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7-84 <br /> 112 <br /> ORANGE COUNTY PLANNING DEPARTMENT <br /> HILLSBOROUGH <br /> NORTH CAROLINA. <br /> 27278 <br /> rkECEPAIE <br /> V F711 <br /> izakai LLI) <br /> 17.-JETE--q.--i <br /> caso. <br /> ORANGE COUNTY <br /> PARTICIPATORY PAVING PROGRAM <br /> APPLICATION <br /> 1 .(4e), the undersigned, request that the road(s) referenced below <br /> be paved under the Participatory Paving Program of Orange County. <br /> .STA.L1./AMS 44/4 eqe,44s4/a/5/00 09 <br /> NAME OF ROAD(S) and STATE ROAD NUMBER(S), if applicable, <br /> The spokesperson for this project Is: <br /> (NAME) <br /> (ADDRESS) 17 T,4 j. Al I Aff.0 z3 <br /> G":41,4 73? <br /> (PHONE) 9.Z9-.2/ 9 (w) 5'+:2 -es WV <br /> A current tax map, on which is highlighted the road(s) , or portion <br /> thereof, to be paved under the County PPP program is attached. <br /> gika- 6,174' ee)(,1 4,r,1 <br /> NAME OF APPLICANT SIGNATURE OF APPLICANT <br /> DATE <br /> / 1172,7 <br /> :12.:J <br /> RETURN COMPLETED APPLICATION FORM TO: ORANGE COUNTY PLANNING DEPARTMENT <br /> ATTENTION: SUSAN SMITH <br /> 106 EAST MARGARET LANE <br /> HILLSBOROUGH, NC 27278 <br />