HomeMy WebLinkAboutBuilding Miscellaneous 1993-10-5
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HOUSING INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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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
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APPLICANT' S ADD~ESS: \.. 'l~
APPLICANT:
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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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.
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, FOR OFFICE USE ONLY
DATE PAID:
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RECEIPT NUMBER:
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
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