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HICKORY FIRE DEPARTMENT
Fire Prevention Bureau
Phone: (828) 323-7522 Fax: (828) 323-7476
FIRE INSPECTION REPORT
Occupant �/ U hf7�,a�.-� Date
Address _ �?� / �� % ��J S �^ Phone No.
Type of Occupancy —,".17 Irispector
Type of Inspection: Initial Inspection �e-Inspection Other
Comments:
Inspection Status: Approved
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Temporary Approval Disapproved
No. of Violations: Re -Inspection Date:
Name of Occupant:
(Pie a Print)
Occupant Signatu '
Re -Inspection Fee:
Title:
(Please Print)
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