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Application <br />- FOR - <br />Certificate of Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 46601 <br />;Viailing Address: County -City Building, South Bend, Indiana 46601 <br />Phone: 574-35-9798 - Fax: 574-235-9578 • Email: SBSJCHPC9co.st-joseph.in.us <br />Website: http://%,i�w.stjosephcounhindiana.com/s chp/index.htrnl <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY ENTRIES CONTIINED IN THIS BOX »»» OFFICE USE ONLY <br />Date Received IS� V? 0V 6 Application Number oZ U D 6 - 06 /S <br />Past Reviews: ❑ YES (Date o.f Ltst Review) n NO <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date: <br />�ocal Landmark F� Local Historic District (.unnte) <br />❑ National Landmark F� National Register District (.vante) <br />Certificate of Appropriateness: <br />Denied F-1 Tabled n Sent To Committee ❑ Approved and Issued <br />DATE <br />Address of Property for proposed work: I O ^� �✓ 1 i C t�C n <br />Street � :unberanrd Street Name � �O:J gc'_�/ �/V <br />Mame of Property Owner(s): (Please Print) (Jrb' a o Fn �e r p r/�i .r p A SSor_ . 0 <br />Address of Property Owner (s): I1 D J C U un �y - e t h v 45) C . 1)-7 iJ, ^)e -f 1zrjon . S. icy ( 1 <br />Contractor(s) Name: _l. osL.J,!L <br />Contract Company Name: -n,5'„j�1� <br />Contractor Address: 1 S W e s ie r n tJ 2 6 0 <br />� // / ,. J <br />City: � iy m � �� �� s J �'V S�� � Phone: � 9C% 3 .5 :S <br />Current Use of Building. VA W,1 -Y Or S4!, b .i [ ) r S c-1) S SdL , <br />(Single Family — Multi-F:nnilrt — C0m??1,'J7l — Gorernme :t — Industrial—V.acara — etc.) <br />Type of Building Construction: �-�r G <br />(Lt gat Fr:nne — Brick — Stone — St -1— Concrete — Otl:er) <br />Proposed Work: r_1 In-kind ] Landscape ] New )(Replacement (not in-k:r:d) I Demolition <br />(more tlum one box wart be checked) <br />Description of Proposed Work: Wnr K �o <br />I�yL'S i <br />