HomeMy WebLinkAboutApplication Files_83610_pg0016 TOWN OF SOUTH WINDSOR
STAFF SITE CHANGE
FOR SITE & SUBDIVISION
CHANGE ORDER CONTACT PERSON Mgt Phone No. ef,90-6 yj•2,I4'
Address 2ev Siy *Ie jir// A?rj oo4< 1�/in� yr . 4d 01607V
Site Name Joe ohs Wrir cm-S j ;„lcA Ar // P&Z No. �/1- l o f
Owner ,_ � �,� Week. Phone No. ��b•�� ��Y9
Contractor 7'Zo oo f ,
Signature of Owner 1 Ae,,oate: /I
Signature of Design Engr. .�� a,. ,, �VA•, Date: Aof 90 .1.*/1
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CHANGE: (Describe location and nature of change. Include
Four (4) copies of plan/profile of Change. )
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Or
Reason for Change: (Why is change required)
APPROVALS: (As Req fired);
Dir. Of Planning -`6rt Date: )7 /,) ! ( /
Town Engineer 9 titi J t Date:
Dir. of Public W`rks Date:
Other: Date:
STAFF COMMENTS:
White - Town Engineer Yellow - Applicant
Pink - Director of Planning Goldenrod - Engineering Department