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1$ <br />Application <br />- FOR - <br />Certificate of Appropriateitess <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lzhyette Blvd, South f.3tl,,(9, Indiana 46601 <br />aMafiing Address: Cou—,-G, 11 C' t, Indiana Ax'ef) I <br />I - I <br />Phone: 574-2.35-97,)S , Vax:574-235-97578 <br />OFFICE USE ONLY-- DO NOT COMPLF,'Tf.*�(IN)'I-',%ITRIESCO;lv*T,11,1�ED IN THIS >--OFFICrUSE ONLY <br />Date Received Application Munber-,40 I <br />Pas( Reviews: [�<ES (lixooila,t ReNCIV) NO <br />Staff'Approval authorized by: . .. ....... litle: <br />Historic Commission Review Date: <br />Local Landmark 5;Kocal Historic District (.mmte) e4&1;e1 yja-,&k <br />National Landmark ��-National Register District (Nrame) <br />Certificate of Appropriateness: <br />[IDellied Ellhbled Elselit"bCommittee DApproved and Issued <br />DAH <br />Address of Property fou proposed v,,,m-k:nCb Q-44 '1:J'- k 4 6% <br />S1 Nu,,Jvr,v0 Sm -.,f <br />Name of Property Owner(s): ni)0Y1aqu-c-3 <br />Address of Property Owner(s): <br />-aca— <br />Contractor(s) Name: P t . ..... <br />Contract Company Name: <br />Contractor Address: <br />City: � Phojle:U� 7-eA � a t 7 - 15 3 <br />Current Use of Building:. <br />(Sb?,gte Faml Xfirdji-lanlily - r",mlift'rELI 6)vermnent - 11ndusirid - Vacam, - de.*,) <br />Type of'Building Comtruction: <br />1'name 1,rkk Ston: -- SWI, - Colic?"!e 0:174") <br />--,-i <br />New [-�Keplacement (not m4wd) Demolition <br />Proposed Work: In-kind [:] Landscape L <br />(r1101,'Rwn rune bay m;ry A, ch"rk"') <br />Description of Proposed W"ork: Rpoto C-9, V-X'sS6 <br />ct-s V- <br />OwnerlContractor- Pax: (a(-C1q Y, 50 —LP—,,_ C-111"11 <br />Md� -wiih ontuom. C" <br />and/or . .... .. . .... - . .... . .......... <br />APPLICATION REQUIRF11,11 AWS ARE LISTED ON I?EVI-.-IZSE SIDE -- <br />