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013 <br />North Carolina Department of Transportation <br />Division of Highways <br />Petition for Road Addition <br />ROADWAY INFORMATION (Please Pdntaype) <br />County: Le c, Road Name: <br />(F%ase Yst aWWnal street nwnes and largths on the back of this tam.) <br />Subdivision Name: L V l e- ) aGV - es � �_1L Length (4e# `) I t) <br />Number of occupied homes having street frontage: 19 Located (miles): <br />miles N [$[ S ❑ E ❑ W ❑ of the intersection of Route S 1532- and Route 5JZ 15 <br />(Check ate) (SR NC, US) (SR NC, US) <br />We, the undersigned, being property owners and /or developers of b (X 1 e h c* CS in <br />(✓ County, do hereby request the Division of Highways to add the above described road. <br />CONTACT PERSON Name and Address of First Peddo (Please Pdntrrype) <br />Name: K i Cl/xe Co-fSo!1 Phone Number. <br />Street Address: ID- Aya ss. , .s p � . S r1 t' / ,�)� � - 7 3 3 Z <br />Mailing Address: San► o-- <br />PROPERTY OWN ERS <br />Name Mailina Address Telephone <br />Form SR -1 (3/2008; Rev 1/2010) <br />