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N <br />Application <br />FOR - <br />Certificate of Appropriateiiess <br />I fistoric Preservation Commission of South Bend & SL Joseph County <br />125 S. 1aifavetle Blvd,cxmfli Beiid, Indiana 46U)l <br />41 <br />Alatun Address: 4-ourity-4- t 11 11A" M I91C'11, I , T I <br />" 4 A A411 <br />I <br />Pfioiw:,574-r15-1r,/98 0 Fax: r,-4-235-95578 <br />Website: littp://'ivivw.stioseplicotintviiidi,,ina.com/lscl-tl)/'Uldexlitilil <br />OFFIVEUSE ONLY D(.) NOTCO.MPLE77. ANY ENTRIES COINTMNED IN THIS BOX >>>>>> ()I:'I:'ICF USE' ONLY <br />Date Receive Application Number <br />Past Reviews -ES (nate,, za,i kaz,i�w) <br />I E] NO <br />Staff Approval authorized by: <br />Title: <br />Historic Commission Review Date - <br />Local Landmark 41 Local Historic District Wanse) <br />Fj National Landmark 7National Register District Maw) <br />Certificate of Appropriateness: <br />F] Denied Tabled Sent To Committee E] Approved and Issued DAIT <br />Address of Property for proposed work:. 172-q r- - '61— <br />Sheet Numlir and Strut ,%rame <br />Name of Property Owner(s): (11f'eac 1'rhif)E71,ui <br />. . . . . ...... . ...... . . . . ............ <br />Address of Property Owner(s): <br />Contractor(s) Name: <br />Contract Company Name: <br />Contractor Address: <br />CitV.. <br />Phone: <br />Current Use of Building: Ff rwi <br />jijju5!r;.A - Vacant -- etc.) <br />Type of Building Construction - <br />Wood Traim- - Vi ick — Storle Steel - ('01'-A'te - othcr) <br />Proposed Work: . Ej' In-kind E] Landscape n New Replacement Demolition <br />(mole ml?l bo'xmal�v 'IN, ch'.'Ck'q") <br />Description of Proposed <br />�_Z_ W 1 A49ZL <br />900AS i A/ OP CAI t%C7. <br />--j 7 -2 - - -/ i-/ I C -111a <br />Owner/Contractor. Fax: <br />u-ifl' cm-rcit'A' I rz 1 with (1? 11.11 or"e <br />. .................. and/or . ... .... . w...._....__._........_ ..... . . .... . .............. . .... ............. .. ..................... <br />