Laserfiche WebLink
• <br />• <br />JUL 0 8 2018 Mit <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/govemment/department/community-investment <br />Phone: 574/235.9371 Fax: 574/235.9021 <br />Email: hpcsbsjc@southbendin.gov <br />Timothy S. Klusczinski, 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 <br />USE ONLY <br />Date Received: WV2-618 Application Number: 201 — y -) U 3 A' <br />Past Reviews: ❑ YES (Date of Last Review) ❑ NO <br />Staff Approval authorized by: Title: <br />Historic Preservation Commission Review Date: <br />❑ Local Landmark <br />❑ National Landmark <br />Certificate Of Appropriateness: <br />El Denied ❑ Tabled <br />Address of Property for proposed work: <br />Local Historic District (Name) — <br />dNational Register District (Name) <br />❑ Sent To Committee ❑ Approved and issued: <br />Name of Property Owner(s): .r r ti J F h 1 %� _ 5 n nr Phone #: SO - 3 - <br />Address <br />Address of Property Owner(s): `dO <br />(Street umber=-5'treet Name—City—Zip) <br />Name of Contractor(s): ,�f� ! YJI Fie f ! �' Phone #:,12 �L <br />Contractor Company Name: fE, b t c ,q 6 Sac r WJF S <br />Address of Contractor Company: / i" Yt � na , f_a,4 d �• n,r f J 6F -AA <br />eu o zip 6 / 5� <br />(Street Number—Street Name—City—Zip) <br />Current Use of Building: <br />Vacant—etc.) <br />Type of Building Construction: (A n L 4 inn F - <br />(Wood Frame—Brick—Stone—Steel—Concrete—Other) <br />Proposed Work: (more than one ❑ Landscape ❑ New 1 '"1 Replacement (not in-kind) ❑ Demolition <br />box may be checked) <br />Owner e-mail: and/or ctor - <br />• c <br />g and/or <br />Signature of Owner Signa o ntr for <br />By signing this application I agree to abide by all local regulations related to project t obtain a Building I paztnient Petniit, ifapplicable. <br />APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE— <br />