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Application <br />- FOR - <br />Certificate of Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 46601 <br />Mailing <br />AAA Building, South Bend, Indiana 46601 <br />Phone: 574235 -9798 • Fax: 574 - 235 -9578 • Email: SBSjCHPC@co-st-joseph-in.us <br />Website: http: / /wwwst osephcountyindiana .coin /s chp /index html <br />OFFICE USE ONLY » »» DO NOT COMPLETE ANY ENTRIES CONTUNED IN THIS BOX » »» OFFICE USE ONLY <br />Date Received Application Number <br />Past Reviews: [ YES (Date of Last Reaiew)A 1— nl7 , Yp Y ttD Ej NO <br />Staff Approval authorized by: <br />Title: <br />Historic Commission Review Date: <br />n Local Landmark ocal Historic District (Name) <br />National Landmark E National Register District (Name) l'.ha�l 1 pam <br />Certificate of Appropriateness: <br />E] Denied F Tabled Sent To Committee [] Approved and Issued <br />DATE <br />Address of Property for proposed work: 3 �{ rS • of L f . , t c. <br />Street Number and Street Name <br />Name of Property Owner(s) (Please Print) c,t • n n I d Ve -t <br />Address of Property Owner(s): 1 31 f2� ,,t! S . r•4', I > r <br />Contractor(s) Name: �a rL.0 I a <br />r <br />Contract Company Name: �2 tr• n+ S cq 0, �i n <br />Contractor Address: <br />City: `j01J LI^ &" Phone: <br />Current Use of Building: < I. <br />Single Famil / Multi - Family – Commercial – Government – Industrial – Vacant – etc.) <br />Type of Building Construction: <br />(Woad Frame – Brick – Stone – Steel – Concrete – Other) <br />Proposed Work: F1 In -kind Landscape [-] New [:] Replacement (not in -kind) . F� Demolition <br />(more than one box may be checked) <br />Description of Proposed Work: a f � -k a,J P *,.t -, or: .-.�.1 CL JaciL. f i✓. 4�• r ��.M.vc�� <br />Of W I �t AlorA � J rAj tj. Q ri . J4cY' f-L'Gc <br />4t m <. , 4 Ci -Q C6 <9 lno td�;e..�. � �/J ,� -1 S�.L _j'LL< } o 6 r :e1e p avwS ' / �o w+u +et. <br />M 41 VNG A -ty S.ct,,jrjR tj , F .hCf7•� ��.lK - e1 1Q1t}� { ta�7.., �. <br />Owner /Con tor: �7L1 x'31 �93�( m a -ail Lou fe .Ngcte- "cc.n0 <br />• <br />(This office mr- pond only one designee) _ <br />x( l and /or <br />\L wve,/L oCyi `^ '}rt4 Pci I� �Vtv.t n- _� Lw,\ <br />