HomeMy WebLinkAboutB4-1741 HKY FIRE RPT 8-19-04.PDFkilwwo HICKORY FIRE DEPARTMENT 0 T,�
A M tkr Fire Prevention Bureau
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FIRE INSPECTION REPORT
Occupant Date
Address f- 7��':7 Phone No.
Type of Occupancy Inspector
Type of Inspection: [2/Initial Inspection El Re -Inspection Other
Comments: -
Inspection Status: Approved _ Temporary Approval Disapproved
No. of Violations: Re -Inspection Date: "9 3 / 6 L"; Re -Inspection Fee:
Name of Occupant �J, �\ �Ck� Title:
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Occupant Signature- Page of