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.,. , �. <br /> .. APPLICATION FOR A HISTORIC DISTRICT <br /> � "CERTIFICATE OF APPROPRIATENESS" <br /> ey sta�t• Application # Contributing: Yes / 1Vo Date Submifted: <br /> (Applicant, Please provide informafion befween the dou6/e lines) <br /> ro ert Address or Location: , � � �° � �A� �`���`� �/ <br /> r r v <br /> Owner's Name: I��n � I C� � ' C`�� ���E Phone: 3S� � 7�� � <br /> Appiicant's Name & Company (if different): <br /> ApplicanYs Mailing Address: �C� �X°'� ��� �4�` ��! �l � 3 S� � <br /> App. Contact Info: Phone: 7 6 � �� �� Fax: Email: <br /> Type of Property: Residential� Commercial Public or Other <br /> PROPOSED RESTORATION / RENOVATIONS / REPAIRS / RELOCATION / ETC: <br /> �� � <br /> ExteriorWalls ,SC �[���`��,prn Signage Q y�,�, <br /> � Exterior poorBa 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, p�tio, etc. <br /> Fencing Building, Demolition or Relocation • <br /> � Exterior Painting & Color Changes General Repairs (describe below) �� � � Y1 � S <br /> Roofing � Other'(describe below) fP.P�C�C �X i St � n� <br /> Gt.S dd D� e s c� r� � PG{ . <br /> Detailed description of proposed work: (attach other sheets if necessary) <br /> The Historic Preservation Board requires that the following information MUST be included with an application prior to e <br /> application being accepted by staff: <br /> • Detailed Plans, including a site plan and elevafion(s); A►� ���. �� `� <br /> • Color and material samples; �� (�, <br /> . Manufacturer's sales literature; '� I �� � �� U J <br /> • Photoaraphs: and � <br /> Any ther su ortin documentation to show that the pro osed rk is n istent ' the adopted Department <br /> of I ' r d <br /> SIGNATURE OF E OWNER and/or A <br /> (Applicant do NOT write BELOW th i ne) <br /> ACTION TAKEN Date: � � �� <br /> ❑By Staff: Approved Denied Reason for Denial: <br /> IJ By HPB: Approved '� Approved with modifications noted below* and/or on attached sheets <br /> Denied <br /> � " HPB Condition(s) of Approval: <br /> Signed: � 1 �"� Date: `� �� "/U <br />