HomeMy WebLinkAboutOccupancy Application 1994-1-3
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE:j~~. '3/ /99'7' JOB NUMBER: ,?,Yo::-.-...""""
ADDRESS OF INSPECTION: :::Z-:;>2.::> ~ ~ .
OIlNER: W.LAt~C~.~ ~r?pAl'.?.P.
OIlNER'S ADDRESS: ~~ .
APPLICANT: ~.~ .~~...o'.Z2Y- ~~~/r.:..
APPLICANT'S ADDRESS: ~
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: ~- Y'b.- ,~
PHONE NUMBER: 7.:4'6- y~
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PROPOSED USE: l;:f..;~~ 4..;/....~~ ~~~ ~~:...-.::::- ;:fr-
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
~ APPLICATION FORM MUST BE SIGNED BY THE OIlNER OF THE PROPERTY TO BE
INS ECTED. ,~
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FOR OFFICE USE ONLY
DATE PAID:
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RECEIPT NUMBER: IIZ /"'3
DATE OF REPORT:
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DATE OF INSPECTION:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: