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HomeMy WebLinkAboutOccupancy Application 1995-5-1 ~ . . OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION ccc::=:========:================================================================ DATE: .-I~/L Ztt5//'9.~ ADDRESS OF INSPECTION: --::? ~?,..., , - - JOB NUMBER: ~'3'?? ~....... ~~~/C: ~~. _ - , a- .'/ r-;--- , .. OIINER: ~,(.~ ;; ?/~L?:: PHONE NUMBER: LYe>' ~~>,.e:::: .Jf~4~~~C. OIINER'S ADDRESS: ~ -j -:.:::: ~ ,., ~~~ ~. ~':S;;nE 979c::::-........ . '... , . ". - APPLICANT: ~~~ ~~~~ h.- APPLICANT'S ADDRESS: /~? /Ys:? #'/~ _?--:" _?~/\'t-p ";J1;?Y?? FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 72tC-/9/~ dJA .7Y~~ ~ . /' =e=======================================================cc===================== PROPOSED USE:/J?~~.#77~~ ~;; i.::L cF ~~.~ ? ~~/YC7;:''''--~, &.........L~~ W:-~~~-"- ,,2)AV~,J1'-..p4 ~~~t'$~~~~~~ FEE-IS REQUIRED AT THE TIME OF APPL;C;;IO~ - THIS APPLICATION FORM MUST BE SIGNED BY THE OYNER OF THE PROPERTY TO BE INSPECTED. ---- ~~M~~7,y(l</1(-Q (J6~t F41' Lou ~UITY) SlGNATUR2' OF PROPSRTY OIlNBR FOR OFFICE USE ONLY DATE PAID: 6-I--QS' RECEIPT NUMBER: tlJl'1/k'O DATE OF INSPECTION: DATE OF CERTIFICATE OF COMPLIANCE: DATE OF REPORT: .. ....~ ,. COMMENTS: . .-