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Application <br />db <br />FOR - <br />CerN f icate of Appipptiateness <br />Historic Preservation Commission of South Bend & St Joseph County <br />125 S, Lafayette Blvd., South Bend, Indiana 46601 <br />MOW AddreW Go M-Uty Bu9I=% South Bend, Indiana 466111 <br />Ph= 574-235-9798 • Fac 574235-91578 • Enud SESJCEiF'C@)MstJoeephinus <br />Website: http://www'.s =p'hcountyindi°na=/*11P/Wdex ata nl ' <br />OFFICE USE ONLY»>>» DO NbT COI iF= ANY ENTRIES CONUMM IN T>�S BOX >»> > OFFTCE USE ONLY <br />Data Received Application Number_A�" t'- <br />Pest Reviews: ❑ YES (mkiyt etRaim) O -NO <br />Staff Approval authorized by: Tale: <br />Historic Commission Review Date: <br />Local Landmark ❑ Local Historic District Wam) <br />[) National Landmark ' ❑ National Register District Ovam) <br />Certificate of Appropriatenemm: <br />[] Denied [:]Tabled Sent To Committee 0 Approved and Issued. DM � <br />Address of Property for proposed work: <br />. Strat Nwnbanut stns Nana � <br />Name of Property Owner(a): (Pioustart) P l `% ,6�' alt mss'' <br />Address of Property Owne(s): a d' .$ + �► �' '�' ' : S I! <br />Contractors) Name: _ L^A/__0 e S <br />Contract Company Nam:7t1 <br />Contractor Address: /V d L. 6C� . M <br />CBy, Phone: <br />Current Use of Building: 11-e t '0 n? `sem <br />(SigkFsw*-Mutt-fir*-CarixwW-G mtnact-ltuIxstrlal-Yaawrt-de) <br />Type of Building Constructiorz <br />(VVWJFMW-&ick-Show -Steel-CMCA*-OOW) - <br />P d Work:' In-kind ❑ Landscape . ❑ New (Replacemer►t (nct to idnd) ❑Demolition <br />�� <br />box be duxka� ' . <br />(rte *�► :• v ,2.�!-�: <br />1� <br />Description of Pi+oposed Work: R' 'O'OV <br />,Q�-T-T N* <br />C)wner/Contmctor. FI=e-mail_ sA`�"X'it/u T b-7� DJC r <br />(rbboffiaeu+Ht u�tliontyou�e ) tem--mid <br />or <br />r <br />-- APPUCAITON REQ= MENTS ARE LISTED ON REVERSE SIDE -- <br />