Laserfiche WebLink
From. 08/04/2011 12:49 #456 P 001l001 <br /> � j b� 1 <br /> � 9� J��!' " li�J �� <br /> , ' ` x'. 3��Z <br /> r�" <br /> .-�� APPLICATION FOR A HISTORIC DiSTRICT <br /> - "CERTIFECATE OF APPROPRIATENESS" <br /> ey statt.• Application # Contributing: Yes / IVo Dafe Submifted: <br /> (Apptfcar� P/ease provFde frrformaflon between fhe dou6/e lines} <br /> Property Address or Location: __, v49 �l-h �tYQ Y�# <br /> Owner's Name: ���hn�rx.� �-�� ��,c..r� Phone: �',1; �77.`� _ ��ic3 <br /> AppticanYs Name & Company (ifdJfferent): .')�7�r��- 1�. �lz ��� ���alc' `�i��, �y�� <br /> Appl9canYs Mailing Address:____ 1�.� l( I�.,� �i� �� , c �� -,�,,, I'lr ��.�i :� Z3 <br /> APp. Contact,lnfo: Phone: " ,� Fax: .�5z,,]__�_`1 � 4�� Emafl: milba�-C�_E�rHn1J1�k_v�' <br /> _ Type of Property: Residenfiai � Commercial Pubiic or Other <br /> PROPOSED RESTORATlOF! / RENOVATIONS / REPAfRS / RELOCATION ! ETC: <br /> Exterior Walis 5ignage <br /> E�derior poors Lighting <br /> Windows New Main BuUdng or Addition to Existlng Buildng <br /> Porches New Aocessory Bidg. (garage, carport, shed) <br /> Awnings or Canopiss New dec�C, ramp, patio, etc. <br /> Fencing Butlding, Demclitlon or Rebc�lon • <br /> '} �Exterior Painting & Cobr Changes General Repairs (desaibe below) � <br /> , ✓ Roofing Other'�describe betow) <br /> Defailed description of pmppsed wor{c: (attach other shee#s if necessary) r'1 �- ����� (1yy <br /> �� � �.i��PA_ c,MrrAcsr <br /> The Hlstoric Preservatbn Board requires that the foliowing informatian MUST be included with an appiicatton prior to the <br /> appGcation being accepted by staff: <br /> • Detailed Plans, induding a site olan and elevation(s): <br /> • Color and material samaies: <br /> • ManuFaeturer's sales ture: <br /> • Phobaraohs: and <br /> • Any other_���o � mer�tatlon to show that the proposed work is consistent witt� the adopted Department <br /> of Interior S'tandards. <br /> 1 <br /> � <br /> SIGNATURE OF THE OWNER and/or Al�PU <br /> (AppJfcant do NOT wrlte BELOW this One) <br /> ACTtON TAKEN Date: <br /> y Staff: Approved• Denied Reason for Denial: <br /> ��C]By HPB: Approved Approved with modificatlons noted belaw' andlw on attached sheets <br /> Denied <br /> " HPB Condition(s) of Approval: <br /> Signed: � Date: �/a�/�/ <br />