Laserfiche WebLink
Application <br />— FOR — <br />Cer0ficate of Appropnfateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 466M <br />Mailing Address: County City Building, q_'tu T1..A T.A.."n AAMI <br />Phone: 574-235-97% * Fax 57'4-235-9578 Errud, SMCHPMwst-joseph­fttus <br />WebsiL- httpr//www-sqosephc=4*xliammm/*-hp/indmhtaiI <br />OFFICE USE ONLY »»>x DO NOT COMPLETE ANY EWM CONTUNM W THIS Box >">>> OFFICE USE ONLY <br />Date Received 6' Application Number I D . / / ">6 B <br />Past Reviews: []3,fu (Mtequsf &.Vkw) n NO <br />Staff Approval authorized by, Title: <br />Historic Commission Review Date - <br />Local Landmark Historic District (Name) 1414442r� <br />National Landmark [IiNatlonal Register District Waw) <br />Certificate of Appropriateness. <br />Denied []'tabled Sent To Committee CRIApproved and Issued ',3' <br />DATE <br />Address of Property for proposed work. 6 0 f -P,49A.. A Lf'o <br />St&d Number and Stred Name <br />Name of Property Owner(s): (Pimse print) W A y <br />Address of Property Owner(s): <br />Contractor(s) Name. Iq SH t-, e- L I— F* -9,1V e <br />Contract Company Name: <br />Contractor Address: <br />city, Phone: <br />Current Use of Building: <br />(Single Family -Multi-F4rmity-r-ommm-ial-Commment -Industrial- Vaml -tic.) <br />Type of Building Construction-, E,j ftm_fr_ <br />(WoW Fraena - Stick- Stm -Steel - anade - Other) <br />Proposed Work: 4?_1n-klnd ] Landscape [] New E] Replacement (not in -00 0 Demolition <br />(wti burn me L= may be dWW) <br />F�' <br />Description of Proposed Work: P G. )41C_` )v5 w Its7- <br />t p_41" &V <br />Owner/Contractor: Fax <br />and/or <br />e-mail <br />