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HISTORIC PRESERVATION COMMISSION <br />OF SOUTH BEND AND ST. JOSEPH COUNTY <br />County —City Building, South Bend, IN 46601 <br />http://www.southbendin.gov/government/department/commun ity-investment <br />Phone: 574/235.9371 Fax: 574/235.9021 <br />Email: hpcsbsjc@southbendin.gov <br />R ee . 3 8LP D5 S x.O' <br />K5igo <br />Timothy S. Klusczinski, President A Certified Local Government of the National Park Service Elicia Feasel, Historic Preservation <br />Administrator <br />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: <br />Past Reviews: <br />Application Number: <br />❑ 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 OfAppro riateness: <br />Denied ❑ Tabled ❑ Sent To Committee ❑ Approved and issued: <br />Address of Property for proposed work: 322 W Washington St., South Bend, IN 46601 <br />(Street Number —Street Name —City —Zip) <br />Name of Property Owner(s): Nancy & Eric Horvath Phone #: ( <br />Address of Property Owner(s): 51990 Meadow Ridge Ct., Granger, IN 46530 <br />(Street Number —Street Name —City —Zip) <br />Name of Contractor(s): Self Phone #: ( <br />Contractor Company Name: <br />Address of Contractor Company: <br />Current Use of Building: Single Family <br />(Street Number —Street Name —City —Zip) <br />(Single Family —Multi -Family —Commercial —Government —Industrial —Vacant —etc.) <br />Type of Building Construction: Stone - Lower, Wood Frame - Upper <br />(Wood Frame —Brick —Stone —Steel —Concrete —Other) <br />Proposed Work: ❑ In -Kind ❑ Landscape ❑ New ❑ Replacement (not in -kind) ❑ Demolition <br />(more than one box may be checked) <br />Description of Proposed Work: Replace wood window that protects the stained glass window. The wood muntins rotted <br />and the window panes started to fall out and break. I would install a new wood window, but I am planning on a window without the muntins. <br /> <br /> <br /> <br /> <br />and/or Contractor e-mail: <br />and/or X <br />Signature of Contractor <br />By signing this application 1 agree to abide by all local regulations related to project and to obtain a Building Department Permit, if applicable. <br />—APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE— <br />