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O4'SpLITH d � HISTORIC PRESERVATION COMMISSION <br /> OF SOUTH BEND AND ST. JOSEPH COUNTY <br /> rl ,,E4C, 1 County—City Building,South Bend,IN 46601 <br /> http://%vww.sotithbendin.gov/govemnient/department/community-investment <br /> % 1k <br /> Phone:5741235.9371 Fax:574/235.9021 <br /> ls�s ' Email:hpcsbsjc @southbendin.gov <br /> Timothy S.h IIUCAIISki,President A Certified Local Government of the National Park Service Elicia Feasel,Historic Preservation <br /> Administrator <br /> LOCAL HISTORIC LANDMARK—OWNER CONSENT <br /> I,the undersigned property owner, grant the Historic Preservation Commission of South Bend and St.Joseph <br /> County permission to have the property located at: 1040 W. W1-SN)"qr 7�4T <br /> �Z 7P gW r7, I &A 46 �1 <br /> Declared a Local Historic Landmark tinder ordinance. <br /> I do also approve of the classification of this building under Group B Standards for Local I listoric Landmarks. <br /> Signature of Owner: _ Date: (� <br /> Filed in Clerk's Office <br /> JUL 18 2018 <br /> KAREEMAH FOWLER <br /> CITY CLERK;SOUTH BEND,IN <br />