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NORTH CAROLINA STATE DEPARTMENT OF TRANSPORTATION <br /> DIVIS:ON OF HIGHWAYS PETITION <br /> <br />North Carolina, _ <br />County of ,_ ~~/,L <br /> <br />Petition request for (check one) <br /> <br />Addition to State System <br /> <br />Paving ( ) <br />Maintenance I~rovement ( ) <br /> <br /> We the undersigned, being property .owners on <br />~dF~c~ LFi((~, (lj~, ~F~:~C~ ~L,' (~scrlb~ oF give local na~ mot <br />Seconda~ Road N~er) In ~Jj~'~ .. County do h[r~ request the <br />Otviston of Highways of the ~part~nt of Tr~spor~tion <br />the above-~scr~bed mad. <br /> ~ fu~her advise that the mad requesterS..~ ~s ~ ~ 'miles <br />in length and at the present ti~ there are /~ occupied ho~s l~te~ on <br />the mad and having entrances into the mad, . <br /> <br /> Finally, we agree to dedicate to the Division of Highways a right-of-way of <br />the necessary width to construct the road to the minimum construction standards' <br />required by the Division of Highways. This right-of-way will extend the entire <br />length of the road that is requested to be improved and will include the necessary' <br />areas outside the right-of-way for cut and fill slopes and'drainage. Also, we <br />agree to dedicate additional right-of-way in the public mad. intersections for'., <br />sight distance and design purposes and to execute said right-of-way agreement. <br />forms that will be submitted to us by representatives of the Division of Highways. <br /> <br />REMARKS <br /> <br />Four copies of recorded subdivision plat enclosed if applicable <br /> <br /> PROPERTY OWNERS <br /> NAME MAILING ADDRESS TELEPHONE <br /> <br />The Otviston of Highways should contact the first petttionee ltsted below: <br /> <br /> ....' <br /> <br />Revised Form SR-1 (5-83) All previous fov~6 obsolete <br /> <br /> <br />