HomeMy WebLinkAboutOccupancy Application 1992-12-17
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: .D Ec:::..l5MoE'e- n 1'142-
ADDRESS OF INSPECTION: 2.147 MAl!\1 S1.
JOB NUMBER: q:Z--t~
mINER: ~()L-L- -I-N0\A5-rl2-l15S
mINER'S ADDRESS: .p.o, E'>mc '2~bBI
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PHONE NUMBER: "1e4-'2-/OV
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PROPOSED USE: ~ k c::i- (\ 'c..AJ + f' ~ ~~ '
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APPLICANT:
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
ON FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
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FOR OFFICE USE ONLY
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DATE PAID: 12.--~ Jtz....
RECEIPT NUMBER:
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: