HomeMy WebLinkAboutOccupancy Application 1981-4-13
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OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
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DATE: ;/-fJ/~I' ( 13/ /"1~(
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JOB ADDRESS: 1~:3 1- tf1o"lVl Ne.d'" (':Jvl~kj~o(J
OWNER:---.:1':;{. f'r J:::: 8 veJctf-o.... ADDRESS:
NUMBER OF UNITS:
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APPLICANT: ~ AODRESS: ~ U 9102 w e I c:J->.-..<Z..c,.. ~~ /7Y'-/
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FOR ACCESS TO PROPERTY - TELEPHONE: IL~ v 4-1-- I"Vv, C:.fl.. \.f~" ;!t.4-.//l4f-
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A $20.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
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~RE OF PROPERTY -OWNER ~ .
FOR OFFICE USE ONLY
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Date of Inspection:
Date of Cert. of Compliance:
Receipt Number: ~n?~ <Z ><
Date of Report:
REMARKS:
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