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$20.00Receipt1No <br /> 0/7/06562319 <br /> 61:'"4% HISTORIC PRESERVATION COMMISSION <br /> 6 Ilik OF SOUTH BEND AND ST.JOSEPH COUNTY <br /> �� wee County—City Building,South Bend,IN 46601 <br /> 'e '�_ — http://www.southbendin.gov/government/department/community-investment <br /> .-,446"..W% Phone:574/235.9371 Fax:574/235.9021 <br /> e65 Email:hpcsbsjc@southbendin.gov <br /> A Certified Local Government of the National Pant Service Elicia Feasel,Historic Preservation <br /> Administrator <br /> APPLICATION FOR A—CERTIFICATE OF APPROPRIATENESS <br /> OFFI(E USE ONLY'»»>DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX«««OFFICE USE ONLY <br /> Date Receied: 10/7/19 Application Number: 2019 1007A <br /> — <br /> Past Review 0 YES (Date of Last Review) 0 NO <br /> Staff Approval authorized by: Title: <br /> Historic Prservation Commission Review Date: 10/21/19 <br /> © Local Landmark ❑ Local Historic District(Name) <br /> ❑ National Landmark ❑ National Register District(Name) <br /> Certificate CO Appro riateness: <br /> Denied ❑Tabled ❑Sent To Committee ❑ Approved and issued: <br /> Address ofProperty for proposed work: 60649 Hickory Road South Bend IN 46614 <br /> (Street Number—Street Name—City—Zip) <br /> Name of Property Owner(s): Ben and Carrie Modlin Phone ii: (574) 340-5674 <br /> Address olProperty Owner(s): 60649 Hickory Road South Bend IN 46614 <br /> (Street Number—Street Name—City--Zip) <br /> Name of Gotractor(s): Self Phone#: <br /> Contracts Company Name: <br /> Address olContractor Company: <br /> (Street Number—Street Name—City--Zip) <br /> Current Lie of Building: Single Family <br /> (Single Family—Multi-Family—Commercial—Government—Industrial—Vacant—etc) <br /> Type of Bidding Construction: Wood Frame <br /> (Wood Frame—Brick--Stone—Steel—Concrete—tither) <br /> Proposed Work: (more than one ❑Landscape ❑ New El Replacement(not in-kind) Demolition <br /> box may b checked) <br /> Removal at decayed existing siding,animal feces,bat habitat exclusion,beehives,mold,waterlogged and damaged matenal,removal of wet <br /> Descriptim of Proposed Work: <br /> cellulose insutdm from within the wall cavity.Installation et new fiberglass ball insulation,new exterior grade sheathing,tyvek house wrap,new fleshings,new Ceted Celrlar Composite PVC Wood <br /> simulated sidinand architectural him material Cansuuction methods to follow the manufacturer's written specifications.Please see supporting documentation. <br /> Owner a-.ail: modlincarrie@gmail.com_ and/or Contractor e-mail: coachmodlin@gmail.com <br /> X and/or X <br /> Signaturwf Owner Signature of Contractor <br /> By signing this application I agree to abide by all local regulations related to project and to obtain a Building Department Permit.if applicable <br /> —APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE— <br />