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APR 062019 M <br />HISTORIC PRESERVATION COMMISSION <br />OF SOUTH BEND AND ST. JOSEPH COUNTY • <br />County—City Building; South Bend, IN 46601 <br />http://www. southbendin.gov/govemmelit/department/community-investment <br />Phone: 574/235.9371 Fax: 574/235.9021 <br />Email: hpcsbsjc@southbendin.gov <br />Timothy S. Klusminski, President A Certified Local Government of the National Park Service Elicia Feasel, Historic Preservation <br />Administrator <br />APPLICATION FOR A — CERTIFICATE OF APPROPRIATENESS <br />OFFICE USE ONLY»»»DO NOT COMPLETE ANY ENTRIES CONTAINED IN THIS BOX }« <<<<OFFICE USE ONLY <br />Date Received: AbOl 2big Application Number: <br />Past Reviews: ❑ YES (Date of Last Review) ❑ NO <br />Staff Approval authorized by: <br />Historic Preservation Commission Review Date: <br />Local Landmark <br />❑ National Landmark <br />Certificate Of App n <br />teness: <br />enied ❑ Tabled <br />Title: <br />Historic District (Name) ^ CMP f P n r <br />DTational Register District (Name) <br />❑ Sent To Committee ❑ Approved and issued: <br />Address of Property for proposed work: 745 - Leland Ave - South Bend - 46616 <br />(Street Xumber---Street Name—City—Zip) • <br />Name of Property Owner(s): Jonathan and Kathryn Keurphone#;, (616) 843-5401 <br />Address of Property Owner(s): 745 - Leland Ave - South Bend - 46616 <br />(Street Number—,9reet Name—City—Zip) <br />Name of Contractor(s): Building ourselves Phone #: N/A <br />Contractor Company Name: N/A <br />Address of Contractor Company:. N/A <br />(Street Numbei- Street Name—City--Zip) <br />Current Use of Building: Single Family <br />(Single Family—Multi-Family—Commercial-Government—Industrial—Vacant—etc) <br />Type of Building Construction: Fence <br />(Wood Frame—Brick—Stone—Steel—Concrete—Other) <br />Proposed Work: ❑ In -Kind ❑ Landscape ❑ New ❑ Replacement (not in-kind) ❑ Demolition <br />(more than one box may be checked) <br />Description of Proposed Work: <br />We would like to build a fence from the front of the house on the <br />property around to the back of the property (See blueprints for details) <br />Owner e-mail: jrkeur@gmaiLeom and/or Contractor e-mail: <br />X KazSia' A" and/or X <br />Sign ture of Owner Signature of Contractor <br />By signing this application I. agree to abide by all local. regulations related to project and to obtain a Building Department Permit, if applicable. <br />—APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE— <br />• <br />