Laserfiche WebLink
01 <br />Application <br />-FOR - <br />ert%fi'Cate of Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 46601 <br />il±lailing Address: County C ity F3uilding, bouth Bend, hlddiana 4ha n <br />Phone. 574-235- • Fax: 574-235-9575 • Email: SBSJCi-il3C@cost jolt ph1 us <br />Website: http://ivNvu,stjosephcountyindiana.com/sjchp/index.htzni <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX} >>>>>> OFFICE USE ONLY <br />Date Received Application Number _94 l L- I� L 3 <br />Past Reviews: E] YES (Do., r f La,,, Rmieao) <br />Staff Approval authorized by: <br />[] NO <br />Title: <br />Historic Commission Review Date: R 120 1 <br />❑ Local Landmark Local Historic District Wamne) ( M �i n 19i i i - <br />E]National Landmark National Register District {iYame�•YIffj nDO,, OL <br />Certificate of Appropriateness: <br />E] Denied ❑ 'T'abled F1 Sent To Committee [] Approved and Issued <br />oaTF <br />Address of Property for proposed work: <br />Street'Number and Street Name <br />Name of Property Owner(s): (Tease .Print) , ,' 4f. <br />Address of Property Owner(s): z .> 4 41 <br />Contractor(s) Name: <br />Contract Company Name: t },„r ;3 - i si <br />�f'.h6rxil V, lip; N ” (o <br />Contractor Address: lGl" <br />City: 1, :' .. ,/ Phone: <br />Current Use of Building: <br />(Single Family - Multi-Family(Conurrtreia Gozvminent - Industrial - Vacant -etc.) <br />Type of Building Construction: <br />(Wood FrameBrlc — Stane — Steel — Concrete — Other) <br />Proposed 'Work: In-kind (� Landscape M New [] Replacement (not in-kind) <br />E] Demolition <br />(more than one box may be clinked) <br />Description of Proposed Work: <br />/ <br />1 ' .� ^a.� �. f!Fin fi P f? .. <br />! <br />Owner/Contractor: Fax: e-mail <br />Wis office will correspond with only one &-ignee) <br />1`.� ', _ ,s and/or <br />-- APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE — <br />