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HICKORY FIRE DEPARTMENT V, 014,
Fire Prevention Bureau
IbIl Phone: (828) 323-7522 Fax.- (828) 323-7476
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6-5 -- t� 1 -1 FIRE INSPECTION REPORT
Occupant -:5 �f_ C U Date Z
-73
Address Phone No.
Type of Occupancy Inspector
1XI;600 �-61_
Type of Inspection: 'Initial Inspection Re -Inspection El Other
Comments:
No. of Violations:
Name of Occupant:
M1233UMM
Occupant Signature:
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Disapproved
Re -Inspection Fee:
(Please Print)
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