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9�0 <br />JUL 1 31017 <br />North Carolina Department of Transportation N.C. Dept. of Transportation <br />Division of Highways Division of Highways - 7th Div. <br />Petition for Road Addition District 1- Graham <br />ROADWAY INFORMATION: (Please Printrrype) <br />County: OCAtIQ Road Name: �0 (am <br />(Pfease Ist additional street names and lengths on the back of this form.) <br />Subdivision Name: �QO� � 0-Agm Length (miles): IL IS V <br />Number of occupied homes having street frontage: Located (miles): 4600, 1.25 m; <br />miles N [./ 5 ❑ E ❑ W ❑ of the intersection of Route US 7p and Route � $$ <br />(Check one) (SR, NC, US) (SR, US) <br />We, the undersigned, being property owners and/or developers of ayC t4 &gn WaJS- PI.3 in <br />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: Cro��e�( LI�D(.CS;n� Phone Number: <br />7M -!5%, - ftZZ <br />Street Address: 5712 Jorr"Ii ' L-(.. I>Nkao%. KX, Z7765 - -... f <br />Mailing Address: 0& ,Lt _ <br />PROPERTY OWNERS <br />Name Mailing Address Telephone <br />©Tt'0- 0 N pi <br />Form SR -1 (312006; Rev 1 /2010) <br />