Laserfiche WebLink
Application <br />- <br />FOR- <br />Certificate of Appropriateness <br />Historic Preservation Commission of South Bend & SL Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 46601 <br />Mailing Address: County -City Building, South Bend, Indiana 46601 <br />.Phone: 574-235-9-98 • Fax: 574-235-9578 • Email: historic'@micl- an .org <br />Website: http-.//communitymichiana.org/historic/ <br />A Certified Local Government <br />OFFICE USE ONLY>�»» DO NOT COMPLETE ANY ENTRIES CON_AY,F) IN THIS BOX >y»» OFFICE LYSE ONL' <br />Date Received SDI o`i' 2,- `' S Application NumberA 0 0 3 . Q (Do, -4 <br />Past Reviews: ❑ YES (Date ofLrst Review) <br />Staff Approval authorized by: <br />❑ NO <br />Title: <br />Historic Commission Review Date: W - / b - ROO 3 <br />❑ Local Landmark Local Historic District (Name) 7C W AT�t2. <br />❑ National Landmark National Register District (Name) <br />Certificate of Appropriateness - <br />0 Denied ❑ Tabled ❑ Sent To Committee ❑ Approved and Issued <br />DATE <br />Address of Property for proposed work: S09 FDE1%4-7_]�c4//7' <br />Street Number and Street Name <br />Name of Property Owner(s): (Please Print) . ' '10-4UE W10fet-67- <br />Address of Property Owner(s): J� `� Le'[7CiFWA► �t <br />Contractor(s) Name: SFI-F I9ZPoRruE0 <br />Contract Company Name: <br />Contractor Address: <br />City:- - , Phone: <br />Current Use of Building: 5riLD6tr.F FAwlt-1 <br />(Single Family - Multi -Family - Commercial - Government - Industrid - Vacant - etc.) <br />Type of Building Construction: oNc 1?►4ut"r✓Aa WgLcf< rRal-toj IV15C- `,&05C�,uII <br />ll Wood Frame — Brick - Stone - Steel - Concrete - Other) <br />Proposed Work: ❑ In-kind � Landscape ❑ New Replacement (rot in-kind) ❑ Demolii <br />(more than one box rm y be checked) <br />Desc*ipti:�n of Proposed Work: �r <br />