HomeMy WebLinkAboutApplication Files_85048_pg0393 TOWN OF SOUTH WINDSOR
STAFF SITE CHANGE
FOR SITE & SUBDIVISION
GENERAL:
CHANGE ORDER CONTACT PERSON
Address— 1�e
Phone No. j:�t.�j �51 �.
Site Name ! -
Owner P&Z
l-:-. i L L Phone No.
Contractor l - ;t' ( - j c T�i c'
Signature of Owner
f` Date:
..4,,Signature of Design Engr.lr` ,
r, q, Date:__
CHANGE: (Describe location and nature of change. Include
Four (a) copies of plan/profile of Change. )
G yr ft�r-P r/ SLityr� F f
S ie/i vi
Reason for Change: (Why is change required)
APPROVALS: (As Req ed)
Dir. Of Planning
Bate: —_—
Town Engineer
Date:
Dir. cf Public Works
Other: Dater
STAFF COMMENTS: Date:
White - sown Engineer Yellow
- AUiJlic�nt
Pink - Director of Planning Goldenrod
Engineering Department