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4 <br /> SIGNATURES OF APPLICANT <br /> PROPERTY OWNER(APPLICANT) WITNESS <br /> COMPANY Orange County NAME <br /> SIGNATURE SIGNATURE <br /> ADDRESS P.O. Box 8181 ADDRESS <br /> Hillsborough, NC 27278 Phone No. 919.245.2628 <br /> AUTHORIZED AGENT WITNESS <br /> COMPANY Grounded Engineering NAME <br /> SIGNATURE SIGNATURE <br /> ADDRESS P.O. Box 37132 ADDRESS <br /> Raleigh, NC 27627 Phone No. 919.438.3694 <br /> APPROVALS <br /> APPLICATION RECEIVED BY DISTRICT ENGINEER <br /> SIGNATURE DATE <br /> APPLICATION APPROVED BY LOCAL GOVERNMENTAL AUTHORITY(when required) <br /> SIGNATURE TITLE DATE <br /> APPLICATION APPROVED BY NCDOT <br /> SIGNATURE TITLE DATE <br /> INSPECTION BY NCDOT <br /> SIGNATURE TITLE DATE <br /> COMMENTS: <br /> The proposed driveway is a temporary construction entrance to be used during the duration of the construction. It has been <br /> located in the corridor for the existing right-of-way that has been dedicated for a future roadway extension. <br />