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HISTORIC PRESERVATION COMMISSION <br />OF SOUTH BEND AND ST. JOSEPH COUNTY NOV O 5 2020 /'v1 A County-City Building, South Bend, IN 4660 I f<. e.e,, r\J O. I ·7 5 7 7 :Ji � �o.oohttp://www.southbendin.gov/government/department/community-investment Phone: 574/235.9371 Fax: 574/235.9021 Email: hpcsbsjc@southbendin.gov Michele Gelfinan. President A Certified Local Government of the National Parle Seivice Elicia Feasel, Historic Preservation Administrator 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: --------Application Number: <br />Past Reviews: □YES (Date of Last Review) ___________ □NO <br />Staff Approva l authorized by: ______________________ Title: _________ _ <br />Historic Preservation Commission Review Date: _____________________________ D Local LandmarkD National Landma rk <br />D Local Historic District (Name) ________________D National Register District (Name) ______________ _ <br />Certificate Of App�iateness: LJ Denied □ Tabled D Sent To Committee D Approved and issued: _______ _ <br />Address of Property for proposed work: _9'�\�L\�-L���\_O/'\d���A_'1_e.f'\�-ve,..�--��-� __ 'B_t _e_Vl_d_· __ '-l(o�(o l CoC: <br />r:1, �-\-c,.\ ,\ �-:/�tr:;/.J1.umJJ_£���--City-Zip) <br />Name of Property Owner(s): Qv'iV"O �( 1 ::} Pi. \ L::vi ( l\/l S '20 Phone#: <br />Address of Property Owner(s): _.,,.�:;..;;._; _____________________________ _ n . 1 _ • t:"" _, __ . (Street Number-Street Name-City-Zip) '"-\ C..Y' I .::>°"' C-V\.C..... "l,.. Name of Contractor(s): �P\s_· -=--�-�-'--=v�-������ .. ��--...,---\...�U=C,�_• _____ Phone#: <br />Contractor Company Name: A.�� CV\.� tl..010H�L LC.. <br />Address of Contractor Company: L \ "L(D w w�'Jev-r. A......,c.. <br />(Street Number-Street N ame--City-Zip) <br />1-HoCool <br />Current Use of Building: __ '3_,t"'\_<c)c½lL ___ t7_��-l_· \_'--{ ______________________ _ (Single Fam ily-Multi-Fbmily--Comm erc ial--Government-Jndustrial-Vacant-etc.) <br />Type of Building Construction: _'-N.c....1cc.=-.cc_d_�Fv.��c:�VVU... ___ ,_���\�C::--�\L.�,-S_-\--...> __ C.._C..O ______________(Wood ilram e-Brick-Stone-Steel-Concrete-Other) <br />Proposed Work: (m ore than one <br />box may be checked) 0Landscape �New D Replacement (not in-kind) D Demolition <br />Owner e-mail: C,,< g,n+:t c@ 8rv"\Ol� \ -{..D'l"\and/or Contractor e-mail: R·l '-""-\ @. g. Ssdr\�v"'oottn5 • <br />�-- <br />u:::itn X ./1 .2, and/or X Signature of �er........, S ign_a_t _u -re -o f _C_o _n -tr _a_c -to_r ____________ _ <br />By signing this application I agree to abide by all local regulations related to project and to obtain a Building Department Permit, if applicable. <br />11/5/2020 2020 <br />n/a <br />xx <br />Chapin Park <br />Chapin Park <br />1112A <br />Elicia Feasel H.P. Administrator <br />s 2020-1112A