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TOWN OF SOUTH WItVDSOR
INLAND WETLANDS AND WATER COURSE
APPLICATION
E�RECEIVED BY THE \\
.INLAND WETLANDS AGENCY ACTION THIS APPLICATION SHALL B
INLAND WETLANDS AGENCY AT THE REGULAR-
LY SCHEDULED MEETING ON THE SECOND MON-
APPLICATION NO. DAY OF THE MONTH AT THE TOWN HALL.
RECEIVED. DATE-_- �e THIS APPLICATION MUST BE FILED IN TRIPLICATE
- PUBLIC HEARING DATE AT THE OFFICE OF THE TOWN CLERK TOWN OF
(if necessary) SOUTH WINDSOR, AT LEAST TEN DAYS PRIOR TO
COMPLETED APPLICATION THE REGULAR MEETING DATE
' a''o per»�T/�FsCg65A PERMIT GRANTED DATEAr +%s i�.,mc=?/��/A A SET OF PLANS MUST BE SUBMITTED"
TO THE
TOWN ENGINEER AT (.EAST TEN DAYPRIOR TO
PERMIT DENIED DATE THE REGULAR MEETING DATE,
PLEASE PRINT.
1, APPLICANT Elva Kibbe TEL, NO.
` ADDRESS 770 Burnham St. CITY & STATE 'Smith Windcnr, ('
. ann`
2, OWNER— Same as abovg TEL. NO.
ADDRESS CITY & STATE
3. LOCATION OF PROPERTY Northerly side of Burnham St.
+ NAMES OF ADJACENT PROPERTY OWNERS Hartford Electric Light Co. ,
Sar h Ridi'n Elv Kibbe E el .n F. Johnson and Richard & Elva J. Kibbe
STATE CLEARLY AND BRIEFLY
5. PURPOSES AND DESCRIPTION OF THE PROPOSED ACTIVITY,AND THE TIME ELEMENT INVOLVED:
No activity proposed in limits of-inland-wetlands
ATTENTION: THE APPLICANT UNDERSTANDS THAT THIS APPLICATION IS TO BE CONSIDERED
-� COMPLETE ONLY WHEN ALL. INFORMATION & DOCUMENTS REQUIRED BY THE
AGENCY HAVE BEEN SUBMITTED.
APPROVAL MAY ALSO BE NECESSARY FROM THE+PLANNING AND ZONING COM-
^� MISSION
AND
�1rwAniv�
- NPTTv!' �'1'YRf67L'PS71�TrtT
AN APPLICATION FEEIS REQUIRED. C?)NSULT THE REGULATIONS.
A SIG,N IS R, rtUTlRED, CONSULT THE REGULATIONS.
SIGNED:
(Applicant)
I�Ai1�R ►ia1,,, �� (Owner)