Laserfiche WebLink
Dale Kokot <br />03/07/2814 13:29 5742359578 <br />zzq�a ; <br />Application <br />574-247-9331 P.1 <br />ff <br />♦�tE�ccyr Certificate gfAppropriateness <br />HISTORIC PRMRVAnON COMMISSION <br />is of SOUTH BEND & ST, JOSEPH COUNTY <br />125 S. Lafayette aivd,, south Bend, IN 46601 <br />http*//www.stosephc-ountyindiamcom/depammu/SiCHP/iDdex.htm <br />p: 574-235-9798 ('574-235-9578 c: SBSJCHPC(c�co.at;oseph.in,us <br />I I I I I I, I 1 III ,I I III.I, I ,II.11• , , , <br />l i 11 I <br />OFFICE f►NZ h } ojiO NQa, j MP NV Ti rdrTA JLI 1[ 19 90ytK<ecxQFFrCE USE OMY <br />.taste Received: <br />Paatlieviews: `YES tArreotrnrtRavtcw► PD31 <br />Sssfi Approml ootboriud byt Tit e: <br />Historic Yreservadoo Commission Review Date: <br />t <br />Local Landmark LocalHi4tpTicDistrict(Nam ,".':4, � .1r <br />NatioaatLandmarkatiansiRe�istcrAisirietovaYrr! <br />CertilicateofAppro natcucu: <br />ri Denied <br />r <br />M Tabled C] Sc-tToCemmitlet e�pprovcdaudrued: <br />Iu II I I n I Ilii lli 11 r, .,I, YII IIIi III II III ,I ,II II, ,.i I I .I I I it IliiYn +„ Il ii,arYI11.IIJ„II II IIII I I, .IY I ii., .i <br />(Please Print) <br />Address orProperty for proposed vrorlt: r C ��,,, . �iQ�� <br />Nance of Property Owner(s): <br />(StreetNutmba+•—StreetNarne—Ci• Code)t <br />� ,c+ hC v _ F Phone N: E � � <br />Addrera of Property owner(s): <br />r'1 �- ^7Y c� t Aa <br />eel Nunrb(cF�-j- Street Namr t0 --Tip e1 <br />Name orContractor(s): <br />S n �,�rt� t( , `ifrn v i' wo, 9: C2 9 q —14-2", <br />Contract Coaapatry Namc: <br />A J`r�. Q" IL i c ` n ,dot <,- <br />Address of Contract Company: <br />Number-{Srreee Name—G`try—Zig wide) <br />Current Use of Building: <br />y(5rreet <br />(Singh Fa+►diy�i lfulri-Farnfjly--CarrinErria!—Governrrvcm—!na'usrrtat--Yacrx►u--etc.) <br />Type of Suming Construction: <br />�i'ood,Frama--l3rick-.Stone--Srerl--tr.erncr�tc--{?1Frzr) <br />Proposed Wor$: F1 In -Kind is r`�1 a adduope El New Q Replactt.et (not in-kind) Demotitiau <br />(more than oar box may be cbeckec# <br />Description of Proposed Work:j,�y'y <br />Ovmer/Contractor Fan #: i 7 i7 i e-mail: � j, <br />(Staff wpotrd with my <br />t designee) - <br />x <br />Sipature of Owner <br />and/or X <br />Signatare of Contmetor <br />---ArPLt.CATION RF.QV NIPNTS ARE LISTED ON REVERSE SIZE— <br />