Laserfiche WebLink
Application <br />-fur. <br />Certi JCate of Appropriateness <br />! 8 ,q1,'' a Iliriorlr !'frntv t'ou►tnisyittn u(�ivaih Ilrud de 511 „lnitr�ih (;outliy <br />1s�s 227 West lefierson Blvd - ItM 1 123 South Bend IN 46601 - 1830 <br />Phone: 219- 235 -9798 Fax: 219 -235 -9578 e.— 114 historic(amichiana.arg <br />A Certified Local Government <br />11Ft-MATKON1P -1— O N f tffIIMP. F: VEANVisNl1tit'SMNTAINFOtN1111 5 nf)X< , r-0FFtt'R /dSRAN1. <br />Y <br />v i <br />Date Received ! 20 1a Appiicntion Number: 2000- d 11$ <br />Past Reviews: ❑ YES (tun.rtru,tarxt+at ❑ NO <br />Tmning Type -_ 01 1 1 All S11.o <br />Staff Approval authorized by: / Title: 1 44 Lt'.�..1J <br />historic Commission Review Date: <br />❑ Ucai Landmark ❑ Nattanal landmark <br />❑ National Register District im_): }(�_ <br />t Deal ttistorlc D'utrlet mot: �, U� tit l�j e <br />Certificate of Appropriateness: <br />❑ Denied Tabled Sent To Committee <br />La Approved and issued <br />Address of Property for proposed work: I Oq VAK t515 C)I, . <br />. M Nrnalnn sd Snwv Mwe) <br />City :�r� • {�. Township:�" =1 <br />Name of Property Owner(s):marxn � ) t v j W A '`} <br />Address of Property Owner: <br />Contractor's) Name: <A—M <br />Contract Company Name: <br />Contractor Address: City: <br />Contractor's Phone No: Owner's Phone No: <br />Current Use or Building- ✓ i F1k+ tf Qq a jt y j2 � <br />1.Stttyteia+niJy. afxM•Frmt + rtat.Gehtra lMrXrtal. Vacs,. etc <br />Type of Building Construction: <br />(tt'oMi Ffaw .- &M .,float - Ctrti. 4onetete • QA,) <br />Proposed Work: np Inkind ❑ Landscape ❑ New D Replacementfaotta t,4 <br />fill *M "M MAT aHfs” Af rrwftNy <br />� <br />Demolition (Completion ofsenerate Form Also Required) <br />Description of Proposed Work: V, Ana I r?L4-e,5 0-- 1 L,''r' <br />o 5 it,N '`"1'R t M t � tom -otter t�v nli�ws <br />1N / i tJ �-► is � �� ,�. <br />Clru Ml i 6 1 ` 7 b& 4 p G <br />Owner rntall: <br />(Al, oj¢W wf!l rnmrp aeJr>rh,wrly arc v4 'tAwT1 <br />S aafa a of Owner Signature of Contractor <br />Al'PLICA'i'ION ItFQUitttMPN "fS AIIL; LIS'I'EI) ON ItEVLitSIt SiUL. <br />Any and all business of this office is handlers via e-ntoll and fax, with least preference to U.S. Mall <br />T, <br />t. <br />