HomeMy WebLinkAboutSpecial Inspection Application 1997-6-23
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HOUSING INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
DATE:
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ADDRESS OF INSPECTION: . 3S? '4 2.. Vr\(Q.~,-^-, ~
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OWNER'S ADDRESS: '-1-0/5' h ~-+h. tit'/7 f1J
APPLICANT:~-\--t--d ~I B. ~c.-bCo
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OIlNER:
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APPLICANT'S ADDRESS:
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
=====~=~=========~=~===~~~~--~~~~~~=~~~~=~==~==============~=~=====~=========~==
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OIlNER OF THE PROPERTY TO BE
INSPECTED;
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TWE' UrPMPERTY OIlNER ~ CJ~
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FOR OFFICE USE ONLY
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DATE PAID: W,,~),().c\'1 RECEIPT NUMBER: ~\o31j \
DATE OF INSPECTION:
DATE OF CERTIFICATE OF COMPLIANCE:
DATE OF REPORT:
COMMENTS:
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HOUSING INSPECTION APPLICATION
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CITY OF SPRINGFIELD
BUILDING DIVISION
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ADDRESS OF INSPECTION: ~o1J- rmM :51-.
OWNER: ~VY)e$. ~. ubS&-t.
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APPLICANT: r:;:~j 0. marf-e,/ I ~741-7C~(j)C7('9"'?2':>d.57)
APPLICANT'S ADDRESS: "3 t?'s S- . AtxI4 "E I. sl ' .
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JOB NUMBER: !1..-7n C[jD
DATE:
PHONE NUMBER: ~,t,,;rJtJ
OWNER'S ADDRESS:
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED. ----
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FOR OFFICE USE ONLY
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DATE PAID: (/7- /J - 97
RECEIPT NUMBER: O:J(,,; /7~
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
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COMMENTS:
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