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Application <br />- FOR - <br />Certificate of Appropriateness <br />I listoric Preservation Commission of South Bend & St, Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 40(A)i <br />Mn; I;n A rlAv"— e-, , #y—City R 1 1. South P - ; T -4,—n AAAM <br />Phone: 574 -2:r) -W/98 , 1"ax:5774,235-9578 <br />WOL)sitv: litti)://www.stjoseplicouiityiiidiiiia.coiii/sjclip/itiLtex.littill <br />OFFICE USE ONLY >>>>>> 00 No,r COMPLETVANY EN^IVIES CONTAINED IN TIMS BOX >>->>> OFFICE USE ONLY <br />Date Received_. 7 Application Number, 4 0 lei. ......... <br />Past Reviews: El YES (r),-, ------ F] NO <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date: <br />F1 Local Landinark 1 -9 -focal Historic District (Mone) <br />National Landmark E] National Register District (,vante) <br />0 <br />Certificate of Appropriateness: <br />Denied (1-1 Tabled <br />Sent Tu Committee 'L—t.-�Approved and Issued <br />,)Al E <br />Address of Property for proposed work:_ 221 / 219 W North Shore Drive <br />Street Nianber and <br />David Castellanet/winifred E. Wyatt <br />... . . .. ... .. ........ <br />Address orProperty Owner(s): Same as above <br />Contractor(.%) Nan-te. unknown <br />Contract Company Name: ------ <br />Contractor Address: <br />City. <br />Current Use of` Building: <br />Type of Building Construction: <br />Mone: <br />1'4111,1�y Midti-l"nnit'v - Cvnljowrhll - Gowl"Imeta - Imfustrial Vacant - etc) <br />.. ...... . ....... ....... <br />(IN't,od l'towc - Vrick - Stone - Steel - Con -rete - Other) <br />Proposed kVorl<: 1- w1 In-kind k]Landscape C] DlZeplacetnent(noin-Avid) [I Demolition <br />(11wir thmi oi!, Nov noP /k, cho, kz d) <br />Description of` Prol)os(�(1k,'G,,t)rk: Remove rotten Norway Maple Tree. <br />- ........... . -.- .... . _rotten . .. . ..... . .... .. ..... . ------ . .. .... <br />Owl) er/Contra ct or: e-mail <br />M.k- offite ndl o1i i(,jvad wiNi ot.4.yow desism'.) <br />.. ....... . <br />C;? <br />attv� XT <br />APPLICATION REQUIRENIVVI'S ARE LISTED ON REVERSE SIDE <br />