HomeMy WebLinkAboutB3-1813 HKY FIRE RPT.PDFHICKORY FIRE DEPARTMENT �QR°TEpri
Fire Prevention Bureau
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/ FIRE INSPECTION REPORT
Occupant ; c (t j, �KJ �/�l/l T; Date
Address �Phone No.
Type of Occupancy sector Z67—
Type of Inspection: nitial Inspection Re -Ins ctionn Other
Comments:
Inspection Status: A
Temporary Approval
No. of Violations: Re -Inspection Date:
Name of Occupant:
(Ple se Print)
Title:
Disapproved
Re -Inspection Fee: _
(Please Print)
Occupant Signature: Page of