Laserfiche WebLink
/ L-1 i I Vv <br />--7 Ll 5 OG of G1! <br />Application <br />- FOR - <br />Certificate of 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• SBSJCt-t1'Mo.sr-joSeph inuS <br />Website: http://www.stjosephcountyindiana,com/sjchp/indexhtml <br />OFFICE USE ONLY»» > DO NOT COMPLETE ANY ENTRIES COMMINED IN THIS BOX »»» OFFICE USE ONLY <br />Date Received it' I 1 1't Application Number 2- ° -7 - i f o i <br />Past Reviews: BYES (Da!eofWt Reviev) 700 c, - to z a ❑ NO <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date: <br />Ej Local Landmark [Local Historic District (Name) Q�►.�e �. �-1 <br />Ej National Landmark E] National Register District (Name) <br />Certificate of Appropriateness: <br />[] Denied [] Tabled [] Sent To Committee [] Approved and Issued <br />DATE <br />Address of Property for proposed work: "i0(o AJ �q--JOS('pi--, .5�. � 5C>t:�]� •T�rY� J � ��'�t ` <br />Stmt Number and Sheet Name <br />Name of Property Owner(s): (phase Print) I "Y t K t Yl 14110 r-IIYc ,� <br />Address of Property Owner(s): 7()(0 /t - ,. �i�Sc , '9- `JCS t X41 (-A -: t. 1-1 w'i4) <br />Contractor(s) Name: N-r_c lY.Pni 1,01 r <br />Contract Company Name: <br />Contractor Address: 115 Lo PC) t''a'1 <br />City: -=-) 1AL�sJ �i� Phone: (n3oo <br />Current Use of Building: .:5I rte' 1-e--PL-0_N I I L-( <br />Single Family - Multi -Family - Commercial - Government - Industrial - Vacant - etc.) <br />Type of Building Construction: n�41t'r <br />(Wood Frame - Brick - Stone - Steel - Concrete - 011ier) <br />Proposed Work:In-kind n Landscape (] New (Replacement (not in-kind) Ej Demolition <br />(more than one box tray be ehe;ked) <br />Description of Proposed Work: <br />Owner/Contractor. Fax -.'n -yd ©`'5i; -0 3 Sa- e-mail 5t_)uq)-413 Lugs p Gr -4- <br />M's 4 e � respcm �ith only one designe�Y _) <br />—C��� " and/or <br />— APPLICATION REQUIREMEWS ARE LISTED ON REVERSE SIDE — �� <br />