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'12/21/2010 11:05 5742359578 HPC SOUTH BEND PAGE 11 <br />APPIl tratfon <br />—FOR — <br />Certi <br />Certificate of Appmpriatows <br />Mstaie ftauvatim Cmiwdaim of South Bertd & St. Joseph emm <br />svum VMKLrrz <br />Flu= F= 5'71& it * Ems ih 5SjCHFCftx* ph,{muus <br />W"ft h*/ /wwws l pindian&=/q&p/tn&c*1 <br />t]FFlC+E iiSE QMWP% r? - NOT COW= Aihtlr' CONS Dy OMCif tM ONLY <br />Date Received 10 Wr(� Appu %tom Nu:nw 2D_ t L - 0 3 t 0 <br />> R� fl q►3 _ O NO <br />Sra# Approval authorized by: <«� �I asd r1fle: <br />Histaatc Comma ssfan ROVIA l► Date: <br />UxWmark ❑r aptHbto& nbuki t <br />. [� Natirmal �, (� Ns�onal ' Df�tcict pvm�� <br />.Cerbtkicift of App P <br />DOMed Q'Eabled O Sent Zb Comndueee Q Approved and wed D �cb� <br />C� <br />Address of haperty for proposed wo& b 6 4 � ! p <br />4 C. r.o v `{ *( > 7 Z 50u <br />t t Q <br />Str�tN�mLrrtndSheatl+T�me �•,'� <br />Name of PPrWeety 0wnm(s): ( ePffw) C4T r <br />Address ofFmpWy Damer{s}: f©OO "mac ��t ��°� �' �YZ�tF� O Fit &-[ wlo, <br />CanUaw,(a) Nam,, 4 C r)GrII U- S C 4 ( p.A <br />Contrad Company Name: <br />G..,:..xv.� Addres: l 2 S S , Z `b e k - 4&53 <br />CwTem Use of Builftr,.... ,. � v �2 ( w►. i �{ <br />Tnm of Buildi Construction: "MmA4.t� <br />Pmp)sed Work tiM1&�adFra�c-- SrwaF -�E�t- Gaeta -tt�r} <br />-kind nLIn&MM 014 D> ftementcwr mb4 DDemolitio <br />Descriptim of Proposed Work <br />S d Liu 1 e� <br />e S & v��.Ge l d S ® 4� <br />� r Fay � 77Z �- -4�9��{ �,���, w v <br />(7moffinerwiR <br />and/or <br />