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HomeMy WebLinkAboutOccupancy Application 1978-12-18 - d. \. .c . '\.:'.J! , " " .'--'''f ::~..i . . ~~ \- " . ' ...,.,:, 'i-9\'.' .~,... . ~~"! . .\,. . .~.~ " . . OCCUPANCY INSPECTION APPLICATIt "5 .9 CITY OF SPRINGFIELD BUI WING DEPARHIENT ~ "m /7'0? ~ JOB ADDRESS: ...2/ 03 W~ NUMBER OF UNITS: / OWNER:,r:{J~;~ 77%n.rP5',J ADDRESS: .;2/(j':J ~/A/ U. , n r I. . /)f?~ APPLICANT: ;t(/ W4-0/'tr6' Y /66 "'~?"F'--'ADDRESS: fl/6' ..J b f"J Y?"'L, 72- G /?2S- EXISTING BUILDINGS FOR ACCESS TO PROPERTY - TELEPHONE: A $20.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS, APPLICATION FORI.1 ~IUST BE SIGNED BY THE OWNER OF TilE PROEPTY TO BE INSPECTED ~-?A .-SIGNATURE OF' PROPERTY"'OWNER FOR OFFICE USE ONLY ------------------------------------------------------------------------------------- Date of Inspection: 1.2-/t?- 7 r Date of Cert, of Compliance: Date of Report: Receipt Number: REMARKS: