Laserfiche WebLink
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 />Mailing Address: County -City Building, South Bend, Indiana 46601 <br />Phone: 574-235-9798 • Fax: 574-235-9578 Email: SBSJCHPC@co.st joseph.in.us <br />Website: http://www.sqosephcounVindiana.com/sjchp/index.htual <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANYENTRIES COMPUNED IN THIS BOX » — OFFICE USE OArLY <br />Date Received _ Z0o 7 - Application Number oZ 00 % _ 40,fd G 6, <br />Past Reviews: F� YES (Date of last Review) NO <br />Staff Approval authorized by: <br />Title: <br />Historic Commission Review Date: oZO &240 a0-0 7 <br />[] Local Landmark ['Local Historic District (Name) �eJ <br />National Landmark F_� National Register District (Name) <br />Certificate of Appropriateness: <br />Denied E] Tabled [-] Sent To Committee Ej Approved and Issued <br />DATE <br />Address of Property for proposed work: <br />Street Number and Street Name <br />Name of Property Owner(s): (Please Print) 1►��C - <br />Address of Property Owner(s): �. X. t �� arA—MA IM, Z4&'1Qq <br />Contractor(s) Name: --tom ITh=a.1 (-t F1,—=r5 -Pn- 7 <br />Contract Company Name: <br />Contractor Address: <br />City: Phone: <br />Current Use of Building: ) ,Prltfi' <br />(Single Family -Multi-Fainily- Commercial - Government -Industrial—Vacant - etc.) --- -- - --- — - <br />Type of Building Construction: lbca-) T:�.Pd_4e <br />(Wood Frame - Brick - Stone - Steel - Concrete - Other) <br />Proposed Work: In-kind ❑ Landscape R New F1 Replacement (not in -land) _ Q Demolition <br />(more than one box may be checked) <br />Description of Proposed Work: 'P 7-cfa i f 4011 <br />Owner/Contractor: Fax -3Q - I FT ( e-mail G Vk nr.(uklc .(Y-0-4 <br />(This office will correspond with onlyone designee) <br />and/or I 7kt ii `tel <br />— APPLICATION REQUIREMENTS ARE LISTED ON P.EVERSE SIDE — <br />