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INSTRUCTIONS FOR COMPLETING PETITION: <br />1. Complete Information Section <br />2- Identify Contact Person (This person serves as spokesperson for petitioner(s)). <br />3. Attach four (4) copies of recorded subdivision plat or property deeds, which refer to candidate road. <br />4. Adjoining property owners and/or the developer may submit a petition. Subdivision roads with prior <br />NCDOT review and approval only require the developer's signature. <br />5. If submitted by the developer, encroachment agreements from all utilities located within the right of <br />way shall be submitted with the petition for Road addition. However, construction plans may not be <br />required at this time. <br />6. Submit to District Engineer's Office. <br />FOR NCDOT USE ONLY: Please check the appropriate block <br />❑ Rural Road [I Subdivision platted prior to October 1, 1975 [�] Subdivision platted after September 30, 1975 <br />REQUIREMENTS FOR ADDITION <br />If this road meets the requirements necessary for addition, we agree to grant the Department <br />of Transportation a right -of -way of the necessary width to construct the road to the minimum <br />construction standards of the NCDOT. The right -of -way will extend the entire length of the <br />road that is requested to be added to the state maintained system and will include the <br />necessary areas outside of the right - or-way for cut and fill slopes and drainage. Also, we <br />agree to dedicate additional right -of -way at intersections for sight distance and design <br />purposes and execute said right- or-way agreement forms that will be submitted to us by <br />representatives of the NCDOT. The right- or-way shall be cleared at no expense to the <br />NCDOT, which includes the removal of utilities, fences, other obstructions, eta <br />General Statute 136 -102.6 (see page 29 for Statute) states that any subdivision recorded on or <br />after October 1, 1975, must be built in accordance with NCDOT standards in order to be <br />eligible for addition to the State Road System. <br />ROAD NAME <br />Form SR -1 (3/2006) <br />ROAD NAME <br />R] <br />