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Application <br />-FOR - <br />Ced 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 -City Building, South Bend, Lndiana 46601 <br />Phone: 574-235-9798 • Fax 574235-578 Email• SWCHPCOM-st josephinus <br />Website IMV//wwwsgomphco gwidiana.com/sjdtp/mcL-x.hbW <br />OFFICE USE ONLY»»> -DO NOT COMPLETE ANYENTRIES CONpIINID IN THIS BOX »»» OFFICE USE ONLY <br />Date Received 3 7LW ?-0O 8 Application Number— � � - /W 3 <br />Past Reviews: ❑ YES (ante a f test xealew) <br />Staff Approval authorized by: <br />❑ NO <br />Title: <br />Historic Commission Review Date: r% X40- WOO 8 <br />❑ local landmark ® Local Historic District (Now) ILL <br />❑ National Landmark ® National Register District (Name) <br />Certificate of Appropriateness: <br />❑ Denied ❑ Thbled ❑ Sent Tb Committee ❑ Approved and Issued <br />DATE <br />Address of Property for proposed work: r734 f ARILAVE . <br />-�-• Street Number and Street Name <br />Name of Property Owner(s): (Mase hint) .I aN(� E i',ARga SN�iMAn� <br />Address of Property Owner(s): ' e734 PARK ,AVE . <br />Contractor(s) Name: 'PRO (p►•lq'-Mtx'_" iaJ <br />Contract Company Name: <br />Contractor Address: 11003 L WIELANh VMS M <br />City:SCGOLR Phone: <br />Current Use of Building: 5746 LE rAM't(.1 <br />(Single Family- Multi-Family-Commirdal - Government -Industrial - Vacant- etc.) <br />Type of Building Construction: W0013 FfZAMe <br />(Wood Frame - Brid - Stone - Steel - Cmaete- Other) <br />Proposed Work: ❑ In-kind ❑ Landscape gNew ❑ Replacement (not in-kind) . P<Demolition <br />(mai than one bar may be chodked) ^- <br />Description of Proposed Work: TgWI i RW CSF F%19T 1AJ 6 11 Y,20 C � <br />NE.W ZZ x20 GA9665 <br />Owner. ontractor. Fax: (.S'14) 14) 04- Z831 e-mail ti 1 USWT.t-R? k)'• rr'm <br />(reds o& Tnll arrespondToth only am&gnee) <br />and/or - <br />— APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE — <br />