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Application <br />FOR - <br />Certificate icate o f 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 46601 - <br />Phone: 574-235-9798 * Fax: 574-235-9578 • Email: SBSJCHPCQco.st josephnLus <br />Website: http://www4osephcountyindiana.com/s chp/index.html <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY ENTRIES CONvuNED nv T[HS�BOX >>>>> '\OF�FIC/]Fj' i1SE ONLY <br />Tlato Vara lwad 9A.0— <br />— APPLICATION REQLIHMME IS ARE LISTED ON REVERSE SIDE — <br />