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:r <br />r <br />Application <br />-FOR - <br />Certii fxcate of Appropriateness <br />Historic Preservation Commission of South Bend. & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 4001 <br />Mailing AddressrCounty-City Building South Bend, Indiana A=1 <br />Phone:574-235. M - F= 574-MSJZM - EmaI SBgCHPC®rn stjoseph in us <br />Website: http://wwwsgoseph=nty'tncikr=bm/ochp/Wedftd <br />OFFICE USE ONLY»»» DO NOT COMPLETE ANYENTRIES CONDUNED IN THIS BOX >" OFFICE iISE ONLY <br />Date Received /l 020 / Application Number 242 I ! <br />Past Reviews: [] YES ()ate of U0 xet Q ❑ NO <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date: <br />❑ Local Landmark ❑Local Historic District (Name) <br />National Landmark []National Register District (Name) <br />Certificate of Appropriateness: <br />Denied [] Tabled ❑ Sent Tb Committee n Approved and Issued <br />• t)A78 <br />Address of Property for proposed work- 3010 W1 <br />Name of Property Owner(s): (Please Print} l� n i nrz �� WV$ tt, <br />Address of Property Owner(s): <br />Got L.on�.,�to1 .S� er1 Itv . 4Cvt�'?sa <br />Contractor(s) Name:�+�_ <br />Contract Company Name:"IT <br />Contractor Address: " T?2--7';::p <br />City. Phone. <br />Current Use of Building. ��'•" <br />(Single Family _ Multi Famjjy — Commercial —Gove n mt — Industrial — Vmnt —etc.) <br />Type of Building Construction: <br />(Wood Frame—Brick—Stone—Steil—Conente—Other) <br />New ❑Replacement (not in-kind} [] Demolition <br />Proposed Work; ❑ in-kind ❑ Landscape <br />(tee than one box my &erta4 , A <br />Description f Proposed Work: <br />Owner/Contractor.Fac 2tel' �'' I e-mail <br />�AC� 19, eAAn JKC"s4C Y%er Gra Yh-- <br />.J'�"' arui�or �V�C�1�fi3G'_Yi)E'Y�• �''�liC'" . <br />t. -A 4k,te2S z3k-4t7:; <br />APPLICATION REQUIRENfEAM ARE US7W ON REVERSE SIDE — <br />