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4 <br />Application <br />-FOR- <br />� 'MM&MN", d Certificate of Appropriateness a b <br />HISTORIC PRESERVATION COMMISSION °m cor <br />R 186 • of SOUTH BEND & ST. JOSEPH COUNTY <br />125 S. Lafayette Blvd., South Bend, IN 46601 " <br />http://www.stjosephcountyindiina.com/departments/SJCWmdex.htm <br />p: 574-235-9798 f: 574-235-9578, e: SBSTQWC@Co.st-josqhJn.us <br />OFFICE USE <br />ON jLY»»»DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX«««OFFICE USE ONLY <br />Date Received: Application Number: x017 — 03130 <br />Past Reviews: ©"YES (DateofloslRevierv) 3015 El NO <br />StaffApproval authorized by Title: <br />Historic Preservation Commission Review Date: <br />❑ Local Landmark ❑ Local Alstoric District (Name) <br />❑ National Landmark" F1 National Register District (Name, <br />Certificate ofAppropriateness: <br />E] Denied ❑ Tabled ❑ sent To Committee ❑ Approved and issued: <br />�,.. <br />(Please print) <br />Address of Property for proposed work: Leeper Park <br />(Street Number—Street Name -01 Zip Code) <br />Name of Property _Orvner(s): Parks and Recreation Board of Commissioners Phone #; 574 299 - 4765 <br />Address of Property Owner(s): 321 E Walter St; South Bend, IN 46614 <br />'(Street Number-S'h eel Name--�Citl�Zip Code) <br />Name of Contractoi•(s}: South Bend Venues Parks andArts Department. Pi,one #: 574 - 299 - 4765 <br />Contractor Company Name: <br />Address of Contractor Company: 321.E Walter St, South Bend, IN 46614 <br />(Street Number—Street Naine-City—Zip Code) <br />Current Use of Building: Public Park <br />(Single Family—Multi Family—Coniniey cial---oovernment—Industria)—Vacant—etc.) <br />Type of Building Construction: Other ••- Park Modifications/Walks/Planting Areas <br />(JYood Frame=Brick—St one=S Leel-�-Concrete-Othei) <br />Proposed "Work: ❑ In -Kind ❑ Landscape ® New . . ❑ Replacement -(not in-kind) ❑ Demolition <br />(mare than one box may be checked <br />Description Qf Proposed work: New public ADA accessible formal .labyrinth garden with an emphasis on <br />restorative health alid meditation in ekisiinlr obeli space of Udt)dr Park with intervretive, <br />education sianaLre and benches <br />Owner/Contractor Fal #: 57�. - 235 5540 �_ e-mail: jmartine@southbendv. <br />00 <br />and/or .X <br />Sign! re of er Si lure of Contr etor' <br />i <br />"" APPLICATIONREQUIRE MENTS LISTED'ONRZVERSE"SIDE—"' <br />