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- -,� c� n��- � C C� /!� c�- � l' c� lr� 1`�( ��h i C C� n��G� S h��� � E c� � ct t � b� <br /> /f"C�-K- �l'iXec( rd}�rn�dr2� a.�t�'/`in i.s Q�h� �i� ,n S� 2�c/�nQ <br /> r ,� ,'�,�-,�l��c�' �fc��7/tr �m�, �/.���s e� ree� t <br /> � f� � �P�� �l �rh� �` q � �1��� C�s is I�n�[v ��� ff �.��� - f -�`� ,C� oce�� <br /> .-1. �r��� 5 �` f�`��'� � APPLICSATION FOR A HISTORIC DI TRICT���tfs C hC�' �S <br /> _� , "CERTIFICATE OF APPROPRIATENESS" � �. l� ct,°�? � �%5 <br /> � x � L!-U a . <br /> ey sta� Application # Contributing: Yes / No Date Submiited: <br /> (Applicant, P/ease provide information beiween fhe double lines) (� / <br /> Property Address or Location: <br /> s � o o--�-�- t < < �� <br /> Owner's Name: , C.XxI - Pho e: <br /> AppiicanYs Name 8� Company (ifdifferenf): q,o... /N <br /> ApplicanYs Mailing Address:� ��t- � �—� <br /> App. Contact �info: Phone• � 10 Z� S� F�; Emai1: <br /> Type of Properiy: Residential Commerciai Public or Other <br /> PROPOSED RESTORATION / RENOVATIONS / REPAIRS / RELOCATlON / ETC: <br /> Exterior Wails Signage <br /> Exterior poors Lighting <br /> Windows New Main Building orAddfion to Existing Building <br /> Porches New Accessory Bldg. (garage, carport, shed) <br /> Awnings or Canopies New deck, ramp, p26o, etc. <br /> Fencing . Building, Demoi'�ion or Relocation • <br /> �� Ex#erior Painting & Color Changes General Repairs (describe be(ow) ' <br /> ___ � Roofing Other'(describe below) / / <br /> De led descripfion Df proposed rk: attach other ets if n ssary) !' `� � �� Cs ` ` `� �`! `� r �� <br /> The Historic Preservation Board requires that the foilowing i rmafion MUST be included with an appficafion prior to the <br /> apptication being accepted by s�aff: <br /> • Detailed Plans, inciuding a site �lan and elevafion(s): <br /> • Color and material sam�les; <br /> • Manufacturer's sales literature: <br /> • Photoqraohs: and <br /> • Any other su�QOrtinq documenta6on to show that the proposed work is consistent with the adopted Department <br /> of interior Standards. <br /> SIGNATURE OF THE OWNER and/or APPLICANT <br /> (Applicanf do NOT write BELOW this rne) <br /> ACTION TAKEN: Date: <br /> ❑ By Staff: Approved Denied Reason for Denial: <br /> ❑By HPB: Approved Approved with modifications noted below* andlor on attached sheets <br /> Denied ' , <br /> ' ) '` HPB Condition(s) of Approvai: <br /> _� <br /> Signed: Date: <br />