HomeMy WebLinkAboutB1103-495 HKY FIRE RPT.PDFHICKORY FIRE DEPARTMENT
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Fire Prevention Bureau
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6 u n �` 5 FIRE INSPECTION REPORT
Occupant-! �P� Date
Address Phone No.
Type of Occupancy Inspector
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Type of Inspection: Initial InspectionJ�j �e-lnspection � Other `
Comments:
Inspection Status: Approved Temporary Approval Disapproved
No. of Violations: Re -Inspection Date: Re -Inspection Fee:
Name of Occupant: Title:
(Plea Print)
Occupant Signature. L
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(Please Print)
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