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Application <br />- for - <br />Certificate 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: historic@michiana.org <br />A Certified Local Government <br />OFFICE USE ONLY>»»>DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX«««OFFICE USE ONLY <br />Date Received eP245Y7-Z :y—,/7 20 _ Application Number. 20(gR- O 15//7 <br />Past Reviews: ❑ YES (ruTEOFL,STREVIEIM ❑ NO <br />Staff Approval authorized by: <br />Title: <br />Historic Commission Review Date: <br />❑ Local Landmark ❑ National Landmark <br />❑ National Register District N—): <br />Local Historic District (N—.): <br />Certificate of Appropriateness: <br />❑ Denied ❑ Tabled <br />❑ Approved and issued <br />20 <br />❑ Sent To Committee <br />Address of Property for proposed work: Iv 1) R I ue$4 �A,A .bl-u <br />Sven N1eaber and Srw Naw <br />City: 5c,. -d\ Owner's Phone No: ).Y3-4) 5 r1 <br />Name of Property OWner(S):(PRINn 6W1 �- ICF �A) ilu"I GAps EI lE tCA1t\1,rP) <br />Address of Property Owner: I o U- DOIE `ru--T11, IkP,D W yl -.t(6 <br />l <br />Contractor(s) Name: "C u.,w I ( A'e'",u r: n Pro �,Jk G 'J <br />Contract Company Name: � 4 v.p (( (.ones k' k 2ud <br />t <br />Contractor Address: 27-399 lac-f'n,,, t R, t City: —L11- n i,>-1,10 <br />Contractor's Phone No: J71,1,71ct� Ids ircvZy��"' ° <br />Current Use of Building: ;&".,L, yti,�I <br />(SLWleFamily-Ho/G-F"dy-Co nodal-Go—mew -Industrial- Vacant -tic. <br />Type of Building Construction: 5{v«a <br />(Wood Frame -Brick - St�on(e-Stsd - Corrode- Othe ) <br />Proposed Work: ❑ Inkind El Landscape [J New ❑ Replacement(natin-kid) <br />(more than one box may be clucked) <br />❑ Demolition ''II <br />Description of Proposed Work: Q <br />Iu Inof/avC <br />Owner/Contractor: Fa:: e-mail: <br />(This offin r+ll rorresyond with only one drag eJ - <br />IA -W, -f— '& . <br />Signature of Owner Signature of Contractor <br />APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE. <br />