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7173 ref <br /> North Carolina Department of Transportatio <br /> Division of Highways <br /> Petition for Road Addition DEC p q 2013 <br /> NC",, Dent. of Transportation <br /> 7th Div. <br /> Divisio Graham <br /> ROADWAY INFORMATION: (Please Print/Type) Dis"'GL 1 <br /> County: ® -{f/ Road Name: p-)4,./ v%/c. C OV iC' <br /> (Please list additional street names and lengths on the back of this form.) <br /> Subdivision Name: 77-1E j� ' V Length (miles): <br /> Number of occupied homes having street frontage: Located (miles): <br /> miles NOSE! E ❑ W❑ of the intersection of Route and Route <br /> (Check one) (SR,NC,US) (SR,NC,US) <br /> We, the undersigned, bein a property own- and/or developers of /Qy S 77 . Cook-7 in <br /> c -'V -� 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: 3 E g-tiN&e" / Phone Number: 9/9-93 - 94/67 <br /> Street Address: /06 ,thLiN 5 0.174V <br /> Mailing Address: /t6 4:306.04.S" !24 /, c-1- ALL /LL N 7S72 <br /> PROPERTY OWNERS <br /> Mailing Address Telephone <br /> !a�i v-A A_sEs'T iL ( T a lei gb if 0 Z.Se <br /> Pck <br /> QVAZ‘.2,`, Z13 /00 M AV6PC .� 91 C/ (07) -51' 2.2 <br /> t rig �r � �-�� qt (q q vi -71270 <br /> IA ;f k4j siet <br /> Form SR-1 (3/2006; Rev 1/2010) <br />