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A~'+"n.G 41N~~!"F 3 <br />~~s <br />North Carolina Department of Transportation <br />Division of Highways <br />Petition for Road Addition <br />~~P 2 4 2aos <br />9i..i2. DF:3rF. ~fi~~ <br />~Ei~t~1' i - OfiAHAM <br />ROADWAY iNFORMATIUN: (Please PrinUType) ~,q G t ~ FX ~ ~ ~~~~. ~~' i ~ i~r <br />Possv~ t,J,~ { I~ ~ { Tv~ ~ . v,v <br />County: ~,~__ Road Name: ~A~S '~" X43 ~~-. ~~^ ~ c T ~ ~-~'/v4,~ <br />(Please Its? edditionai street n e5 end tenths on theme back et N~- <br />Subdivision Name: t JCgJ~ /~ 1/`/4:~I ~ -~-•:., Length (maesi: ~ , ~ ~ ~ j , <br />Number of occupied .homes having street frontage: ~ LoCa#ed (mugs}: .~ .. ~.~ j~ i~ , <br />!°'~ mi{~ S ^ E ^ W ^ of the intersec#ian of Raute 7rD and Route rn'4~L° <br />(Check ex>Et) (SR, NC, US) (SR, NC, US) <br />We, the undersigned, being property owners and/or.dever fob ers of ~ ~JCAJGf~ ~,q. t ~,c,,,.,., in <br />~~~~ County, do hereby request the. Division of Highways to add the. above described road. <br />CONTACT PERSON: Name and. Address of First Petit'wner. (Please ~rint/rype~ ,~ <br />Name: aJ r~?G-~ ~ . ~A :2T 1!5~.~ Phone Number: , q /~ ^ ~y2 ^ ~g0 Z <br />Street Address: 2, r{"Z, C~-~'S~-(~ f~OG'IC. ~'9-/'rvt <br />Q ~ _ <br />Maiiing Address: t .~ ~ ~~ 0 /'~ 1~ C; ~ x'73 (~,f <br />PROPSRTY OWNERS <br />Name <br />Mailing Address <br />Telephone <br />Z 2~ <br />Form SR-1 (3/2006) <br />