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m <br /> NORTH CAROLINA ~TATE DEPARTMENT OF TPJ~NSPORTATION <br /> DIVISION OF HIGHWAYS PETITION <br /> <br />tiorth Carolin~ <br />County of ~~ <br />Petition request 'for (check one) Addition to State System (v~ <br /> Paving ( ) <br /> Maintenance Improvement ( ) <br /> <br /> We the undersigned, being all of the property owners on ~a#~ ~ . <br /> {Describe or give local <br />name or Secondary Road Number) in 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 <br />sixty (60) 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 />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 1244, <br />1959. Session of the General Assembly of North Carolina. <br /> <br /> REMARKS <br /> <br />Two coPies of recorded subdivision plat enclosed if applicable <br /> <br /> PROPERTY OWNERS <br /> NAME ADDRESS <br /> <br />The Division of Highways should Contact the first petitioner listed below: <br /> <br /> " - <br /> <br />Revised Fo~ SR[I_~-Z~II previous foms obsolete <br /> <br /> <br />