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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 Address: County -City Building, South Bend, Indiana 4b601 <br />Phone: 574-235-9798 . Fax: 574-235-9578 • Email: SBSjC1-1PC@cost-josephin.us <br />Website: http://www.sgosephcountyindiana.com/s chp/index.html <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY ENTRIES CONwuNED nV THIS BOX »»» OFFICE USE ONLY <br />Date Received °Z? 452164 -LG -70 // Application Number 020 /7 — - 0,542 �, <br />Past Reviews: R,(TS (Date of Last Review) <br />Staff Approval authorized by: <br />of/ Qce,q ao o 9 ❑ NO <br />Historic Commission Review Date: %2•iy a0 <br />R Local Landmark Local Historic District (Name) <br />❑ National Landmark National Register District (Name) <br />Title: <br />Certificate of Appropriateness: <br />R.Denied F] Tabled F] Sent To Committee E] Approved and Issued <br />Address of Property for proposed work: 13271 Adams Road, Granger, IN 46530 <br />Street Number and Street Name <br />Name of Property Owner(s): (Please Print) Michael Wheeler <br />Address of Property Owner(s): 13271 Adams Road, Granger, IN 46530 <br />Contractor(s) Name: N/A <br />Contract Company Name: To be determined through competitive bid process <br />Contractor Address: N/A <br />City: N/A <br />Phone: N/A <br />DATE <br />Current Use of Building: 'Single Family <br />(Single Family — Multi -Family — Commercial — Government — Industrial — Vacant — etc.) <br />Type of Building Construction: Other - Site Revisions <br />(Wood Frame — Brick — Stone — Steel — Concrete — Other) <br />Proposed Work: [:] In-kind 2 Landscape New E] Replacement (not in-kind) ❑ Demolition <br />(more than one box may be checked) <br />Description of Proposed Work: See attached narrative, site plan, and figures. <br />The Troyer Group (engineer) is submitting this COA Application on behalf of <br />St. Joseph County Enqineerinq, Friends of Granqer Paths (proiect sponsors) and <br />Michael Wheeler (property owner). <br />Owner/Con actor: Fax: 574-259-9982 e-mail cjc@troyergroup.com <br />(This of�c�eJwil nd ith only one designee) <br />1� Z • /r'1"'— and/or <br />— APPLTC47ION REQU EMENTS ARE LISTED ON REVERSE SIDE — <br />