Laserfiche WebLink
I <br />HISTORIC PRESERVATION COMMISSION OF SOUTH BEND AND ST. JOSEPH COUNTY County-City Building, South Bend, IN 46601 http://www.southbendin.gov/government/department/community-investtncnt Phone: 574/235.7478 Fax: 574/235.9021 Email: hpcsbsjc@southbendin.gov <br />Michele Gel:finan, President A Certified Local Government of the National Park Service Elicia Feasel, Historic Preservation Administrator <br />APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS <br />OFFICE USE ONLY»»»DQ NOT COMPLJJ;TE ANY ENTRIES CONTAINED IN JWS BOX«««OFFICE USE ONLY <br />Date Received: ______ _ Application Number: ____ ;--____________ _ <br />Past Reviews: □ YES (DateofLastReview) _________ _□NOStaff Approval autboriz.ed by: ___________________ Title: --------- <br />Historic Preservation Commission Review Date: ________________________ _ D Local Landmark D National Landmark <br />Certificate Of Apppm.riateness: u»enied □ Tabled <br />D Local Historic District (Name) _____________ _ D National Register District (Name) ____________ _ <br />D Sent To Committee D Approved and issued: ______ _ <br />Address of Property for prop osed wor�: '6 lo 3 t:(Y<tt Ave. , Sou.th Bend, :I-to lo I�(Street Number-Street Name-City-Zip) <br />NameofPropertyOwner(s): M<H K So:el\Phone#: 61t 2qg J �3o <br />Address of Property Owner(s): _...::,:3:;...la=--i..3�_.F�o.::::..r:....;e::::;i.,.,1...$ t--!.---.:A:.....:....lv�e_�, --1,\S:e>-,J..)�Ll�±L..:bw.......,,L..,8!..l.-e.J..n..ud.,a__,,_, _41.-..JJ.fau.ala�I to�-­(Street Number-.:.Street Name-City-Zip) ' <br />Name of Contractor(s): -_ \),-=OJ=, ..__1'_,,\-L_\.:...,__O;::::.....a_r__;ti:._:'...J!2.�----------Phone#: <br />Contractor Company Name: _O�r�n'-=-· ..=Z;,.___C�o:.!-o!l...s4-;\ru;�c.::...C:b...!..,L.;. O�Y\.-1..-___________ _AddressofContractorCompany: ]37 �-etd iY..., Dr-bOLlfu B-end 1 �N ii..o_(,p \q(Street Number-Street Name-City-Zip) ' <br />Current Use of BuHding: _ ___._M�u�th�i:-;;::tl-::;:CL�m�,�· l�✓r-;:;--:;-�----=--;---::::-----=--:--�-----­(Single F amily-Mulli-F amily----Commercial-Government -lndustrial-Vacant-etc.) <br />Type of Building Const ruction: ------.!.W�o..i...owd�;:-:h�tMD=�e�-;--;:;:---;;:--;--:;::-----::--:--------­(Wood Frame-Brick-Stone-Steel-Concrete-Other) <br />Proposed Work: (more than one box may be checked) D Landscape D New � Replacement (not in-kind) D Demolition <br />Owner e-mail: cSnt/ I l'l)Cll'. kll4 @3 l'l')C(-(/. @nand/or Contractor e-�ail: Qr n-z_ �30 @��00 . LO yyx --------------and/or x Cx; n, -e,_/ 0/'t'i Signature of Owner Sign::a:tu:r::e�o�f�C�o=ntra-:::'!.ct�o=r�J-..---------- <br />By signing this application I agree to abide by all local regulatioas related to project 111d to obtain a -0..:1.1 ... -n-..-- n-: if .u-... ..,.,.._.....,... c ... m1t, applicable.