:'l- AAlb [iBl?i{AUOfo,J S/hP FbR LtMLEAu6f: 5TttL ~1L/)tft)M fR.oDiJ.r;n. OPtfl.IfTiDtV 11~(f A 1t6f1 ~q~r;;E PtIlSMAl;.k GmtR. A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OYNER OF THE PROPERTY TO BE INSPECTED, ---- XSIG~~;f:(' J ~'~, --------------------------------------------------------------------------~ FOR OFFICE USE ONLY DATE PAID: lVV7-/~ RECEIPT NUMBER: IAv~ DATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: