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07/14/2010 07:35 <br />5742884766 <br />SOUTH BEND ROOFING <br />PAGE 02/03 <br />A,Pplication <br />-FOR - <br />Certic', frmte of Appn"'atmess <br />Hb t t PneseoWlon Commissim of Sot* Bend & St. id$Vh Comfy. <br />M & LATeft BiV4 South Bend,, lnd m 1d601 <br />qty Maldi . Soul► Bend, i _Ui lAff" <br />Phone S*Z3&M a FtX5M-M6MB � S Cn e�jveePh to u� <br />wddk hop: / /wwwj,,.,j :.4 <br />OFFICE tM OlYLY}>"» NOTCOMUM COMM IN ZMS » > »> QMCE USE ONLY <br />Date Received a a0 to : ' AppIIcatioq Number as / v_, 0 80 2- <br />•. f <br />Psat Reviews: p <br />Staff Approval a Awft d by. Tltle: <br />Ebtark Com adwon Role w Data: ~ de . _. _. . <br />Local Lmdmork ❑ la* Histacic Dlatrict 0k*4 <br />National Landmark. ❑ NdhMd R Tlii ft- N=d <br />(3erMate of Appreprlatage <br />heated Q Ubled • (❑ Sent Tb C=mlWa [] Apprand and Uued <br />VATS , <br />A&h 6r ftp : 66984 Pine Road <br />. se�ec i+t�aaout sane x:,� . <br />Name of Property O Sk Q wepa) Ken Swank <br />66984 Pine Addrm of Pioperq► Ovmer(ar . <br />C;onftmft( Nmm Barr •Mi 1 tenberaer <br />C uftWCompanyNamm South Bend R Lnq & Sidjnq Cn . <br />CantractorAddre= 1138 W. Washington .StrP <br />City: South RPUd. TN :Pbon�• <br />Cut' mt U9e of Budd!* S i' n nl'p Fam ily, :...' <br />?y►pe of Butldi�g Coon: ' B r i c k <br />(wed - saw - sw - C« -ors.) . <br />Propond Work Ya -kind New Re 0=mm t -rt) ❑ �emoiiti� <br />D Window Renlaceme hpH <br />Qwc�nlCoritiac�or. Y�a� ' .e3mt1 .. ... _ <br />and /a: <br />rr&" : IWS AMA • nr Y SCwatn na► v xWLlnCP MY2V _ <br />