Laserfiche WebLink
APR 3 0 2025 RQC.6UPI <br />Teo W m'- <br />CITY OF SOUTHBEND <br />AND ST. JOSEPH COUNTY <br />HISTORIC PRESERVATION COMMISSION <br />Sarah Andrews, A Certified Local Government of the National Park Service Ross Van Overberghe <br />Historic Preservation <br />President www.southbendin.gov/hpc <br />Administrator <br />Certificate of Appropriateness Application <br />Property Address for Proposed Work <br />Street Number Street Name <br />4 Le� 6'011/ 6 <br />City Zip Code Parcel ID (Office use only) <br />Primary Property Owner(s) <br />Name # <br />Primary E-mail <br />S e r' , 4 y 60 c7 Gt seti j i to L'� G t6 <br />Address (if different than above) <br />Contractors to be used <br />m va S <br />Company Area of Vlork (ex: roof, windows. icndsCcofrg; <br />I_57zf.)n�� <br />Nome <br />Company <br />Name <br />Compony <br />Blame <br />Phone # <br />E-mail <br />Area of Work (ex: roof. windows. landscaping) <br />Phone # E-mail <br />Phone # <br />Area of Work (ex: roof, windows, landscaping) <br />E-mail <br />Continued on back —+ <br />227 Wesi Jefferson Blvd„ Suite 1400S 1 Ph: 574-235-9371 1 Fx: 574-235-9021 1 hpcsbsjc@southbendin.gov <br />