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Application <br />- FOR - <br />Certificate of,Appropriateiiess <br />historic Preservation Commission of South Bend & St. Joseph County <br />123 S. Lafayette Blvd, South Bend, Indiana 4(kOl <br />4 :1, ( A A I ,its, r- 4 0.t v � n , KZ,, if rZ,, A I ... 4; A AJn I <br />;I rl 1 i oun v- I 1 4 <br />Slr5* I'm'101PO <br />Plv)i w: 57 1-1)5 979S• FxcS)74.2�&9378 aiL, l <br />Wvb�,iV lct luntyi nAl iattail <br />OITICE USE ONLY—- ­S NOT COMPUTE ANYEWRIES CONTUNED IN THIS BOX >>>>>> OFFICE USE ONLY <br />Date Received !!9„ 47 z . ao 0 Application Number_ ­­ ­­­­ . . ...... <br />_......... / <br />­ _�/ 0 - 10206 <br />Past Reviews: 0 YES NO <br />Stall'Approval authorized by: Title: <br />Historic Commission Review Date: <br />;oral Landmark [-; K <br />�jj _scat Historic District wamr) <br />National Landmark i'i National RvgisterDis(rict (Nalml- <br />Certificate of Appropriateness: <br />roved and Issued <br />[7 Denied f <br />Tabled Sent To Commilt(T <br />J�pp <br />Address of Property for proposed worl- <br />Nwnh-r ar-d 5frrc ,., M -me <br />Narne or Property Owner(s): Prml) 7-;,,, �( <br />Address of Property Owner(s)- _6 j" -4- ?P� <br />_5 <br />Contractor(,-,) Name, /3v b (5-,-tr .'-f <br />Contract Company Name: <br />Contractor Address: <br />City:_ Pimp: C�) tt- �j Ci <br />Current Use of Building: Ax <br />Type of 1.31 fitd ing Construction- e C, <br />f Pri, k - - S!4,t-I - O!,"11 -r) <br />Proposed Work: �1n-kind �"ndscallv [_-New F711)pmolifion <br />Description ol'ProposedWork: e_x) lc� h", <br />Owl Fax: tt :D — -5 <br />We <br />andfltar <br />— APPLICA77ON IZEQUIRIAMNIIS A RfLISTED ON REII'RSE SIDE — <br />