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Michele Gelfinan, President <br />7o <br />HISTORIC PRESERVATION COMNIISSION f--7 5 � 2-4 <br />OF SOUTH BEND AND ST. JOSEPH COUNTY • <br />County—City Building, South Bend, IN 46601 <br />http://www.southbendin.gov/government/department/cominunity-investment <br />Phone: 574/235.9371 Fax: 574/235.9021 <br />Email: hpcsbsjc@southbendin.gov <br />A Certified Local Government of the National Pads 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: t5 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 Appropriateness: <br />E] Denied ❑ Tabled <br />Title: <br />❑ Local Historic District (Name) _ <br />❑ National Register District (Name) <br />❑ Sent To Committee ❑ Approved and issued: <br />Address of Property for proposed work: 1242 E Jefferson Street, South Bend, IN 46615 <br />(Street Number --Street Name—City—Zip) • <br />Name of Property Owner(s): Leo J McKernan Phone #: <br />Address of Property Owner(s): PO BOX 110729, Naples, FL 34108 <br />(Street Number—Street Name--City—Zip) <br />Name of Contractor(s): Al Lusk Phone #: 574-239-7016 <br />Contractor Company Name: Premier 1 Construction, Inc. <br />Address of Contractor Company: 105 E Jefferson Blvd, Suite 216 <br />(Street Number—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: Concrete Slab, Masonry Walls, Wood Truss Roof with mix of PVC and slate tiles <br />(Wood Frame Brick—Stone—Steel—Concrete—Other) <br />Proposed Work: (more than one ❑ Landscape 0 New ❑ Replacement (not in-kind) ❑ Demolition <br />box may be checked) <br />Description of Proposed Work: Leo McKernan would like to have a 14'-2" x 19'-0" addition added to the South East Corner <br />of his home to accommodate his need to have the living room be in dose proximfty to the kitchen to reduce his overall steps taken throughout the day while he resides at this home. <br />Ovper a -m ' : and/or Contra e- ail: al k pr mier1 construct • <br />X6 and/or X <br />Sign t re o der" Sign t rLDe <br />By signing this application I agree to abide by all local regulations related to project and to obtain a Buildin .1 Permit, if applicable. <br />—APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE— <br />