HomeMy WebLinkAboutOccupancy Application 1992-1-2
.
.
OCCUPANCY INSPEGTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
======================================================c=______==================
DATE: /- 2- q~ JOB NUMBER: CJ2.WJ4
ADDRESS OF INSPECTION: &~NW"'~'-D Iillf't-L (OLD ~~ !:'7OC.e" ') )i'I'70 CJ.<~,.,t"''-
I Wlt't~r
.-f"'=~ 11VN64.e-s J;vC1.he.ANC-({C-INW'1&!)f!tu)PHONE NUMBER: 7 ZG. - 7e:JZ
OIINER'S ADDRESS: I9::1.D (jL'1"",,'L ~ ~NGPtec...D _
APPLICANT: ZL~~. PR.5. Ll)OI:m..<:..C~Tl
.APPLICANT'S ADDRESS: ~;;( 10 (~b' Uv~
-
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: ,'?Lf-Y-- 'H}7S,
~
/ A/('_
================================================================================
PROPOSED USE: Il\JbUO"R... ~/. '1 FVI\.J C. 6N7'0'??
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THI:2PPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
I~PEC ED. ./ A? '
/ /l ,/L/LJ -
t/L~/Z;r~ -
SIGNAlM"E OF P1l.0PERTY t:ll#Il;R/""AN_~
----------------------------
FOR OFFICE USE ONLY
DATE PAID:
/-::>; ~r
RECEIPT NUMBER:
----------------J'---
. d//~~I.~~
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
--- ,
....,..-,J,/r Sffl'-~ FR#w\.. ~A'1,{{"S5 l>ieV6S, /1'l~'S
\/ ~€: ~UB ~/NG, / r7 "
~ Wl:: AC:6Ak- CJW/V~ qp 77If: />'1Ac..(,...
IrJSrJR.IIN~ IS 7lf<= ~