HomeMy WebLinkAboutB1103-491 HKY FIRE RPT.PDFbLDi103- °1I
61�,3 HICKORY FIRE DEPARTMENT
1 Fire Prevention Bureau
0 Phone: (828) 323-7522 Fax: (828) 323-7476
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FIRE INSPECTION REPORT
Occupant �" I Gt S �' ,� C �O.0 1� ct a j n/- Date
Address % oZ y m a Phone No.
Type of Occupancy /-L Inspector
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Type of Inspection: ❑ Initial Inspection Re -Inspection Other Ot/
Comments: , aah
Inspection Status: Approved Temporary Approval Disapproved
No. of Violations: Re -Inspection Date:
Name of Occupant: Pln-�
(Please Print)
Occupant Signature:
Re -Inspection Fee:
Title: -PLAjT
(Please Print)
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