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Application <br />- FOR - <br />Certificate of Appropriateness <br />Historic Preservation Commission of South Benxi & St. Joseph County <br />125 S. Lafayette iflvd., South Bend, indiuut 4UM <br />l9iru1, Address; County City Building, South Dcnd, 4644y1 <br />Mont 5742`1,5-979$ • Fax 574-235-9578 • i?mail: S8SjC111'C@co.st josephin.us <br />. Website: http://www.st ok-plu:ountAidiana.com/oip/indoxJitn-a <br />O FICC• Mr VO NUT COMPLETE ANY ENTRIES CONTAINED <br />r�IN THIS BOX ssa»s OFFICE E15E ONLY <br />Date Receiverdh_M 1 _ Application Number 1r2> > -- <br />?011 <br />CIA <br />Nast Reviews: YES (vwu qua NO <br />Six Approval authorizedhy: -(" j��1C01-W�: S,e-k Title: <br />Historic Commission Review Date: <br />Local Landmark Ef Local Historic District (Na)n,,) 1 IQ� ✓1 �a r� <br />[� National Landmark (National Register District (Nine) <br />Certificate of Appropriateness: <br />Q Denied U Tabled ❑ Sent To Committee Approved anti Issued _. <br />t',nt'a <br />Address „l' Pr(,pe. y for proposed work: f,a 14 AV/ <br />StrFr.! Nunrhrrand Start Nnmr. <br />Name of Property Owncr(s): Uwaaserrinr) <br />Address orProperty_Owner(s): �} %T[y�.. �i�� f S0,11h few <br />Contractors) Name: TR <br />CaryUnacl Company Name: <br />Contractor Address: <br />City: Phan:: <br />Current, Use of Bitildin• ./'v(f(g,4e)F01r1l1 <br />wi ll -I <br />V (510y JMUlti hitinly Cunnm maul Cuenrrnmcnt lndustnrd Vuntnt dr.) <br />Type of Building Construction: _ fla -P <br />(Wand t Yarm. — brie, — Shitft — SMS l — Cosietr S — 1.111fvr) <br />Proposed Work:. In -kine) Lawid.%adpe ® New ❑ Replacement (nor in-kind) Demolition <br />(more doers wtv Loa may it elrc ird) <br />Desai tioti of Proposed Work:���/w <br />Owner/Goxbeetvr: 'Fax: ��f ��f Z email (1411.111-I1vlfAlelV <br />(This office will evrep and Tran nniy op 0 d+;;igrrer) <br />and/or <br />— AP'PLICA71ON REQ'LlT1ZG1Vi1.'VI S Af& L1S1IiD ON la -VERSE SIDE — <br />