Laserfiche WebLink
Application <br />-for - <br />Certificate of Appropriateness <br />4 <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 South Lafayette Boulevard <br />Mailing address: 227 West Jefferson Blvd - South Bend IN 46601 -1830 <br />Phone: 219 - 235 -9798 Fax: 219- 235 -9578 e-mail: historic@michiana.org <br />A Certified Local Government <br />OFFICE USE ONLri » » >DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX «« «OFFICE USEONLY <br />Date Received <br />2002 <br />Past Reviews: ❑ YES (WHOptwsraeVIES7 <br />StaRApproval authorized by: <br />Historic Commission Review Date: <br />❑ Local Landmark <br />❑ National Register District (ue,w: <br />❑ Local Historic District (,v„ -): <br />Certificate of Appropriateness: <br />Application Number: 2002- <br />❑ NO <br />Title: <br />❑ National Landmark <br />❑ Denied ❑ Tabled ❑ Sent To Committee <br />❑ Approved and Issued 2002 <br />Address of Property for proposed work: atm . <br />�(++ SwaM.ek-ra,dSreNNwd <br />City: JOLF-k ,8?,,k4� � Owner's Phone No: �± <br />Name of Property Owner(s):rrwNn <br />Address of Property Owner: /3 0.1,6/ — C tBtu10r h e <br />Contractor(s) Name: <br />/U //4 V V J <br />Contract Company Name: NM <br />Contractor Address: / V //q City: <br />Contractor's Phone No: /t' 1, <br />Current Use of Building: 1 cwtt <br />(Slnyle F—* -Huib- Family- Commerdel- Covernma-t- Industrial. Vacant -ea <br />Type of Building Construction: Zrl CK <br />(Wood Frame. Brick - Stone -Sled - Conoete- Other) <br />Proposed Work: ❑ Inkind aLandscape ❑ New ❑ Replacement(naa.4i -d) <br />(more than one box may checked) <br />Demolition / .CcZ /V� <br />l�2it�l <br />Description of Proposed Work: /) 0 �`t c2 Se,S7t7S q atZr -' 1-a-z , S <br />11) , - 1) SQ /Gao of a,-AS & 4, Ae use A <br />i l! <br />7i' QcHCr�ctuu assoe�a� i�ct�e�iHgs Qat��c� ��. <br />L 4 T 4 /iSoh op .ass, a:,u:,4 Acs ->�' ar o, 76 .l&4r i;w . - 4/) /uSS Z,,0 ajl h e0,s,,,.�t •ct,l� u t-eJi , 5, p/K Gtttrt�'i a.t.� o,F ...aa�t.,�.e �k-�d . <br />Owner /Contractor: Fax: e-mail: <br />(rho — � o ffice mH eorreepond uuh only one denynee) <br />/dIl!/Q �dL(Jf dN BI�W� P� &for <br />Signatu of Owner SC��t Signature of Contactor <br />APP IC TI ' REQ�UIRE d MENTS ARE LISTED ON REVERSE SIDE. <br />