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Michele Gelfman, President <br />HISTORIC PRESERVATION COMMISSION <br />OF SOUTH BEND AND ST. JOSEPH COUNTY <br />County—City Building, South Bend, IN 46601 <br />http:l/NN ww.southbendin.gov/govemment/department/community-investment <br />Phone: 5741235.9371 Fax: 5741235.9021 <br />Email: hpcsbsjr@southbendin.gov <br />Elicia Feasel. Historic Pmserration <br />Administrator <br />A Certified Local Government of the National Pail Service <br />APPLICATION FUR .A — (1Fk2TIFICATE OF APPROPRIATENESS <br />OFFICE USE ONLY-- ­D0 NOT CONIPI.ETE ANY ENTRIES CONTAINED IN THIS B0X«««OFF10E ESE ONLY <br />Date Received: Application Number: — <br />Past Reviews: ❑ YES (Date of Last Review) ❑ NO <br />Staff Approval authorized by: Title: <br />Historic Preservation Commission Review Date: <br />❑ Local Landmark Local Historic District (Name) <br />❑ National Landmark ❑ National Register District (Name) <br />Certificate Of App ro riateness: <br />Denied ❑ Tabled ❑ Sent To Committee ❑ Approved and issued: <br />Address of Property for proposed work: 628 Park Ave, South Bend, IN 46616 <br />(Street Number—Street Name—City—Zip) <br />Name of Property Owner(s): Joyelle McSweeney, Johannes Goransson Phone #: 610-745-3059, 610-733-0244 <br />Address of Property Owner(s)- 628 Park Ave, South Bend, IN 46616 <br />(.S1ree1 Number—Street Name—City—Zip) <br />Name ofContraetor(s): Greentree Environmental Services, Inc Phone#: 219.764.2828 <br />Contractor Company Name: Green Tree Environmental Services <br />Address of Contractor Company: P. O. Box 2297, Portage, IN 46368 <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: Brick <br />(Wood Frame—Brick—Slone--Steel—Conerele—Other) <br />Proposed Work: (more Ilion one ❑ Landscape ❑ New ❑ Replacement (not in-kind) ❑ Demolition <br />box may be checked) Vr>%OAS <br />S VF A G <br />9. Description of Proposed Work: As part of an urgent, extensive lead abasement project, Greentree has determined that at the <br />v.r d er � �wP'r rw bw�e en w+•Mawm r�pon eon Sr .brp+Coriry nprur.Mn s w orM oPo^ rd yr wroan eeca.x 1Mn w MW C.Wren n✓Mq nM+a.� a SW ..k• wvtlW wb irra rye M <br />+� window Jambs are deterrorated which are fnetgn impact surfaces Replace ��${ IOep�yBtbyfE�L+. d1 f2[Snot uSe ecapSulation On IndiOn impact Surfaces R r$ not an option <br />J� wp.c...d n r+a� wb..snwq rror uaq vim dr r. w uwn�ry r Awv e.. rte^ r....orap mr..-dws w�uw a �+�9 r.* wx oFau.. d w rw d u...�awra w ao.a w.+nwan nr sokw. wm. a .rarm.e.m msr w c. r u.ry -wa. a � <br />com <br />joyelle.mesweeney@gmaii.reentree@ rntree-net <br />Owner e- _ and/or Contractor e-mail: g g <br />and/or X Sam U6�L1'12Q►ZiL <br />X dfflCE Manager <br />Sion, re of Ot9ystgnuig <br />Signature of Contractor <br />ibis application I agree to abide by all local regulations related to project and to obtain a Building Department Pent, if applicable <br />