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~m NORTH CAROLINA STATE DEPARTHENT OF TRANSPORTATION <br />~:: DIVISION OF HIGHWAYS PETITION <br />im.. North Carolina <br />"-'- County of ~ ~",~ ~ <br /> <br /> Petition request for {check one) Addition to State System (~,~ <br /> Paving ( ) <br /> Haintenance Improvement ( ) <br /> <br /> k'e the undersigned, being all of the property o~ners on <br /> m (Describe or give local <br /> name.or Secondary Road Number~ in ~'~,r~ County do hereby request the <br /> Division of Highways of the Department of Transportation to <br /> m the above described road. <br /> We further advise that the road requested to Y~ -~xY is <br /> m in length and at the present time there are ~, occupied homes located on <br /> the road and having entrances into the road. <br /> <br /> ~v.~FiQ~lly, we agree to dedicate to the Division of Highways a right-of-way <br /> m sixt~ (~/6) feet in width extending the entire length of the road that is requested <br /> to be improved along with the necessary areas for cut and fill slopes and drainage. <br /> Also, we agree to dedicate additional right-of-way in the public road intersections <br /> m for 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 /> in order that the Division of Highways fulfill the requirements of Chapter 1~44, <br /> m 195g Session of the General Assembly of North Carolina. <br /> <br /> RE(.IARKS <br /> m Two copies of recorded subdivision plat enclosed if applicable <br /> ! <br /> <br /> PROP[RI¥ O~NI:RS <br /> m NA~IE ADDRESS <br /> <br /> m The Division of Highways should contact the first petitioner listed below: <br /> <br />! <br /> <br /> ! <br /> Revised Form SR-1 {6-78) All previous forms obsolete <br /> <br />! <br /> <br /> <br />