HomeMy WebLinkAboutOccupancy Application 1983-2-28
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OCCUPANCY INSPECTION APPLICATION ~'. ~~
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
DATE: rl-~ g- 83>
JOB ADDRESS: ~ 0 t9. 0 f\I1 A-" r{ ,f'f
OWNER: ~ A L ~ ~ N,. c HtJ/.!JS c: ()
OWNERS ADDRESS: (If 1../9 Qo U wo I.J..f 0 R E lJ. (;.
APPLICANT: ..5 .ff~L.I. ~""fFi~H2.:S~S r "" c
APPLICANTS ADDRESS: :1 7 , 0 P€ pp~ It- f~€ C () R.
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, NUMBER OF UNITS:
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FOR ACCESS TO PROPERTY -' PLEASE INCLUDE TELEPHONE NUMBER: 7 i:2.., - G. I ~ ~
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A $24,00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FOID1 MUST BE SIGNED BY THE OWNER 'OF THE PROPERTY TO BE
INSPECTED.
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, ' ~~ OF PROPERTY. WNE ~!fIkkk'
_________________~______~Qg_Q~~!g~_y~~_Q~~X__________________________~.--
DATE OF INSPECTION: DATE OF CERT. OF COMPLIANCE:
DATE OF REPORT:
REMARKS:
RECE IFT NUMBER: '6 (p 0 t( q ~