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Welcome to the City of Roxboro, NC, Action Line

Today is Saturday, November 21, 2009.
Pool Registration

Purpose. use this form to request Pool Permit.

* Information is required.

Contact Information

* First Name:
* Last Name:
Business Name:
Email:
* Daytime Phone: (
* Address:
* City:
* State:
* ZIP:

* Type of Pool
Above Ground
In Ground
Wading Pool
 
* Size of pool
 
* Capacity
 
* Fill
Hydrant (metered)
Hydrant (unmetered)
Garden Hose)
 
Meter reading
 
Date of Fill
 
Date of Refill
 
* Form completed by
 
Are you in City Limits?
 
* do you have a security fence?
yes
no
 
Check here to have email confirmation of this request sent.

* Information is required.

Notes:

If you send us a message, you'll receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Information we receive may be considered public information which is subject to disclosure under current state law. Learn more about our Privacy Policy.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.

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