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<br />APPLICATION FOR A HISTORIC DISTRICT <br />"CERTIFICATE OF APPROPRIATENESS" <br /> <br />By staff: Application # <br /> <br />Contributing: Yes / No Date Submitted: <br /> <br />(Applicant, Please provide information between the double lines) <br />Property Address or Location: )"1 Z I 1ft, 5lr~e-l- Z~pl}vrt,( '/f~ J Ft 5..JJ~ l.. <br />, <br /> <br />Owner's Name: MPt'c 1II $ P r ,. C L Phone: 1'/ .J . Z~. - g 2 8'~ <br /> <br />Applicant's Name & Company (if different): <br /> <br />Applicant's Mailing Address: <br />~/> l~l- /S(JO #)b7 Ir~9. /) <br />App. Contact Info: Phone: P Fax: <{ /3 - / D' - Email: Jot., r >e:. go, j,.ptJ ff~/ . CO"" <br /> <br />Type of Property: Residential t/" <br /> <br />Commercial <br /> <br />Public or Other <br /> <br />PROPOSED RESTORATION I RENOVATIONS I REPAIRS I RELOCATION I ETC: <br /> <br />Exterior Walls _ Signage <br />Exterior Doors _lighting <br />\....."Windows _ New Main Building or Addition to Existing Building <br />Porches _ New Accessory Bldg. (garage, carport, shed) <br />_ Awnings or Canopies _ New deck, ramp, patio, etc. <br />- Fencing _Building, Demolition or Relocation <br />_ Exterior Painting & Color Changes _ General Repairs (describe below) . , , <br />~ Roofing _ Other (describe below) U.p5> tt:' I ~ .- <br /> <br />Detailed description of proposed work: (attach other sheets if necessary) r-e J? /t;t t: ~ '" e,,+ 1\ ..........tI rI (J M/$ <br />r <br /> <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />that the proposed work is consistent with the adopted Department <br /> <br />SIGNATURE OF THE OWNER andlor APPLICANT <br />(Applicant do NOT write BELOW this line) <br /> <br />ACTION TAKEN: Date: <br />DBy Staff: Approved _ Denied <br /> <br />Reason for Denial: <br /> <br />I::!fuy HPB: Approved ~ Approved with modifications noted below* and/or on attached sheets <br />Denied <br /> <br />* HPB Condition(s) of Approval: <br /> <br />Signed: <br /> <br />; I <br />~tj-- !~ . ,J. /)~~~ <br /> <br />Date: <br /> <br />4ptl.; L '1 J 2" .7. <br />\ <br />