HomeMy WebLinkAboutOccupancy Application 1993-2-25
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: ;2 - 2 ~ - '1'3 JOB NUMBER: ~?:DZL/2
ADDRESS OF INSPECTION: ':2 320 JnA-J/I 5~,V?., SoJ4 ;;: A-.5f sAt:p
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OIlNER: ~ +..g.. I;'} tI(>j""'41~~ PUil 1'0 ;...C'
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OIlNER'S ADDRESS: 23 zt7 /11 ~/,., <:; ~
PHONE NUMBE~: :l~~-~J7t'l7
5',,/]/pe 979'77
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APPLICANT: _ ~(V f), #1er"~>
APPLICANT'S ADDRESS: 2~5"'~23d j/ .5"./:J..,f)J /.J"e t?7f77
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FOR ACCESS TO PROPERTY - 'TELEPHONE NUMBER: -1b ');;}(, -I./Roo \ ~~ (~
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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
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SI NATURE OF PROPERTY O'\IN~ ./ .'
FOR OFFICE USE ONLY
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DATE PAID:
7 -7.hJ13
RECEIPT NUMBER:
7~
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: