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NIO / 1 8 2025 m ik, <br />Rec. (ix, ► qa $.0,QP <br />CITY OF SOUTH BEND <br />AND ST. JOSEPH COUNTY <br />`�$ x HISTORIC PRESERVATION COMMISSION <br />Sarah Andrews <br />President <br />A Certified Local Government of the National Park Service <br />www.southbendin.gov/hpc <br />Ross Van Overberghe <br />Historic Preservation <br />Administrator <br />Certificate of Appropriateness Application <br />Property Address for Proposed Work <br />3 37 fo e lei' <br />Street Number Street Name <br />Soh966'6 <br />City Zip Code <br />Primary Property Owner(s) <br />Name <br />c_T v IP Pe91/6, - 9? <br /> <br />Parcel ID (Office use only) <br />Address (if different than obove) <br />Contractors to be used <br />Company Area of Work (ex: roof, windows. landscaping) <br />, �74-&Li '0 4.-Af toix - /R5-6 <br />Name Phone # <br />E-mail <br />Company Area of Work (ex: roof, windows, landscaping) <br />Name <br />Phone # E-mail <br />Company Area of Work (ex: roof, windows, landscaping) <br />Name <br />Phone # E-mail <br />Continued on bock <br />215 S. Dr. Martin Luther King Jr. Blvd. l Ph: 574-235-9371 1 hpcsbsjc@southbendin.gov <br />