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: 574235-9798 - Fax: 574235-9578. - Email: SBSJCHPC®co.st josephin.us <br />Website: http://www.syosephcoungindkna.com/Ichp/index.html <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY RMIES COMAINED IN THIS BOX »»» OFFICE USE ONLY <br />Date Received e2tro� Application Number p? O t3 9 . d !o O t <br />Past Reviews: [9YES (Date of Last Review) t' & .1 ow'? [] NO <br />Staff Approval authorized by. Title: <br />Historic Commission Review Date: t5-��st:�� % <br />Local Landmark <br />National Landmark <br />Certificate of Appropriateness: <br />tQ'Local Historic District (Name) Cf% .A� <br />F] National Register District (Name) <br />[j Denied n Tabled [] Sent To Committee [i Approved and Issued <br />Address of Property for proposed work:-�I—�- --�1 <br />Stmt umber and Street Name <br />Name of Property Owner(s): (Pizo[�:17 <br />J <br />Address of Property Owners)t: /� X11/( % V, 6S E2 9-�f14�.yi l �j <br />Contractor(s) Name: 01 / A' . nn <br />Contract Company Name: Mn r 1�V n r <br />Contractor Address: r �t .J N �� <br />r .-t\J 105LI2 <br />City: MI WIV/;i � <br />Phone: 5714 aA <br />Current Use of Building: <br />Type of Building Construction <br />1171 !'MA <br />500, q. <br />.�j <br />( ngle Family -Multi-Fa y - Commercial - Government -Industrial - Vacant- etc.) <br />(Wood Frame - Brick - Stone - Steel - Concrete - Other) <br />Proposed Work:j In-kind [l Landscape New f-1Replacement (not in-kind) Demolition <br />(more than one box may be cheeked) <br />Description of Proposed Work: ' 1�ee,A 71(c u ,t <br />Owner/Contractor. Fax: e-mail BA AA b EY t"l /V�;n. Low) . <br />(This office will mrrgvW urith only one designee) <br />and/or - <br />—APPLICATION REQUl'.RF.lViE M ARE LISTED ON REVERSE SIDE — <br />