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Sarah Andrews <br />President <br />CITY OF SouTIl BEND <br />AND ST. ,JOSEPI-I COUNTY <br />HISTORIC PRESERVATION COMMISSION <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 />19.7 coce -1 400 <br />Street Number Street Name <br />City Zip Code <br />Primary Property Owner(s) <br />C7(? keffi <br />Name <br /> <br /> <br /> <br />Phone # Primary E-mail <br />Address (if different than above) <br />Contractors to be used <br />.SC L - I( eic,P <br />Company <br />j em,J Cc ke( <br />Nome <br />Phone # <br />Area of Work (ex: roof, windows, landscaping) <br />E-mail I <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. Ph: 574-235-9371 I hpcsbsjc@southbendin.gov <br />