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7 <br />~~• <br />1 F "• " ~ ~)4~1'~ <br />NORTH CAROLINA DEPARTMENT OF TRANSPORTATION •~ ' <br />PETITION FOR ROAD ADDITION tt~ ~,• . <br />FORM SR-I REVISED 1-9 ~7~ ~ ~ ~:if;l`ri,. <br />Gig?itii;.i ~~~~r`:iiAfVi <br />1R®A.D_VYA1' i1VFORMATION: (Please Print} <br />County: r~~~~~/~ ~ RoadName• dY~~~~7 c~~~~..5~~~~G~/~ ~~.,.L~/,.~ <br />(Please list-a-d*ditiona~ street names and Lengths on the back of this form.) ~,+ <br />Subdivision Name: , t~}~~~y ",,~G%~~ tw,~~~G~ ~'~ ~ Length (miles): ~ /~~~ ~~~ <br />Number of occupied homes having street frontage: . /Y ~~~~ <br />Location: ~..~ rr~'~~-~ , `~~~s N S E r~f the intersection of Route !~ and Route <.~! :~ d j~~~ ~ /(. <br />( (Circle one) {SR, NC or US) {SR, NC or S) <br />We, the undersigned, being property owners and/or developer of ~~~~/'E / ~'~f ~~~~'~~~~ in <br />('m;r ; ~;,~'rjf/ ~ Lj' ~ k County, do hereby request the Division of Highways to add the above described road. <br />CONTACT PERSON: Name and~,Apddress ofjF~irst Petitioner. {Please Print) ~j' / ~• f <br />Name: r-~-'^~~~ ~~C~' ~M /Y -1 L'~~ ~i Phone N,_u,~m/ber: ,-l~t '.~,~~~~r,' ' _';J ~/ <br />Street Address: ! • ~~Ca> ~ ~..'~. ~,` Grrr. `c.._.C C e~f.Q' ° '"!`f ~'~ ~ ~/ ~ d• ~f~~ <br />Mailing Address: <br />PROPERTY OWNERS <br />NAME MAILING ADDRESS TELEPHONE <br />.yh . <br />