HomeMy WebLinkAboutOccupancy Application 1981-11-18
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OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
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CITY OF SPRINGFIELD
BUILDING DEPARTMENT
DATE: /1- /!t-?/
JOB ADDRES S : ~ / b '1 .i., M /# Sf; NUMBER OF UNITS:
OWNER:~dkd--?7'7#/YJ fi{.i&~~~ -.
OWNERS ADDRESS: 7 t/ tJ -S G L/ "3 tU2
APPLICANT: ;07.4'" V~ ~,e/.2.4 L
APPLICANTS ADDRESS: /' S--d ~ ,;2'/- ~I Yr ;;:,c:- 0
FOR ACCESS TO PROPERTY --PLEASE INCLUDE TELEPHONE NUMBER: /?}f/?-~~27 ;'
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. . 1/ A $24. OO~ INSPECTION FEE IS REqUiRED AT THE TIME -----
-~ - . ~ OF APPLICATION
THIS APPLICATION FOID1 MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE~;1
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. SIGNATURE F PROPER Y OWNER-
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________________________~Q~_Q~~!g;_y~;_Q~~X_________________________________
DATE OF INSPECTION: \ \ - '2 ?-,- ~ \ DATE OF CERT. OF COMPLIANCE:
DATE OF REPORT: RECEIPT NUMBER: (:)'ll 0 U1l- - \ \-l?"5-Bl
REMARKS:
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OCCUPM~CY INSPECTION APPLICATION
EXISTING BUILDINGS
/
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
DATE: /1- /!t-? I
JOB ADDRESS: ~/ b '1.i. '/7/A/.N Sf; NUMBER OF UNITS: /
OWNER:~dk.d-;77'7dn fi{..it:;V7,r"N.;:td;...-
OWNERS ADDRESS: 71/ tJ -S G L/ "3 /t..o .
APPLICANT: 0/vC"~ ~/?/.2.4L
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APPLICANTS ADDRESS: /'S--d ~ ,;2'/- - J r J~,c:-O
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FOR ACCESS TO PROPERTY - PLEASE INCLUDE TELEPHONE NUMBER: /?}f/?-~027 ;'
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.........-= ~ ~Z-L.-e. ~~ ../~ - ~ _.' ~-....-.::.-= <EC _._
t:. A $24.00._ INSPECTION FEE IS REqUiRED AT THE TIME
....... . OF APPLICATION
THIS A:PLICATION FOID1 MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BElL
INSPECrED.. f)/ ~I //-'. f, .
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STGNATUREOF PROPER Y OWNER' .
FOR OFFICE USE ONLY
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DATE OF INSPECTION: \ \ - 'I '":\- ~ \ DATE OF CERT. OF COMPLIANCE:
DATE OF REPORT: RECEIPT NUMBER: (:) (j l 0 U.Q.-=J \ -l?"5B
REMARKS:
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