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HomeMy WebLinkAboutBuilding Miscellaneous 1993-10-5 e eo \ '1 o~8oo ~'\ ~1LU HOUSING INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- DATE: \O.C(\ .C\3 _ I r?~B NUMBER: q3\~~ ADDRESS OF INSPEC;ION: d (_rf\-8- (:0~ffiQ. ~ V rei ~ OIINER: ~ Q X\ Ul\)\(1 ~ l(l 1\A t-> ./ PHONE NUMBER: ~ .c\\r,At """S ~;\ESS' \)n %>_'1 II'll 61:) '(4M- (1)l~o ~ (()lLJRQ f ~ C\ '\L\~ APPLICANT' S ADD~ESS: \.. 'l~ APPLICANT: FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: - (~4~ . LfLP+:J. ================================================================================ A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE O~NER OF THE PROPERTY TO BE INSPECTED. ~ /)'y'v]/7 /7A .. - ~ ~ ~L!:.(Ll~P"::- ~ ATURE OF PROPERTY O~NER ~ ,----------------------~-------------------------------------------------------- , FOR OFFICE USE ONLY DATE PAID: \f).s.CY~ RECEIPT NUMBER: \~ DATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: \ ,_~J\O~~ '\:TIllllL rol) ~