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T <br />Application <br />µSsforyE '- <br />6 ♦y c Rr°� • <br />Certificate ofAppropriateness <br />Historic Preservation Commisslou of South Bead & St. Joseph County <br />1865 227 West Jefferson Blvd - RM 1123 South Bend IN 46601-1830 <br />Phone: 219-235-9798 Fax: 219-235-9578 e-mail: historic@mlchiana org <br />A Certified Local Government <br />OFFICE USBOAMr»»»DO NOT COMPLETE ANY EmnuEs CONTAINED IN THIS BO[<a<0*cOFMCN D=ONLP ' <br />Date Received '/IIQiLtr 2Q Application Number: BM-OW%"'7' v'313 <br />i, <br />Past Reviews: ❑ YES (mtafuusrxf ❑ NO %t <br />Zoning Type: Lot Sim <br />Staff Approval authorized hr: Title: <br />Historic Commission Rbview Date: <br />❑Local Landmark ❑ National landmark <br />i�J�National Register District p� <br />U Local Historic District pb.y: <br />Certificate ofApproprlatenen: r ;• ;�., , <br />r. <br />❑Den ❑ Tabled ❑ Sent To Committee '. .•S,• ' y <br />Approved and issued 13 . NO2. 2_Lq_ <br />p riy for N4v4ort t'%:sF: x,; <br />Address of Pro a fo 3fl� <br />SFeeINsMadsNwJ7✓aAvJ '�' :.'4'�:} '''i• _ <br />city.. Sov h .+.. , <br />i3e�c Township: <br />Name of Property Owner(s):m » G1�r. S �e(�?�tr CT ga 1, '`s' `` :`' "' `.•',- ' <br />.t. acs ..�•i'xy:tdd.k..J • <br />Address of Property Owner : IM W ljau.pp,, '^•``rtr .fs< ... <br />Contractor(s) Name: W4 04 Som (3crA �! cr1Ls <br />Contract Company Name: <br />Contractor Addressi 37.1 6i we, ILtr City: Sou1v+4tnj <br />Contractor's Phone No: Si199-411eb' <br />Owner's Phone No: • . �. <br />Current Use of Building: <br />• (Stes4 Fme0p-AfalB-FbwOy-Comnraclaf-GormurM-rnMu4tat-Yamr[. efC _ . <br />Type of Building Construction: <br />(lpeadPrrmr-Bdrt.Sfara-Skirl-Contrera-OMerJ - "�S• . <br />Proposed Work: ❑ Inkind ❑"Landscape E]New ❑ Replacementowt, lttap - T. <br />linarednTeemlesrwybedrceherq •• , <br />❑ Demolition (Comnietion of generate Form Also Reautred) 'jet <br />Description ofProposed Work: X1e W« %e crntAJir. dJtJ�ti Ash l.,ce- i4 . <br />Owner/Contractor: Fax: e-mail: Oreypl4{+) ,,OA bCrA gin. 0� v : i . <br />Signature of Owner Signature of Contractor , <br />APPLICATION REQUIREMENTS ARE LISTED ON REVME SIDE. <br />Ally and aU bushtess of this office it handled via e-mkil and far, with lea$ Praferfuce M U,S Mail <br />