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NORTH CAROLINA STATE DEPARTMENT OF TRANSPORTATION <br /> DIVISION OF HIGHWAYS PETITION <br /> <br />North Carolina <br />County of <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 ~}~/~C~-C~S'/ <br /> <br /> (Describe or give local name or <br /> Secondary Road Number} in ~.'q~Kw~ y County do herebylre~uest the <br /> Division of Highways of the Department of Transportation to <br /> the above-described road. <br /> We further advise that the road requested to ~d~c] is o~ miles <br /> in length and at the present time there are ~L 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 ~ ~ o r (~ ~.~m~ ~y ~ <br /> <br /> Four copies of recorded subdivision plat enclosed if applicable <br /> <br /> ,, <br /> ~ ~'T~)~ PROPERTY OWNERS <br /> <br />NAME MAILING ADDRESS TELEPHONE <br /> <br />The Division of Highways should contact the first petitioner listed below: <br /> <br />-- Revised Fo~ SR-1 (5-83) All previous forms obsolete <br /> <br /> <br />