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-�, 40 <br />z <br />Application <br />- for - _ <br />CertirIcate ofAppropriateness <br />III II , Historic Preservation Commission of South Bend & St. Joseph County <br />tses 227 West Jefferson Blvd - RM 1123 - South Bend IN 46601 -1830 <br />Phone: 219 - 235 - 9798 Fax: 2 19 - 235 - 9578 a - mail: historick(Smichianaorg . <br />A Certified Local Government <br />OF"Cr t=ONLri » » >DO NOT COMPLETE ANY ENTRUS CONTAINED IN THIS BOXKr<e<OFF/CE USE ONLY <br />Date Received 200p Application Number. 2006- 0410A <br />Past Reviews: YES ' (am>oFUsraenM NO <br />Zoning Type: Lot Sin <br />Staff Approval authorized by: Titir. <br />Historic Commission Review Date: I cjl.�jOle-t!aooj <br />❑ Local Landmark National Landmark' <br />❑National Register District pao <br />B — Local Historic District p&.): <br />Certificate of Appropriateness: <br />Denied El Tabled Sent To Committee <br />❑ Approved and issued 20 <br />Address of Property for proposed work: <br />City: South Bend <br />Name of Property Owner(s):,r mn <br />Address of Property Owner: <br />Contractors) Name: T B A <br />Contract Company Nani6 T B A <br />1061 Riverside Drive <br />Jbe.rMr.en..eYSraNsy . <br />Township: Portage <br />Mark Beudert <br />1061 Riverside Drive <br />I <br />Contractor Address: TBA City: <br />Contractor's Phone No: T B A A Owner's Phone No: .541-912-5267 <br />Current Use of Building: Single Family Residence <br />O tleFomdy- Mnkl -F*W&- Commas (ot -Gomm wiff- lndroMd.Vemi -eft <br />Type of Building Construction: Wood Frame <br />(Wood Fame - Brick - Suone - Sued - Concrete - 01aw) <br />Proposed Work- [3 Inkind E] Landscape ® New Replaeement(,btbtkatq <br />(wore thm one bas wry be che&4 <br />Demolition (Completion of Severate Form Also Reouired) <br />Description of Proposed Work: Removal of one dead tree. Construction of <br />new attic gable on react of house with in kind matdrtAls to match <br />existing house as depicted in attached drawings. <br />Architect, STUDIO B ARCHITECTS, LLC <br />Fax: 282 -2994 1 e - mail: crumlishb @aol.com <br />(Ihlsofllce only ot�Jeddneel <br />t -, - <br />S nature otOiittdld( A r c h i t e c t C Signature of Contractor <br />APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE. <br />Any and all business of this office is handled via e - ma il and f,,, with lead preference to U.% Mail <br />