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NORTH CAROLINA DEPARTMENT OF TRANSPORTATION <br />PETITION FOR ROAD, ADDITION <br /> FORM' SR-1 KEVISED 1-9 <br /> <br />ROADWAY INFORMATION: (Please Print) <br />County: C~a~ ~ VY~..5' RoadName: <br /> ' (Please lisradditioaal'stre~t names andqengths on ~e back of this form.) <br />Subdivision Name: ~_?~H'/'C.L~ /7~21.5-ff~/7.]~ ~],~f'e~ L~ngth(miles): t' <br /> <br />N umber of occupied homes having street frontage: <br />Location: miles N S ~_~W of the intersection ofR:oute ./~O~,/~J,~Je-~5'~t/d ~'~-~d Route <br /> (ci~lc one) ' ($R, NC or US} (SR. NC or US} <br /> <br /> ~ c] ~)~ r ~- ~..5 County, do hereby request the Division of Highways to add the above described road. <br /> <br />NAME <br /> /, <br /> <br />CONTACT PERSON: Name and A. ddress of First Petitioner. (Please Print). <br /> <br />Mail~gAddress: d.O~ ~., ~ / <br /> 'PROPERTY OWNERS <br /> ~IL~G ADD.SS <br /> <br /> qaoo <br /> <br />TELEPHONE <br /> <br /> <br />