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NORTH CAROLINA DEPARTMENT OF TRANSPORTATION' <br /> PETITION FOR ROAD ADDITION 31~RT~NT 0~ r~AnsPO~T~no.~ <br /> FORM SR-1 REVISED 1-9 '- DISTRICT ENG~NE£1~ <br /> DIVISION lO <br /> <br />ROADWAY INFORMATION: (Please Print) <br /> <br /> ' (Please list additional str~ names and lenglhs on the back oft~is form.) <br />SubdivisionName: ./~,d/~/~ t.Y OAf .~ ~ ~ I~ 5 Length(miles): <br />Number of occupied homes having sn'eet fi-ontage: [ ~ <br /> <br />Location: ~ . ~ milesN S E~)oftheintersectionofRoute fl//ff Y 3 andRoute <br /> (Ckele one) (SR, NC or US) (SIL NC or <br />We, *,he tmdersigned, being property owners and/or developer of .4~, ~/'?/~' ( q~AJ,/~l. ~. /~ ,~- in <br /> ff~ ,4-.~ ~4 t~ r~ cd 'ff County, do hereby request the Division of Highways to add the above described road. <br /> <br />CONTACT PERSON: Name and Address of First Petitioner. (Please Print) <br />Name: /L/, ~?/ <br /> <br />S~'eet Address: <br /> <br />Mailing Address: <br /> <br />PROPERTY OWNERS <br /> <br />NAME MAILING ADDRESS TELEPHONE <br /> <br /> - (.~ ~ ~ .... <br /> <br /> <br />