Laserfiche WebLink
Application <br />- FOR - <br />CerHficate of Approptiateness <br />Historic Preservation Commission of South Bend & St Joseph County <br />125 S. Lafayette Blvd, South Bend, Indiana 46601 <br />Mailing %. din C—fu n.MA T"Altmn AAM1 <br />Fhmw- 574-235-9798 - Fax 574-235-9578. * Email: SWCHPC0cost-jxep1LirLus <br />Website: httF://www.sqosepheountyindia com/qchp/Wex.hbnl <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY ENTRIES COMMIN THIS BOX »"" OFFICE USE ONLY <br />0-1C 20/0 1.6. 10M.6 B <br />Date Received Application Number— — — — <br />Past Reviews: [BYES (Did,.I&O ftQ /4 hro14- / 9 NO. <br />Staff Approval authorized by. Title: <br />Historic Commission Review Date: AL. 2010 <br />0 local Landmark G3*(Acal Historic District (maw) 5 D G 6I, , 47-F, t F, <br />E] National Landmark [j National Register District (Hann) <br />Certificate of Appropriateness: <br />(3 Denied F1 Tabled F1 Sent To Committee [I Approved and Issued DATE <br />Properly for proposed work: <br />Address ofProp � <br />stare MM and stiret Na <br />meName of Property Owner(s): (Please Print) <br />Address of Property Owner(s): <br />Contractors) Namix cpaq �- <br />Contract Company Name: <br />Contractor Address: <br />City: Phone: <br />Current Use of Building. <br />(Single rawly,- Multi-AM17y;-CrMerdal - QWWMt -Industral- Va=t - etc.) <br />Type of Building Construction: fi/eiAlc? Z?v �� <br />(Vftd Frame - Brick - Stone - Steel - Concrete - Other) <br />Proposed Work: kin -kind Landscape [ New Replacement (not in-kind) Q Demolition <br />(in= fl= one box may be dWW) f y <br />Description of Proposed Work- � X' 1---7 <br />Owner/Contxactor. Far. e-mail <br />(M office, it *e* dmi;=) <br />and/or <br />