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Application <br />WtLOk <br />$ u rtf - for - <br />1`0Il;ii1.rrg�� Cenifcate of Appropriateness <br />'riC o <br />� o <br />~ _ Hlstnrie Pttiscrvatlon Commission ofSouth Bend &St.Joseph County <br />tans 227 West]eff=on S vd- RM 1123—South Bend IN 46601-1530 <br />Phaft:219-233-9798 Fax; 219.2,45-9578 o-meit:hkto&@tniclti:.anaorg <br />A Certiiled Local Government <br />OFFICEWCONS-+»>DONOT C.OMPLE7F,AM'!9h7RFCSCONTAINED iNTHIS BQYcc?<-<V,-FICZ=E4nr <br />DrkPYctei�ed S 20 0g.. AppurAlkaflux1ber: <br />Fast Rexlme: Q YES (WrECV L srft-W0 <br />Zoning TypC 1 aCSizr 604, .r / i�_o <br />StaCALpprotal aariemiaed byr Title: <br />}d:rros=•eCs+nmltsivsAc►kwDant: .�`" fir —,zoo -2— <br />Q)local t.taadmrrk a Nad*W L=drawk <br />QNaffraal 1 g■te: District vw—s <br />Certifieate arARp/nprioi_____tzzmt <br />Daoted Tabled Q Scat To Conunluee <br />/.ppt tried sad 20 <br />Address of 1.1ope3ty For prepW d work 132- • W^yK — <br />s,.. �+.re.•as•n•ra.e <br />City . Sa Vth S&*,%a Township: <br />Name of PropertyOvrner(s).,.m Tnvin ^mA Tc* -1 f_:-mmS <br />t <br />Address of property 0.ner : 1:3,fZ( F_ U1 e"m a Sj. S . <br />Contractor(s) Name, U V V_r%0 W N ^+ 't -MS 4 rkC (-3/4/4-Z) <br />Contma CompturyName: <br />Contractor Address City: <br />Contracizes Ptmne No; Owner's Phone No: <br />Current Use ofBullding: S)Mlel7WVb►(V <br />Type of BuildingCaastraclion.- 436V-1GiC 1WV0A "TY7►rr»� <br />t7l:.•LFirsv-F✓&i • St•.•-J/M. t.Y-ur+ac -Dac) <br />propowed Vt'arl:: � Inl lnd D I.sndscape ® New Replucetnentaa:.A,�o <br />Frwetsn• w-e8ar ss"pr& ei•atet} <br />DeM011ti0o (Comm rtldh of Srorrate Fero Also limaired) <br />De naiption of Propos2d'Worla � ` ;+,p y A-ut iiDVt <br />4dv'�t W i Mtoti t a►cGo ingot rl itCc1 <br />.. kl�tol <br />r. Fig::. b-rxa1L• <br />St;aaia'IeofOxt>;a• ✓ 5ignatarcofCcatraciac <br />APPLICATION MQUIRi?MMS ARE UST—ED ON REVERSE SIDE. <br />.iry and r, j1 bs+siesess a. this office is ban& d via e-mail and far. with lit prrfmmm re MV may <br />