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HomeMy WebLinkAboutSpecial Inspection Application 1975-1-25 .' , ..- ~ . 17bl:S2~r-O 3L(OO COURTESY INSPECTION APPLICATION (RENTER REQUEST) ~ CITY OF SPRINGFIELD BUILDING DIVISION ~ ~~~===========================================================================" DATE: /(J:J~p 5' JOB NUMBER: 95t3o?2- ADDRESS OF INSPECTION: '1(30 I ;fJ A I)) Sjl OIiNER: ;r;!lR(,~ /Ef?/lTCI/1E/2 PHONE NUMBER: ?W -6 tJ~ 6 OIlNER'S ADDRESS: RENTER: f .4RRv (,],i/P I/r:" . ( ~ SIGNATURE OF OCCUPANT (RENTER): / ~~ FOR ACCESS TO PROPERTY - TELEPH~ ~UMB~ 1.1 PHONE NUMBER: k?,~~1~ 7'10- 7t15o 7'1/'- 799'/ )Vtl-/tJ~o ~ "/'1/-799/ ================================================================================ tJ/A 4\.--7 #7 c>< c/ rr<- "& c.J ... TYPE OF DYELLING: SINGLE FAMILY I I DUPLEX I I MULTIPLE I I BRIEF DESCRIPTION OF MAJOR PROBLEMS: Cd ;I'~ li~j..u.... ;tJ../~.M . 7;:.rrJ .6.u. db01-/\- de J at/).QAt " ti....J.j1J01 M6~..:t ~ . U ' J I / ( " ,5'r~ ~ /O-uj,j 17~-1 f IAJ.->'UA. A~~. /,J-(~/J A1~~" A.fr~ l.l~, ~ &! /~ .ri-'-'~ dB" '* A~. ~ 'jJ~/1 , /~y ~ J p/t&'! 1~- dL.i2.- ~/ (1~ /7A~ , / $"&t.: Cfo'" i "MOL r4-<r d& d/ut /A~:P, ~ ~ -I_.k Ju:lL:. ~ .' --- '7 I --------" ;Jjc9g_.' ya~,f:>1J ( JJ!_~!! "-~ ()CJ(F.-L-M-I-l)~7-t!)--f /Jt9scrs IlW l2? /& (<,) c,' , DATE OF ; COURTESY NOTICE A DATE FOR , COMPLIAN 1/' .>) ~ ---- . ! ~DJt2/).~--f-5.lf-2.J ,:YOU ;--.---------- --- -------7~--~ECTION t Un -- -; _ 1'1'. .....-..-...._....~n.--__.._