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HomeMy WebLinkAboutSpecial Inspection Application 1997-5-19 / 70 3S 5 I Lt'l2-{ 00 COURTESY INSPECTION APPLICATION (RENTER REQUEST) CITY OF SPRINGFIELD BUILDING DIVISION ================================================================================ DATE: ,c:~ /1 r Cf ?- ADDRESS OF INSPECTION: J'7 I'Z. ( SA"~ e.. ~ \ JOB NUMBER: ~rJ-Z()((tI S pt-~~ ~-r~~\r! 12 \ 5 OWNER: /...__CAX'\ a. c.. ) L M ;'-yo. O~TNER' S AAI;>DRESS: )3Cf5o rJ(t.VeA/ L-R fte C/,1)J/l'R I 0 q i'1fJ8 . . ;,.v"6 RENTER: L~Y\t'."')^- - J/)~A s'/')r-- G PHONE NUMBER: S, +r-e eJ SIGNATURE OF OCCUPANT (RENTER): PHONE NUMBER: ~-P~/ ~d~ (/ 9 2IC?'. 9-lg'j~ -/7"/ q ?S y( . '9 '1 f5~ FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 7/~. gJ~1 ================================================================================ TYPE OF DWELLING: SINGLE FAMILY I 1 DUPLEX 1/1 MULTIPLE ~ I' BRIEF DESCRIPTION OF MAJOR PROBLEMS: ))r/ lapl /'", IJp!:l/m,,-.. /'" 0/77 / oo/'< .6~?A",/? 11 Ih! ~ Y ;:: Icky[ S ;'" K. f?Y1 rI /) Y\ JL . -!~o ~ )11 <J~J(, 01'7/'I"kr. h/,)X 5j/A//~7 /')11 //1 -x:/J.pJ? /1 1/"' 1('- - /, fA] JI1--\ fi1~C//JIA}A\vr" rlJ1r -trlJ /S a7 ttJfJ,' ^,\r /rJnflJ/.so /'rt 5)",w<-O' <;.,)tJ.. //u -- / .'. -------------------------------------------------------------------------------- FOR OFFICE USE ONLY ------------------------------------------------------------------------------- DATE OF INSPECTION: COURTESY LETTER SENT: .NOTICE AND ORDER ISSUED TO OWNER: DATE FOR COMPLIANCE: COMPLIANCE OBTAINED - DATE: .'W~(UJ ~D[b[b [BS~ ~~rLLL[E[Q) 1J@ ~<<;D=D[E:[Q)(W[b[E &00 DOO$~[E~uD(Q)[j\l] WD!Y[):{JOL\1J ~ ~(Q)~~DOO@ [Q)&V~