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North Carolina Department of Transportati r .a ; <br /> Division of Highways <br /> Y,' ,,F" <br /> Petition for Road Addition v,, i-;, `• f' <br /> Divi-lon : ri;,,,;,.:; <br /> ROADWAY INFORMATION: (Please Print/Type) (rl�""`L �< a �1tY1 <br /> County: 0 R Cf Road Name: U/7 8 R 10 L1k/5 <br /> (Please list additional street names and lengths on the back of this form.) <br /> Subdivision Name: 71-i-& - RES E RV E Length (miles): <br /> Number of occupied homes having street frontage: Located (miles): <br /> miles N ❑ S ❑ E ❑ W ❑ of the intersection of Route and Route . <br /> (Check one) (SR,NC,US) (SR,NC,US) <br /> We, the undersigned, being +roperty owners :nd/or developers of jjjn,3 A/O &Myr in <br /> 0 RIM/6-C- County, do hereby request the Division of Highways to add the above described road. <br /> CONTACT PERSON: Name and Address of First Petitioner.(Please Print/Type) <br /> Name: ,,,,/ V,VE7`7- /.. C°- Phone Number: q/9—q2, — 7457. <br /> Street Address: /£ L A zoh 1 <br /> Mailing Address: /05 60L/4/ G04-}4 � ; io L -/-1,L , /ti - X75/7 <br /> PROPERTY OWNERS <br /> Name Mailing Address Telephone <br /> NV-C \\NelV Sol VA 'vt‘\ 1 GI qA y o :1 9 9 -c j;a `-1-1 401 <br /> TI7 /—,'Vi=e ,.... ..._ ' 4 ' ' - °,I-.. ..�,1% f%ir 1/4-- 1� ? <br /> 4 [ <br /> r' jj (] jj <br /> ._ '1 i ;A. . t .1` 44 17 ri-r, LN W'C bl a_,_1 ■ ,j ' '' >!!' ,..173 3 <br /> st <br /> Form SR-1 (3/2006; Rev 1/2010) <br />