HomeMy WebLinkAboutB3-2079 HKY FIRE RPT -1-30-04.PDF)>
HICKORY FIRE DEPARTMENTR�r 0
it Prevention Bureau
Phone: (828) 321-1522 Fax: (828) 323-7476 y
kjotm, Us ard WAWAGM t9WOWN FIRE INSPECTION REPORT
Date
Occupant
Address
e Phone No.
Type of Occupancy sped r
Type of inspection: Initial Inspection 2'Roo'e-lngpecti,on Other
Inspection Status: Approved V Temporary Approval
No. of Violations: Re -Inspection Date:
Name of Occupant: 10 I--
1-1�., Title:
(Please Print)
Occupant Signature:
101, 1 -7-
Disapproved
Re -Inspection Fee:
(Please Print)
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