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Application <br />. - FOR - <br />CerH f icate of Appropriateness <br />Historic Preservation Commission of South Bend & St Joseph County <br />125 S6 Lafayette Blvd., South Bend, Indiana 46601 . <br />Mailing Address: County -City But�ding, South Bend, Indiana 46601 <br />Phone: 574-235-M • Fex 57405-9578 • F.maR awjuw%.*+m.st josephinus <br />Website httpr//www.slosephCD=VndiamCDM/qdtp/hulexhtml <br />OFFICE USE ONLY »»>> DO NOT COMPLETE ANY ENTRIES CONpIINED IN THIS BOX »»» OFFICE USE ONLY <br />Date Received a. �� . b Application Number Q. -LQ- - 06" <br />Past Reviewr. tdYES (aatc o f t„ t ReVQ ❑ NO - <br />Staff Approval authorized by: Title: <br />Historic Commission Review Date: , jf <br />❑ Local Landmark Local Historic District (Name) AV <br />❑ National Landmark ❑ National Register District ovamt) <br />Certificate of Appropriateness: <br />❑ Denied ❑ Tabled ❑ Sent To Committee ❑ Approved and Issued <br />IMTs <br />�l'1 ( , <br />Address of Proforproposed work. l 4 4 S ' ' <br />PAY <br />Street Nwn6a and Stmt Name <br />Name of Property Owner(s): (Manprint) �, n <br />Address of Property er(s): 944 (Z •� Prx?;' l� ' nN' o i SIR •��3. <br />Contractor(s) Name: 6',kr .P4> 0 CAga5 <br />Contract Company Name: <br />Contractor Address: <br />City: Phone: <br />Current Use of Building- sw FaN '%-\ <br />(SingleFamily-Matti-Pony-Commercial - Gaoeiummi -Industrial - Vacant - etc.) <br />Type of Building Construction: <br />(Wood Frame - Bride - Stone - Steel - Concrete- Other) <br />Proposed Work ❑ In-kind ❑ Landscape ❑ New ❑ Replacement (not in4dnd) ❑ Demolition <br />(mat than onebout traybecha*4 jq <br />Description off P posed Work <br />� l � Civ ""� =—� �n-'-1 `� CL&., <br />C <br />r � n <br />cat&rS i`�u�t W".0— w� SLce� J <br />Owner/Contractor. F= e-mail <br />(Tim ofai rnapond toith only one <br />�/or <br />