HomeMy WebLinkAboutApplication Files_85051_pg0158 TOWN OF SOUTH WINDSOR
STAFF SITE CHANGE
FOR SITE & SUBDIVISION
CHANGE ORDER CONTACT PERSON /0 Th rye a Phone No. 141 `' A,it
Address S >>f J
Site Name f/,dam S d, ..,•'F , P&Z No.
Owners v i ��d 4` Phone No { c s, -7
Contractor
Signature of Owner r Date:
Signature of Design gr. Date:
CHANGE: (Describe loc on and na ure of change. Include
Four (4) copies of plan/prof ile ofC/hange. )
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Reason for Change: (Why is change required)
APPROVALS: (As Requiredj
Dir.. Of Planning t�'!' (-�.. (Y_ Date:
Town Engineer--- 4 -t'- / _. -? ` �,� .,�r Date:
Dir. of Public Wo�rks Date:
Other: Date:
STAFF COMMENTS:
White - Town Engineer' Yellow Applicant
Pink - Directdx of Planning Goldenrod - Engineering Department