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Application <br />for - <br />Certfflicate of Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />227 West Jefferson Blvd - South Bend IN 46601-1830 <br />Phone: 219-235-9798 Fax: 219-235.9578 e-mail: Mstoric@niic ana.org <br />A Certified Local Government <br />OFFICE USSEE ONLY>»»>DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX«««OFFICE USE ONLY <br />Date Received / — 20 Oe,, Application Number: 20q ol0(7 <br />Past Reviews: ❑ YES (DATEOFLASTREVIEln ❑ NO <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date: —1200-2- <br />0 <br />20020 Local Landmark ONational Landmark <br />❑ National Register District Qv.,): <br />❑ Local Historic District (Name): <br />lertificate of Appropriateness: <br />❑ Denied ❑Tabled Sent To Committee <br />❑ Approved and issued 20 <br />Address of Property for proposed work: 1 lv O 1 5�R . 3 3 1 <br />Street Number m d Street Nome) <br />city: Owner's Phone No: 21 R - 25&- O 5Z'Z <br />Name of Property Owner(s):(PRmT) -H1 o 1 -Aa S `2u Pa r-4 <br />Address of Property Owner • &14001 S 331 kwkV-A IN 4toS 4+ <br />Contractor(s) Name: A Cei i1I'ii-%io n #o,nc, be),arJ G' o r- 1 Grua �� c� <br />