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APPLICATION FOR CE4'TiF1CAT£ OF APPROPRIAT18RM <br />"ISToRlo PRosgAVATI+R#i CWISSIOX OF sOM, REND AND BT. JOSEPH CO4JNTY i <br />R001� 123 COUnT-CITY ILDC. IDUTH MEND, IN 46601 (219 293.9748 <br />pato: /f 12/99 owner's No'me:, s los Cmunt E gency Management <br />703 Portage Ave. Mailing Address ,714 jhtaa 5t, <br />Address of. 5 A 2� <br />LA <br />Pro arty : . fir(4�ey,i�ettireen-Fo�taoge°Xve & Leeian <br />I � <br />pasignations Historical Telephone: 2i9� 5.9 4 <br />0 54R I�.TiON OF PR Outdoor warning system. Siren tynp-_ Tn hE used <br />tSo ornadowgrain ,z Thi overage <br />fur Bili✓ 000u + ated a tv <br />[] continuation Sheet - [] Addendum to•Cartifiaats <br />The following information as applicable to the particular situation and the <br />atandards designated shall alsd be submitted as part of this application: <br />Structural drawinoa and spocifioatIOAa, or aite-Plan, fl,4ar` <br />plane, elevations, anoas section plana, renderings, diagrams, or <br />other such plane. <br />Landscaping plana. <br />I <br />X Contractor specifications. <br />Photographs. <br />-- where the proposed project includes a sign, a scale drawing showing <br />the location o}' the sigh on the structure,or property, the type of <br />lettering. snd,thA method of illumination. <br />other_au'ch InforWallon as the Historic Preservation Comeiss.ion may, <br />rsquiro under the provisions of the toning Ordinance of the city of <br />South Band or the $%..Joseph County zoning ordinance, as applicablA. <br />The filing of this application shall be accompanied by a fee of three <br />dollars (53.00), payable to the Niatoric Praservation-Coamission to cover <br />thi►• is incurred in reviawino and processing this Application. [] <br />2 <br />-12 <br />icant's s,i9n tura Applicant's Printed Nance r <br />FOR OFF ICE UWW�, . _..., I <br />_ COMPLETEC APPLICATION MAUVLfs (enta): {CASE #I <br />REVIEW ANO DE.CISIoN OF THE HiSTORiO PAtSERVATION =MMISSIONt _ <br />REVIEW: (} In-kind Replacement {] Appropriate [] inappropriate <br />Continan r. a , - <br />O Continuation Sheet U Addendum <br />oecls16n: [] Approved (] Oenied (} Partial Approval Dates <br />Comments: , <br />Historid Preservation coamission <br />j}Qtica to Aoolicgnt:l ApprdVal of your application anti issuance of a <br />CartifiCato of Appropriatanes+, in no way aignifies compliance with health, <br />safety or general building!:oning standards. Neither doom it release or <br />ra)iava you from compliance with all codas and regulations of the City of <br />South send, U. Jomaph County, or the State'of Indiana. Ths.cammia*t*n ex- <br />pressly disclaims any liability resulting frau skfety or health defects in <br />any atructure•tor which a Car tificats of Ap�roprristsn#sa has boon Issued. <br />0, <br />Apprvv4al of your applicationexpires six months from the (RECISION data. <br />For projects not vubantially campletad, contact "PC for renewals. <br />