HomeMy WebLinkAboutApplication Files_85051_pg0156 TOWN OF SOUTH WINDSOR
STAFF SITE CHANGE
FOR SITE & SUBDIVISION
CHANGE ORDER CONTACT PERSON T Phone No.�
Addressb2 �Cai'h Ph ce G7. s—
Site Name pFFi P&Z No.
Owner +01ct0 1 O'zFjz r ne No.JU• feif d(xGJ
Contractor -AL c.0,&
---- - - -- - -
Signature of Owner A' Date: '
Signature of Design Engr. Date:
CHANGE: (Describe location and nature of change. Include
Four (4) copies of plan/profile of Change. )
A.!
Reason for Change: (Why is change required)
16
APPROVALS: (As Required)
Dir. Of Planning Date:—
Town Engineer Date:
Dir. of Public Works Date:
Other: Date:
STAFF COMMENTS:
W %J1 TAI V I M LW.
White - Town Engineer Yellow - Applicant
Pink - Director of Planning Goldenrod - Engineering Department