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. <br />APPLICATION <br />FOR CERTIFICATE OF APPROPRIATENESS <br />HISTORIC <br />PRESERVATION <br />COMMISSION <br />OF SOUTH BEND AND ST. JOSEPH COUNTY <br />G <br />-93 <br />�V�"��� ��� S}:I <br />Date: <br />��"� <br />Owner's s Name : <br />6ddress of <br />Mailing Address <br />Property <br />of Owner <br />Designation: <br />Telephone: <br />DESCRIPTION <br />OF PROJECT: <br />Stb kWkAAAS0 <br />[] Continuation Sheet [] Addendum to Certificate <br />The following information as applicable to the particular situation and the <br />standards designated shall also be submitted as part of this application: <br />Structural drawings and specifications, or site plan, floor <br />plans, elevations, cross section plans, renderings, diagrams, or <br />other such plans. <br />Landscaping plans. <br />Contractor specifications. <br />Photographs. <br />Where the proposed project includes a sign, a scale drawing showing <br />the location of the sign on the structure or property, the type of <br />lettering, and the method of V lumination. <br />Other- such information as the�Historic Preservation Commission may <br />require under the provisions of the Zoning Ordinance of the City of <br />South Bend or the St. Joseph County Zoning Ordinance, as applicable. <br />The filing of this application shall be accompanied by a fee of three <br />dollars ($3.00), payabl to the Historic Preservation Commission to cover <br />the costs i urred in- a iewing and processing this application. [] <br />Ap licant's s nature Applicant's Printed Name <br />FOR OFFICE USE ONLY <br />COMPLETEQ AP'PL I CATION RECEIVED (date): Z7 93 CASE # : lRg3-07"Z?- <br />REVIEW AND DECISION OF THE HISTORIC PRESERVATION COMMISSION <br />•REVIEW: [] In-kind Replacement [] Appropriate [] Inappropriate <br />Comments: <br />[] Continuation Sheet [] Addendum <br />DECISION: [] Approve.d [] Denied [] Partial Approval Date: <br />Comments: <br />Historic Preservation Commission <br />•Notice to Applicant: Approval of your application and issuance of a <br />Certificate of"'Appropriateness in no way signifies compliance with health, <br />safety or general building/zoning standards. Neither does it release or <br />relieve you from compliance with all codes and regulations of the City of <br />South Bend, St. Joseph County, or the State of Indiana. The commission ex- <br />pressly disclaims any liability resulting from safety or health defects in <br />any structure for which a Certificate of Appropriateness has been issued. <br />Approval of your application expires six months from the DECISION date. <br />For projects not substantially completed, contact HPC for renewals. <br />Y� <br />