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NAME OF FIRE DISTRICT ///'~'/? ~L"~ff~'7'''~$''/'~t~'~) COUNTY ~'~'~'$ DISTRICT IS SERVED BY ~?~ ~A~' ~;)~ FIR~ DEPARTmeNT M ail 'I'll The North (;arolina ~lale l)elmi'tlllenl {}~ [.sura.ee, P. O. B.x 2G;I~?. Raleigh, N1 NORTH CAROLINA REPORT Of FIRE CONDITIONS to till,: C0~MI~ION~R oi~ INSURANC~, Ra e ~}, N. C. As required by section 118-9 0f/be Gent.'a~ S~atutes of North (~arolina, I, Auditor of s:dd County do hereby make th, foHowh,g ,.epo~3 on the ~.~t.~...~..(~.~ ...... Rural Fire D~stricL County of ..~.k~ .................. FIRI'~ DEPARTMENT INFOI{MATION No. ?.D. Houses or Slations .......... ~ .................... No. Pumpers ...... ~ ....................... No. Tankers ....l .................. ~,,. o,,~,. S,,~a~ ~'h,-po~ Wb~e~ ........ ~!~Lg.....~e~.~ ........................................... Tot ,~ Co ~ ....... ~ ................... Type Water Supply: Mobile ......... ~. ................... Hydrants ................................ Combination .............................. LOCAL PIREMEN'S RELIEF FUNI) Names of Trastees of P' 'emen's Re 'cf I,'t n ~pp ~'nte( by ~' 'e De ) 'tment (two) ,. ~.,,-.....:~.e.....W~o.~.~ ~ ~. ~ ~.c.~.. ~ooJ~0 .................. Names orTrus~t:es of ~i~'emen's Relief l,~und appointed by the County Commls~ioaers (two) ..................................... :~. ~ ....... ~e.....~.~ ....................................... ,. ~,.. :~~ ........ ~5¢..e,~o .................... Names of Trustee of ~iremen's Relief Fund appointed by Insurance Commiss toner ~one) .......................................... ~ 2 :1 ,1 ~ Above{eneirelewbiehl Treasurer Fb'emen's Relief Pund Number, l~ your l,'b'e Deimrtment a member off the Nerfl} Cai'olina ~tate l,'h'en~ ~n's Association? ............................................ NORTII CAROl, INA .................................................. Cofinty. ....................................................................... Auditor/l~inane~ officer or .................................................................... Counly, N. C. do hereby certify lbnt the ~o~eEoi ~ i~ ~ ~t'tie. full and eom'ecl report o~ the Pire Department and fire eoodit~lms ~ ............................................ Rural Fire District. Under Section 118-~) of the General ~tatutes of North Carnlbm. 8wm'n to and m~bseribed before me. tiffs .......................................... { ~y o~ ............................. 1~ ............ NOTE: This report can not be accel}ted unless sworn' t. bt'fo 'e Notal'31 or other officer with Seal.