The permit shall be in substantially the following form:
TAX PERMIT
County of ___________ Permit Number ___________________________________
State of North Carolina Date of Issuance __________________________________
Permission is hereby granted to: ____________________________________________
(Name & address of owner)
______________________________________________________________________
(Name & address of carrier)
to remove the following described mobile home:
______________________________________________________________________
(Make, model, size, serial number, etc.)
From: ______________________________________________________________________
(Address)
To: ______________________________________________________________________
(Address)
This permit is issued in accordance with the provisions of G.S. 105-316.1 through G.S. 105-316.8 of the General Statutes of North Carolina.
(Signed) _____________________________________
Tax Collector
(or Deputy Tax Collector)
County of _____________________________