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Application <br />-POR - <br />Historic Preser /ation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 46E01 <br />ii4ai A ddrem: County -pity Budding, South Bend, Indiana 46601 <br />Phone: 5 J Fax 574 - 235.957$ • Email: SBSJCi:PC@rn.st joseph.in.us <br />yVei7site: http:/ Jwwwst3osephcouratyindiana .com /*.hp /index.html <br />DfF3CE USE ONLY » 33O IVOT »» COMPLE tlNY ENI'RTgS CflP1MLY£D IM TT3IS ROX {3FfTCs^ USE . <br />OML <br />Date Received .'S � W7 Application Number qf a D 7 _ 0 SOS' <br />Past Reviews: CRIES (Date of Lut Rniew) <br />NO <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date: <br />FLLocal Landmark Local Historic District (Name) <br />National Landmark National Register District (Name) <br />Certificate of Appropriateness: <br />Denied []Tabled <br />r <br />�] Sent To Committee l] Approved and Issued <br />DATE <br />Address of Property for proposed work: 1114 Lin n 1 nw v West <br />Stmt Number and Street Name <br />Name of: petitioner :(PteasePrint) Code Enfo cem ent <br />Address of petitioner 227 W Jefferson Blvd Rm 1300 <br />Contractor(s) Name: Pelley Excavating <br />Contract Company Name: <br />Contractor address: 1990 Progressive Dr <br />City: Niles, MI Phone: 269 - 681 -9947 <br />Current Use of Building: band n Romp <br />(Single Family - Multi- Family - Commercial - Government - Industrial - Vacant - etc.) <br />Type of Building 'Construction: T.7nn.4 V_0_. <br />(Wood Frame - Brick - Stone - Steel - Concrete - Other) <br />Proposed Work: ❑ In - ✓kind ❑ Landscape [] New C] Replacement ( not in - kind) ® Demolition <br />(;Wore than one bnc rmy be checrad) <br />Description of Proposed Work: Demolish all structures, fill, topsoil & seed <br />Pet it ioner'Corjractor: Pax: 574 - 235 -7703 e -mail ctoppel @southbendin, eov <br />((;r5 it +u�rsprorIIi xith anty one aesian ' <br />�f r• � <br />atherine Toppel J �-' and/or <br />C <br />— ,APPIir i ON -PlQU RF_.'i'IE_NtTS,.LU US= <br />