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HICKORY FIRE DEPARTMENT �`��QRorE�roz
Fire Prevention Bureau
Phone: (828) 323-7522 Fax: (828) 323-7476 n r
FIRE INSPECTION REPORT
Occupant C'(JCC �,p�A% S _(n5
Address
Type of Occupancy
Type of Inspection:
Comments:
nitial Inspection
Date ?' <�-- - C-�
Phone No.
Inspec l"
Re -Inspection Other
Inspection Status: Approved ' , Temporary Approval
No. of Violations: Re -Inspection Date:
Name of Occupant:
Title:
Disapproved
Re -Inspection Fee:
(Ple,"Print)
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(Please Print)