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HomeMy WebLinkAboutBuilding Application 1996-11-27 . . HOUSING INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION ================================================================================ DATE: //-27'~ ADDRESS OF INSPECTION: '::l \, \ ''lJ~rt r\ ,"''v'''', r~ <.., JOB NUMBER: ~/~~~ T,,\",u,9A\ ~ C'c.\\ qS,-\ ';;l.Y-\u PHONE NUMBER: ~ \..Il'loct {,3 01JNER: \', "'" ~ C\. \ r. ~.(' ~'C.C.to<-\-\- 01JNER'S ADDRESS: ~ I, \ ru 't.o..;)(Vv-, 0 rt.\. '" ~r"L-\ _ 0 r~ . G APPLICANT: ("")l ,-'"\r\. f- r- APPLICANT'S ADDRESS: FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: '1'-\ {- leY lo .", ~~ Y - d- ;, \.( T\ '\ ':l...l~' \ ~ \~ =============================================================================~c= A $35.00 INSPECTION FEE IS REQUIRED AT,THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE 01JNER OF THE PROPERTY TO BE INSPECTED. D.r,,~q ~~!r~~-d SIGNATURE OF ~~')!RT'r01JNER -------------------------------------------------------------------------------- FOR OFFICE USE ONLY -------------------------------------------------------------------------------- DATE PAID: //<2'7'5Jt;::: RECEIPT NUMBER: .::?3~e::C; 4? . , DATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: