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COP" <br />HISTORIC PRESERVATION COMMISSION • <br />OF SOUTH BEND AND ST. JOSEPH COUNTY <br />County—City Building, South Bend, IN 46601 <br />htip://www,southbend in.god/govemm entfdcpartment/comm unity -investment <br />Phone: 5741235.9371 Fax: 5741335.9021 <br />Email: hpesbsjc@sauthbendin.gov <br />Timothy S. Klusczinski. President A Certified Local Government of the National Park Service Elicia reascl. Historic Preservation <br />Administrator <br />APPLICATION FOR A — CERTIFICATE OF APPROPRIATENESS <br />OFFICE VSE ONL 3S»»>DO NOT COMPLETE ANY ENTRi rs coNTAINED I N THIS BOX—OFFICE VSE ONL I' <br />Date Recelved: ` Application Number:_— <br />Past Reviews. VES (Date r f Last Renew) (_ A ❑ NO <br />Staff Approval authorized by, u Title: <br />Iiistoric Preservation Cam fission Review Date: <br />Local Landmark <br />❑ National Landmark <br />Z2 <br />ELocul Historic District (Name} -' I af <br />irational Register District (Name) UI`1/'1A IP i Vi r.CA I(►1 <br />Certificate Of Appro rlateness: <br />f Denied ❑ Tabled ❑ Sent To Committee ❑ Approved and issued: <br />Address of Property for proposed work: 701 Portage; South Bend, IN 46616 <br />(Street,\umber-41redt Nanre-01),—Zip) <br />Name of Property Owner(s): Seven Entropy Design Studio Phone #: 858-717-3157 <br />Address of Property Owner(s): 3623 Eastham Drive; Los Angeles, CA 90232 <br />(Street Number—Street Xame-•-Ciry - Zip) <br />Name orContractor(s): Norrie Emmons Phone#: 574-232-9600 <br />Contractor Company Name: H.G. Christman Construction <br />Address of Contractor Company: 23186 Ireland Road; South Bend, IN 46614 <br />(Street Number—Street Nanre—Cit)� Zip) <br />Current Use of Building: Vacant <br />(Single Family—,IInItP-Fa»rily—Conanercial—Gotc►nment—ladirstriat—i'ucpnt—etc.J <br />Type of Building Construction: Wood frame with steel and masonry structural members <br />(11'ood Fran►e--Brick--Stone—Steel•-Concrete—Other) <br />Proposed work: Q In -Kind © Landscape 0 New ❑ Replacement (not hi -kind) ❑ Demolition <br />(store than one box maj, be checked) <br />See attached site plan with notes and product dataAiterature. <br />Description of Proposed work: p <br />• <br />Owner e-mail: and/or Contracts mail: porde@hgchristmanconstruction.com <br />and/or X • <br />Signature of Owner Signature of Contractor <br />By sighing this application 1 agtec to abide by all local regulations related to project and to obtain a Building Deparlmcnt Penni/; irapplicabic <br />—APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE— <br />