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<br />APPLICATION FOR A HISTORIC DISTRICT <br />"CERTIFICATE OF APPROPRIATENESS" <br /> <br />By s ff: Application # <br /> <br />Contributing: Yes / No Date Submitted: <br /> <br />Appli ant's Name & Company (if different): <br />nt's Mailing Address: /6 So7 /-//9A/N.4 ~~, t. i{ -f'L rL :.r .:r S-S/9 <br /> <br />App. ontact Info: Phone:8/.? -Slb'7/.2?as- Fax: Email:/ S~-'lrk'.di) Vo/'ll 7MJ . /V<:" / <br /> <br /> <br />(Applicant, Please provide information between the double lines) <br />Prop rty Address or Location: 5 C( 2 ~ ?? +t..... ST Z epA y rA.I m F~ I::r S-rr z- <br />f?oge,( ~/1lk/-Io/v Phone: 8/.J'~ SILl Sf -Z'78~ <br /> <br />f Property: <br /> <br />Residential <br /> <br />/ <br /> <br />Commercial <br /> <br />Public or Other <br /> <br />PRO OSED RESTORATION / RENOVATIONS / REPAIRS / RELOCATION / 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 />=z- Exterior Painting & Color Changes _ General Repairs (describe below) <br />~ ooting , .:...- Other (describe below)" . <br /> <br />description of P.I~O~~?,' ;:or.k: (attach other eets if ,nec~ssary), /?f2/::t2/.u-l ""(..1/ <br />F/ '-,,~ ~ I / P Kod'~ s: ,r', <br />A"'A; , F",,,,' ".f. l 'Ii' eo. . <br />0/1) .FKh" '1M ~ ~ /../0 K S-E:.. <br />The Hi toric Preservation Board requires that the folloWing information MUST be included with an application prior tD the <br />applica 'on being accepted by staff: <br />· Detailed Plans, including a site olan and elevation(s): <br />· Color and material samOles; <br />· Manufacturer's sales literature; <br />· Photoaraohs: and <br />· Any other suooortina documentation to show that the proposed work is consistent with the adopted Department <br />of Inte' S dards. <br /> <br /> <br /> <br /> <br />RE OF THE OWNER and/or APPLICANT <br />A licant do NOT write BELOW this line <br /> <br />Date: <br /> <br />Approved _ Denied <br /> <br />Reason for Denial: <br /> <br />Approved _ Approved with modifications noted below* and/or on attached sheets <br />Denied <br /> <br />ondition(s) of Approval: <br /> <br />tI'D UL--H <br />Date: 3 -7- DT <br /> <br /> <br />1+. Nf3 ~ <br />