APPENDIX A

APPENDIX A

TO: THE PLANNING COMMISSION: DATE: ________________

DEPARTMENT OF PUBLIC WORKS:

ROAD INSPECTOR:

The applicant ____________________________________________________________

hereby requests the City of Norwalk to accept the following as a city-owned street: ________________________________________________________________________________________________________________________________________________

s/s ________________________

CITY CLERK

THE COMMON COUNCIL OF THE CITY OF NORWALK: DATE:____________

The Planning Commission hereby recommends that ______________________________

___________________________________ (BE ACCEPTED) - (NOT BE ACCEPTED) by the City at this time for the following reasons: ________________________________

________________________________________________________________________

s/s _______________________

DIRECTOR OF PLANNING

TO: THE COMMON COUNCIL OF THE CITY OF NORWALK: DATE: ___________

The Department of Public Works hereby recommends that _________________________

___________________________________ (BE ACCEPTED) - (NOT BE ACCEPTED) by the City at this time for the following reasons: ________________________________

________________________________________________________________________

s/s ____________________________

PUBLIC WORKS COMMISSIONER

TO: THE COMMON COUNCIL OF THE CITY OF NORWALK: DATE: ___________

The Road Inspector hereby recommends that ___________________________________

___________________________________ (BE ACCEPTED) - (NOT BE ACCEPTED) by the City at this time for the following reasons: ________________________________

________________________________________________________________________

s/s ______________________

PLANNING ENGINEER