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Application <br />- for - <br />Certificate of Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 South Lafayette Boulevard <br />Mailing address: 227 West Jefferson Blvd - South Bend IN 46601-1830 <br />Phone: 214-235-4798 Fax: 219-235-4578 a -mail: sasaCHPC0mstjaep1LIn.us <br />Webslte:http://www.stjostpbcountyindLaniLconilsjchpAndel.htw <br />A Certified Local Government <br />0Bu:* use only»»>DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX>»OFFICE USE ONLY <br />Date Received f? Z ' .2-q 2006 <br />Put Reviews: ❑ YES (DATE OFL(.trhEVIEA} <br />Staff Approval authorized by: <br />Application Number: 2006- oL2_,4 - 01 <br />0 NO <br />Title: <br />Historic Commission Review Date: <br />❑ Local Landmark National Landmark <br />National Register District ov—): Ch� �tk <br />Local Historic District (N—,): <br />Certificate of Appropriateness: <br />❑ <br />Denied <br />❑ <br />Tabled <br />Sent To Committee <br />Approved and issued <br />2006 <br />Address of Property for proposed work: FoJS rlF <br />(^ Suer Nu.der o.dSsex Nave) <br />City : t 9cJ'ZL',44- 8F-02� Owner's Phone No: q— "i <br />Name of Property OWner(S):lr;uNn f%�,x-- S s-�✓� <br />Address of Property Owner ; -7-2-t &F*4,o,,r-;t rtsa- E 6 i <br />Contractor(s) Name: f2,40 -- ( rNo S KL <br />Contract Company Name: <br />Contractor Address: city: &Avb,�rsx- <br />Contractor's Phone No: V7 5 - <br />Current Use of Building: J (.sJC,t.L F,�4 kAL—' `t' <br />(Suigle Family-Mu/n-Family-Comm.,dal-Oovarnmant- industrial - Vacant - de. <br />Type of Building Construction: t t--C,i' C�> f-Ak - <br />(Wood Fraena-Stial -Stora. Siad. Conost. • Orhar) <br />Proposed Work: ❑ lnkind ❑ Landscape New ❑ Replacement(n«in-sindl <br />(mar than ane bac may be ch.atad) <br />❑ Demolition <br />t s <br />Description of Proposed Work: �DC (Z! T�5hjZ AbbITLosj <br />h % rbc <br />/4- AECJC W jQF. &X� <br />�ADDt-rtva) WLi` I�t�A7-�- �y�ts-n.JGa S(DwCo ) <br />Feu, XMC.& uxt-4 . ac- -orb Sly- XG l�t�tit -r1a-=4rzD ;PA-Y.weo, <br />40D �>,t- \ 4 j�+� n E nn ruvr' c�et.`i� svy ,At VV- Of Y i• -t . n _die[ <br />Owner/Contractor: Fax: , tj J mail. j <br />(. h" afar Mli 00lpond Mlth only one d—j-,) <br />&!ar � <br />Signature of Owner bignature of Contractor <br />