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Application <br />- FOR - <br />Cert�r' f icate of Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 46601 <br />Mailing Address: County-Gty Buiiding, South Bend, Indiana 46601 <br />Phone: 574-235-97'98 • Fax. 574235-957$ Emai): S95jCHP0@co st joseph1mus <br />Website: http://wwwj§mephcauniyindimuLcom/ochp/hukx html <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY ENTRIES CONTl1'= IN THIS BOX >)-»> OFFICE USE ONLY <br />Date Received oW 'Kaci" 02,00 % Application Number. O Oz <br />Past Reviews: 9& (nrte gjLwt Xrvk,o) <br />Staff Approval authorized by.- <br />Historic <br />y: <br />Historic Commission Review Date: 17 A,.' -ZOO 7 <br />0 Local Landmark ff Local Historic District ov.) <br />National Landmark [] National Register District avow) <br />Certificate of Appropriateness: <br />NO <br />Title: <br />Denied [] Tabled 0 Sent Tb Committee [] Approved and Issued <br />oAss <br />Address of Property for proposed work. t 34 q E_ �e : So,,c(�„r , , ,. Z? N . %G1 I— <br />Stmt Mpm er and Street Nam <br />Name of Property Owner(a): (Pteaae P►tnW . �) j <br />- <br />Address of Property Owners): n,- 5L 2,444 _ , VC t r"" <br />Contractors) Name: �c1J�'�Y1ct�5P�" <br />Contract Company Name: <br />Contractor Address: <br />City. Cs-rss Phone: --;t r7 u - cq 93 <br />Current Use of Building: <br />(ShWUFamay-MulttFandty-Carwmid-cn ernment-Industria!-Voant-etc.) <br />Type of Building Construction: <br />(Wood Frame -Brick -Stan -Stat -Concrete-Other) <br />Proposed Work: ❑ In-kind Landscape [] New 211E�placement (not to -kind) ❑ Demolition <br />(mm a than aye bas maybe dream) -, <br />Description of Proposed Work: o isN i\ urn g, ,) fit.( <br />c� .�,.�1�'s-�'�- 0 l.el c.•c u„) e`�1 �t . te.N�S?�'ex.(�� <br />�,� �.rl� r sent•+-�1` 3— t `' �4j,_u..1 Ll�u, r; �� � -r � . <br />(, L <br />Owner/Contractor: Fax: e_man <br />iTha cfmd trAth ��.�) <br />_ <br />y �X-'`z-f�1 y and/or <br />— APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE — <br />