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NA~E CF.,RE DIS~R,CT /~,-,~/.-...,/2 cOUNT',' ~'.~
<br /> DISTRICT IS SERVED BY ~~/ //~ FIRE DEPARTMENT
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<br /> M ad To The Nm'th (:al'olJlla ~l ale P~lmrl mull( Ct 111SUIqkll(:t% P. 0. I{ox ~(;:{~7. Rah,i~h, N. C.
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<br /> NORTH ,CAROLINA :' '
<br /> ~:;~;' REPORT OF FIRE CONDITIONS
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<br /> TOTlll.; ' '' ' ' '
<br /> COMM]SSi0N~R ct, INSURANC~
<br /> Raleigh, N: C.
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<br /> As required by seetion 1 ]8-9 or the Generul Slalules ct North Carolina. I. A o{lilor o~said Counly
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<br /> FIRE I)I,:PARTMI~NT INI~ORMATION
<br /> ~,.~ 8ei, t. ,~.,'~,,,,,~ ............ ~g ..................... ~,,, Th,,.. ......................................... Vo~,,,t~,-......~ ...............
<br /> Nh. I".D. l louses or S{ations ............. ~ ................. No. Pumpers ....... ~ .......................No. Tankers ....._~ ...............
<br /> No. Oth'~r 8p~dial Purpose Vehicles ........ ~ ................................................... Total Co's ..............................
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<br /> .................................. Hydrants ............................... Combination ...~J ................
<br /> Type
<br /> Water
<br /> Sul)Jl]y:
<br /> Mobile
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<br /> LOCAL FII{I,3MEN'S I[EI~IEF FUND
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<br /> off' eno~sReleflt da omcdhyI'n'el)epartment[two] ......................................................
<br /> .....~-~¢~....~,,,.~ ........................ ~. M,'. _.4~,~/~ ~.~/,,. ..................................................
<br /> I
<br /> Mr.
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<br /> N im~es of TruMees of Fh'emen's Relief Fund appoinled by the Cou it.' C~o n n ssio~ ers [two) ......................................
<br /> :~. ~r. .......... ~,~/~..../~,~Z ........................................ ~. ~.,,.. .~../~..~.: ~( .........................................
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<br /> Treasurer of Firemen's ~{elief rlllld Numher. 1 2 3 ,I 5 Above(encircle which)
<br /> ts you · F ire Department a member of the North Carolina State Firemen's Asseciution? ..~.~.d.
<br /> NORTIt CAR01,1NA
<br /> .................................................. Couaty
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<br />,, . ........................... Audito~TFinance officer of ....................................................................
<br /> County, N. C. do hereby certify that the foregoing is a true, fail, and correct report of the Fire Department and fire
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<br /> conditions of ............................................ Rural Pire District.
<br />:~' Under Section 118-9 of the (;enerul Statutes of North Carolilm.
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<br />; Sworn to and sobseribed befor~ mt,, this .......................................... dlkv of ........................................... 19 ............
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<br /> [8EALI
<br /> NOTIg: This report can not be aceepled unless sw~}rn to before Nit 'y or other officer with 8cai.
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