Laserfiche WebLink
1 <br />f <br />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 46% <br />Phone: 574 -235 -9798 • Fax: 574 -235 -9578 • Email: SBSJCHPC ®co.st joseph.inus <br />Website: http: / /www.st osephcountyindiana.com /s chp /index.html <br />OFFICE USE ONLY » »» DO NOT COMPLETE ANY ENTRIES CONT TUNED IN THIS BOX » »» OFFICE USE ONLY <br />Date Received %5,1aA &-e oWl Application Number 0 ?09 - 1 <br />// D�fO� -3 <br />Past Reviews: 524S (Date of Iasi Review / "�`f� "��� [] NO <br />Staff Approval authorized by: <br />Title: <br />Historic Commission Review Date: <br />❑ Local Landmark , cal Historic District (Name) <br />National Landmark F� National Register District (Name) <br />Certificate of Appropriateness: <br />R Denied E] Tabled [] Sent To Committee F] Approved and Issued <br />DATE <br />j <br />Address of Property for proposed work: JQ I q tqHj14j& AV &kx V-e <br />Street Number and Str et Name <br />Name of Property Owner(s) (Please Print) t-tZ -.17LA9e R F i tK Pa a 43�- A/375 <br />Address of Property Owner(s): <br />Contractor(s) Name: -�.�t Vz f ( Fz nc e <br />Contract Company Name: Sc)*1\ <br />Contractor Address: <br />Citv: 5 0 ,4 t'l 6t n Phone: <br />Owner Contractor. Fax: e -mail d • P c� <br />u office will correspond with only one designee) <br />�We, < (, r y n r s i v Le-` 4-o vv et-4 4T%x _ &A (- e . V <br />Proposed Work: ❑ In -kind R Landscape E] New 2,Replacement (not in -kind) Demolition <br />(more than one box may be checked) <br />��G.0 -t? r 'F iti!) OD �GQ t�.l '�L. - $ Gt.�'►�-P . <br />Description of Proposed WQrk /t <br />5NIe. w, �l bP of w ts lel�q <br />Current Use of Building: A <br />(Single Family - Multi Family - Commercial - Government - Industrial - Vacant - etc.) <br />Type of Building Construction: <br />Nood Fr - Brick - Stone - Steel - Concrete - Other) <br />and /or <br />