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7 <br />~-~~ <br />North Carolina Department of Transportation ~;~~~ ~ ~~ .. <br />Division of Highways <br />Petition for Road Addition ~~~ Q $ 7~~~ <br />N. t;. t: <f. t:f' TtfirlF?dk)ft)f~! <br />C~utSdOW C~ i'{t~i~fAYS <br />FACT 1- GRA4 <br />ROADWAY INFORMATION: (Please Print/Type) ~" <br />County: (~.[~,~~JG-~ Road Name: l LJ! /y Pr Nis L~}~/~ <br />(Please Est additional street names and leng3hs on the back of this forrn.) <br />4, D~` <br />Subdivision Name: ~//tl~~ •/'YJOtt/y! /`~'/N Length (nines): ~~y',n,% <br />0.~5 <br />Number of occupied homes having street frontage: -`/ f~RE~"" Location ~; !~S <br />20?Z <br />mites miles N [~ S ^ E ^ W'~j of the intersection of Route ~_ and Route ~a-lA~~ <br />(Check one) (SR, NC, US) (SR, NC, US) <br />We, the undersigned, being property owners aad~a~-deeps of ; 1 lc~~~ ~iN~S ~!~F rn <br />p~{~-~,L County, do hereby reques# the Division of Highways to add the above described road. <br />CONTACT PERSON: Name and Address of First Petitioner. (Please PrinUType) <br />Name: ~~bv ro.r~ ~ Y1 f 15-F,'~e. -Phone Number: ~ t ~/~S~ -C0~7~ <br />T <br />Street Address: ~ o~ l ~ { (.J r'r'1 ' ~i it ~eS ~ n~ ~ r'ana e, C~ ~fn~~!~ /~C <br />PROPERTY OWNERS <br />Mailing Address: <br />Sr7~.t ~ ; 'c.c.1; n (J; n ~ S oca n ~~ ~- u r 1-0~,~+~ , NG a 7 dos`-- ~'~i~ <br />Telephone <br />Name <br />Mailing Address <br />~/ <br />~ i G~J~~ ~ net /-Grr ~ <br />4~~17g <br />~~c~rba~-t NG x.7705 <br />~~ <br />Form SR-1 {1/2001} <br />