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Applicafion <br />- F 7OR - <br />Certificate of Appropiateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />11; S. Lifavette Blvd., F)uth Bond, Indiana 466H <br />Ma1lin-a Address: County -City Buil-li )uth Bond Indiana 4AWl <br />I T114 <br />Phonv.574-235-W798 # Fax: 5'-1.2z-9578 Email: <br />OFFICE USE ONLY>>>>>> DO N07'COMPLE7"E'A1'Y E"WRIFS CON'MYED TN IIIIS BOX >>>>>> OFFICI]JISE ONLY <br />Date Received--', ct-t�`" a Application Number C� 19 <br />a� <br />Past Reviews: E] YE (derf 1a;lRariez-) [79 NO <br />Staff Approval authorized by: I-Itle. jw�— <br />Historic Commission Review Date: <br />Local Landmark <br />E�ocal Historic District (Nattie) <br />National Landmark National Register District (iVattle) <br />Certificate of Appropriateness: <br />M Denied 0 Tabled M Sent To Committee M Approved and Issued <br />DAM <br />Address of Property for proposed work:— <br />ec, <br />,I. Plot,?, apid:51nIet Nanee <br />Name of Property Owner( <br />s (Ple! rr Pilitt) <br />I <br />Address of Property Ownerr(s):.- <br />f - L) <br />Contractor(s) Name: <br />Contract Company Name, <br />Contractor Address: <br />City: Phone: <br />Current Use of Building: Y14 tr i F -C -L a,- I Lt, <br />(Si)l�"Ie Family d-,,tvn4ir,:ia1 - Covryo,-Cnf - 1r0at ,trial - Vamnf - eh,.) <br />Type of Building Construction: iA-%)0-04 <br />01.',,v: I Franu, - Rrick- Stone - Skel- Cog -rete - Other) <br />Proposed Work: E] In-kind indscape E] New Replacement (m, in-kmJ) 1-1 Demolition <br />(morc thin vne Nw ma.y tv checkd) <br />LAP <br />1 5� Ct <br />Description of Proposed W 2- s— ork: Q, Is' W 7/1 <br />Lj <br />Owner/Contractor: Fax: 10 <br />(ni <br />and/or <br />— APPLIC.TrION REQ[11REMEM FSARE LISTED ON REVERSE SIDE -- <br />