HomeMy WebLinkAboutSpecial Inspection Building 1996-7-10
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HOUSING INSPECTION APPLICATION
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CITY OF SPRINGFIELD
BUILDING DIVISION
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OWNER: c)\{(,Q Y\ B ('0 If' P
OWNER'S ADDRESS: '?:> liDS f2a 1 du V ~-ew L.n y\ p
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ADDRESS OF INSPECTION:
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PHONE NUMBER:
7'-1 lo- ~4 4
APPLICANT:
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APPLICANT'S ADDRESS:
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
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THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED.
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SIGNATURE OF" PROPERTY OWNER
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FOR OFFICE USE ONLY
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DATE PAID:
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RECEIPT NUMBER:
AA44~
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DATE OF INSPECTION:
DATE OF REPORT:
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DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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