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APPENDIX 3 ~ APPLICATION FOR INFORMATION FORM ~ FS/QAP 7.6.1-23 - FORM 3
Emergency Services Department
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toodquarre Jol Governnent Avenue and Beckl Steet | ead | 0083 °
I 'Po'cts0| ren anos Toor 30 216 | Fax 0F2 SB 2308 es
a faeabook cami of Tenwand aa
APPLIGRTION:- srrene suse ze wee "7
CRS ae
R
TSHWANE _ INFORMATIONICERTIFICATE/PERMIT
ERM iGinliod_ Oe More _ ior LANA
-76287_apply for documentation towards the folowing.
chackrlevantasstcaion. «= [1]
res ARIF
Fire Safety Compliance Later xl ars
“Tadng Lisnee oo Rave
Fire Report (House, Flats & Oubuldings) Oo Ro76
Fireworks Display ol et
Five Water Rotation Test per Hyrant [rot Anoanterryano Test ROP
1200
Evacuation Dills & Evacuation Plans
oO
Fie investigations (Others) o
TOTAL
‘rading Name/Building NameiPhysieal address
‘ave Liion
eds Ta 012-358-9510
ra sarying@shwone.so¥-9
y__12029
Bate of Appication
=
=a tis icoarer an be aided wnnotor cial aneuene
For Ofte
- Doparternent Noodlonats > Lefapia a tat tsa TabonyeieS
tanaye = Uintiyange weetzo eaboKo
goro ya Ditto wa TAhogsny
nacowuto yh Vonohaxet bya tamglrmnangh » Uinsango Wosemictbons!Ephut
‘Brargenoy Servese Departent
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