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HISTORIC PRESERVATION COMMISSION <br />OF SOUTH BEND AND ST. JOSEPH COUNTY <br />County --City Building South Bend, IN 46601 <br />http://www.southbendin. ov/governmentfdepartmenttcomrdunity-investment <br />Phone: 574/235.9371 Fax: 574/235.9021 <br />Email: hpcsbsjcCasouthbendin.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 — CERTIIZCATE OF APPROPRIATENESS <br />OFFICE USE ONLI>>>>>> 0 NOT COMPL)uTE ANY ENTRIES CONTAINED IN TRIS BOX«««0FF7CE USE ONLY <br />Date Received: V CP I I S— Application Number:�— O 2 '2 o A 62- 2, 6 ; <br />