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HomeMy WebLinkAboutOccupancy Application 1981-4-27 . . , , ~I OCCUPANCY INSPECTION APPLICATION EXISTING BUILDINGS CITY OF SPRINGFIELD BUILDING DEPARTIIENT DATE: 4'?1I/1 c2 7 /'1 pi JOB ADDRESS: /"'5?? 0 A>z-1"//cJ S I OWNER: .4'7:L~ ~4Kf;:IS 'SPtP/JUQ/'/CLI) NUMBER OF UNITS: I ADDRESS: 79() ~ :=-:pC/.( CUtS. .' APPLICANT: ADDRESS: ")-".,;',;.o7r FOR ACCESS TO PROPERTY - TELEPHONE: I .s Oe!. C.,_/I"i CD rJ/~ L!.4L L * /1,;( ! It, ,..) 1-h4--\f: 15" h 2.. 91" 7',P ,-- A $20.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM ~IUST BE SIGNED BY THE OWNER OF THE PROEPTY TO BE INSPECTED ~~zf-v-~~ SIGNATURE OF PROPERTY OWNER FOR OFFICE USE,ONLY ~ ------------------------------------------------------------------------------------- Date of Inspection: Date of Cert. of Compliance: Date of Report: Receipt Number: '5(,.,~~Co RHIARKS: 34 ,J ,~... _ ....:l. _ .0.. :s.:.....i..... .