Laserfiche WebLink
Application <br />-FOR - <br />CerHficate of Appropriateness <br />Historic Preservation Commission of South Bend do St. Joseph County <br />125 S. Lafayette Blvd, South Bend, lndiana 46601 <br />Mailing A. Countylity Building, South Bend, ludic" 46601 <br />-Phone. 574-235-9M • Fax 574 -235JM • EmaIL' hisWc@Mkhtanaotg <br />WebsIte: http: / /community kk ian&org /hlsw&/ <br />A Certified Local Government <br />OFFICE USE ONLY-- Do MT COMPLETE ANY ENZE CoNTArrN_ ED rN IMS BOX » -- OFFICE USE ONLY <br />Date Received Application Number---- - <br />Past Reviews: [] YFS (Oabq(rad septa) n NO <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date. <br />F1 Local Landmark E] Local Historic District avow) <br />National Landmark ❑ National Register District swine) <br />Certificate of Appropriateness: <br />Denied []Tabled ❑ Sent To Committee [] Approved and issued <br />DIVE <br />Address of Property for proposed work: 16 E Wd_�) n.P 34 <br />Stied Number and Stmt Name <br />Name of Property Owner(s): (Please P _ ( i ; A&, L ( j <br />Address of Property Owner(s): b LB E- vtUn �) A S <br />Contractors) Name: PEA t^_ t: c K Cry . scr: - Pe Cc C O C k <br />Contract Company Name Pe a c e c k � Cr . <br />Contractor Address: KS UU A le w A <br />City: S o CL 6-e Phone: `-1 f�Q __4 4 0 91 <br />Current Use of Building: A ( i <br />(5in�e Fe" - Multi -Famdl Commercial - Covernmad - Indrutritl - Vacant - etc) <br />Type of Building Construction: <br />(Wood Faire - Br.•ck- Stone - Sted - Canute- Other) <br />Proposed Work: [3 - kind F] Landscape ffNew [ (rain - hind) [] Demolition <br />(morn than one b= mgbt chedW) <br />Description of Proposed Work: Q ' (� _(D t.0 i r1 J , 4 0 0 ¢ In � f h vi <br />d L' tt�i i( ��'fr'eS GI0. SSiL <br />vY1 /A {-r ln�� Q 1- �it tY� hP f ��a i (� F Cl l� m ••� ti� e S-e 2 v� <br />�tclla: �-+>"� -],> r 1ng.�,p 1Jnt,� � i ��ln� ved ;�� ac1`I _ �Vn <br />k r a p c TD h r i ( L — r, L v s cib I c r n r 1 *.e - J <br />OwnedContractor. Fix- �i "7— (� sl c/ e-mail L 14R (f 60 i u S b • Pct u <br />Vh ir vffi-- 9="rvondu;th one drs we) <br />A !ice and/or Pis kE� t°`f <br />Signature of Owner Signature of Contractor <br />— APPLICA7TOM,REQWRB412MARELISTM ONREVERSESIDC — IA • - Doo A- (-1-e_ <br />