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Application <br />.. . FOR' - <br />Certi f icate of Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana46601 - <br />1Vlailing Aadmcs: bounty -C.ity Budding, south Bend, Indiana 46601 <br />Pion: 574235-798 • Fmc 574 -M3 % * Em SBgCFIPCQ=st joseph1mus <br />Webslte: http r / /Www.sgosephmun"damnom /gchp /k dmhtml <br />)tf <br />OFFICE USE ONLY ;-r> »> � D DO N__ OT COMPLETE ANY ENTRIES CONADM IN TINS BOX » »» OFFICE USE ONLY <br />Date Received ° Z4 oZ Q to Application Number 02- <br />Past Reviews: [ROM (ad /L't ttMM) NO <br />Staff Approval authorized by: 11tle: <br />Historic Commission Review Date: /fi 020 /D :..... _ <br />Local Landmark [ Local Historic District 0;.) <br />0 National Landmark ❑ National Register District Qvasu) <br />Certificate of Appropriateness: <br />Denied Ubled Sent To Committee Approved and Issued <br />`' DAM , <br />Address of Property for proposed work: V <br />Stmt Nttm6er end Stmt Name <br />Name of Property Owner(s): (Plow Print) .- k v,,+ T <br />Address' Property Owner(s): t �,�,r <br />Contractor(s) Name: cis .L & A `t'l , .. %^, <br />Contract Company Name: <br />Contractor Address: C5 '7 f., 0., <br />City: y� a W %c% ,- Phone.. `i" — t,7 Li _�� <br />Current Use of Building: <br />S FaWQ Multi. family Ckxnwdd - Gmnmant - induskW - vacant - etc.) <br />Type of Building Construction: r -C <br />— (Wood frame - Brick Stone - Steel - Conde Other) <br />Proposed Work: "kind ❑ Landscape ❑ New ❑Replacement (not ix4dnd) ❑ Demolition <br />(move than one bat tray be dux f <br />Description of Proposed Work: <br />Owner /Contractor. F= e-mail <br />^_ ( 7% cf = w3avrrrspond mt7h only onedastpw) <br />Artie, V.0 'L�ttiLi�n�s�L- 1ti <br />x �� _ . <br />"" — APPLICAHONREQLMENIEM'S ARE LI / ONREVERSE SIDE — <br />