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NORTH CAROLINA STATE DEPARTMENT OF TRANSPORTATION <br /> DIVISION OF HIGHWAYS PETITION <br /> <br />North Carolina~ <br />County of ... ~L~v~S <br /> <br />Petition request for (check one) <br /> <br />Addition to State System <br />Paving ( ) <br />Maintenance Improvement <br /> <br /> We the undersigned, being property owners on /7~:d~/~-~Y <br /> (Describe or give local name or <br />Secondary Ro~d Number} in (_]~_~y County do hereby.request the <br />Division of Highways of the Department of Transportation to . <br />the above-described road. <br /> <br /> We further advise that the road requested to ~ is · ).~ miles <br />in length and at the present time there are ~ occupied homes located on <br />the road and having entrances into the road. <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 road 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 /> c"T ' .: .;,=. ) <br /> <br /> ~ 9 ~ ~}t~f~.~.. PROPERTY OWNERS <br /> <br />NAME MAILING ADDRESS TELEPHONE <br /> <br />The Division of Highways should contact the first petitioner listed below: <br /> <br /> ~ :, .: z .~ ~ - -~ . _ <br /> ?.,:. ',>'(. : , . <br /> <br />Revised Form SR-1 (5-83) All previous forms obsolete <br /> <br /> <br />