Laserfiche WebLink
HISTORIC PRESERVATION COMMISSION OF SOUTH BEND AND ST. JOSEPH COUNTY <br />Councy-City Building, South Bend, IN 46601 <br />http://www.soutbbendin.gov/govemment/department/community-investm.ent Phone: 574/235.9371 Fax: 574/235.9021 Email: hpcsbsjc@southben.din.gov <br />TUDOlb.y S. Klu.sczinski, President A Cedified.Local Govemmeotof1he NatiooaJ ParkSemce Elicia Feasel, ffistoric Preservation <br />Administrator APPLICATION FORA-CERTIFICATE OF APPROPRIATENESS <br />OFFICE USE ONLJ'>»>»DO NOT COMPLETE ANY .ENTRIBS CONTAINED IN THIS BOX««<<OFFICE USE ONLY <br />Date Received: -------Application Number: ___ _ <br />PutRffiews: (DateofLastRevielfl) _________ _ <br />Staff Approval authoriud by: ___________________ rrtte: ________ _ <br />Historic Preservation Commission Review Date: ________________________ _ D Local Landmark D Local Historic District (Name) _____________ _□NationalLandmark □National Regi.Rt.erDlltrict(Na1112J ____________ _ <br />Certillcate Of App�riateoea1: LJ Denied □ Tabled D Sent To Committee D Approved and issued: ______ _ <br />Address of Property for proposed work: 516 S Michigan Ave South Bend IN 46601 <br />(Street Number-Street Name-City-Zip) <br />NameofPmpertyOwner(s)� Brian Sheely Phone#: 219-309-3842 <br />Add.rasofPropertyOwner(s): 18902 S. us 421 La Crosse IN 46348 <br />(Street Nwnber-Street Name-C�Zip) <br />NameofContractor(s): _____________________ Phone#: _______ _ <br />ContractorCompanyName: ------------------------------- <br />Address of Contractor Company: ____________________________ _ (Street Nwnber---Street Nam�Zip) <br />Current UseofBu.ilding: _V_a_ca_n_t __________________________ _ (Single FamilJ-Mu/ti-Fami/y--Ccmmercial-GovernmenJ-lndustrial-Vac:ant-etc.) <br />Type ofBuJJding Construction: _B_r_ic_k ___________________________ _ <br />Proposed Work: EJ In-Kind <br />(more than one box may be checked) <br />(Wood Frame-Brick-Stone-Steel-Concrete-Other) EJ Landscape EJ New EJ Rep]Bcemeot (notin-kiml} D Demolition <br />Description of Proposed Wor k: Rerepair roof, repair windows, repair brickwork, Install new <br />exterior lighting <br />Owner e-mail: brianjsheely@gmail. and/or-Contractor-c-mail; ____________ _ <br />and/or X _________________ _ Signature of Contractor <br />By oigning thi• oppliG11tio11 I dgrcG lo llhidc by 111110c41 tcguuttiOM rclatcd lo-proja:t a11d to obtain 11 Building Dcparttllcnt Penni!, if applicablc. <br />-APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE- <br />4/28/2020 2020 0515 <br />X <br />X 5/15/2020 <br />** Additional project elements detailed in approval discussed and agreed to via Microsoft Teams meeting on 5/15/2020