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61 <br />Application <br />-FOR- <br />' <br />C <br />la ertfflteate, of Approp teness <br />1-5 <br />IIISTORK'PRESERVATION COMMISSION <br />of SOUTH BEND & ST. JOSEPH COUNTY <br />Asa *tia <br />125 S. Lafayette Blvd., South Bend, IN 46601 <br />1): 574-135-9798 f. 574-235-9578 SBSjCI-lPCr Co.St-ji)SePI1Ar1.(j5 <br />RIES C()\'I',%] INTIIIS H0X­,x<<<01,T1(TVSE0N1, Y <br />Date Recrived: <br />Application Nimber: ... <br />.... . ............. ............ <br />ti <br />Past Revims. F1 YES (hateella,tReview) .... ...... .. .... ..... . . . ......... N <br />StaffApprotal authorized hy: Title: <br />................ .. . . .... . ...... <br />I listoric Priewrvation Commission He% icm. Date: ................... <br />❑ Local Laodmarh <br />0 National Landmark F] National Register District tvame) ....... ...... .. ... . .... ......... ......... .... .... . ..... .. ....................... <br />Certificate of.kvpropriateness: <br />F] Denied n Fabled F1 scot To Colmnime F] - 1ppro%ed wid issued: ..... .. . .... ...................... ..... ........ .......... <br />–an <br />(Please Prints <br />Address or Property for proposed N% ork: _4±& S,St. ............Joseph St. South Bend,indianal-.- <br />.. <br />(SlivelX11111her <br />lame orProperly 0mier(s):—unknown <br />............................ . . ... . ........... .............. .. <br />Address of Pro1wrty Oivner(s): 602 Maple L 1) -Wak­ p -ru-s-a-J—N46573 <br />WW <br />Joseph Mendez 1-810 LSouth B—en—d7194 W578 (Street Number Slivel Name ('ill' lij) COd") <br />Name of Contractor(s): will-be.bid,out <br />I'llone 4: <br />(.'ontrart Company Name: City_of South Bend Department of Code Enforcement (Unsafe Bldg- <br />.. ..... ... ..... . .. . ..................... South . ..... ............... Code. .............. Enforcement . .. . ........ ­­ . ........ . . ....................... (Unsafe . ........................................ <br />,.%(Itlrcssof(:oiiti-,ict('onii),)iiN- 227 W. Jefferson Blvd. 1300 Coun <br />.. ...... . .... . Qity Bldgt <br />. ..... . .. ..... <br />(Street A)hnbcr sirect gime - CitY. <br />Curreift Use of 13tidding: ........................ Vacant, fire damaged zoned singlejqmi_ly. . ........... <br />.... . ...... . .......... <br />(Single Familik .11til1-Fivnib, Commercial Gorerninent huhist)-hil Vacant e1c.) <br />Typeof Buildim" Construction: wo.P.d.frame. ­­­­ .. .......... -1 ..... . ........... ....... ...... .. . .......... I ...... . .... - . ................................. ............. . .......... ........... .... <br />01'00,11,hinx, BricA Stone Stect Concrete 0dicr) <br />-5 tqtule) <br />Proposed \N ork: F1 In -Bind n Landscape F] Neiv n r -V-1 <br />fillore than one box inav he chocked) <br />Description of Proposed Work: -... D.e.molition of house and fence _and removaj of.b,6.5P.m.ent.­ .... .................... .... ... . . .. ................. . . ... <br />I—— ............ --1 ... ....... ....... . ......... 1. 1-11-.1--- ............. .. .. . .... .... .............................. ... .................... . .................. . . . . . . ............ ... ... . . . . .................... . . <br />I . .. ....................... ... ... . . . . ...... . ... ........ .. ..................... ..... ........ . . . . . .. .... . .. <br />Owner/Contractor Fa-< #: muaii: bhaygood @south bend in.gov <br />. . . ... .... .. .......... I .. ..... ....... . <br />0q,"Taril! -orrespond irilh on/v one devigneo <br />x andfor X <br />sio.nature orO-.%ner Signature of Contractor <br />—APPLICATION REIQUIRENIENTS ARE, LISTED ON REVERSE SIDE— <br />11, <br />