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v�+ „ kr <br /> - APPLICATION FOR A HISTORIC DISTRICT <br /> � , "CERTIFICATE OF APPROPRIATENESS" <br /> ay sra�t•Application # Contributing: Yes/No Date Submitted: ����;P"�"`� - <br /> '\...-. ' t� % <br /> (Applicant, Pfease provide information between the double lines) <br /> ������ <br /> PropertyAddress or Location: J�''�� `'�F� ��� �'"j#%' ��'�'" ��``.��',�,fi+'� ��,Pr�,��; t��'„,�,,,, <br /> Owner's Name: �JU 1 1..���' ��a ����~. S�: Phone: �;.+� �,� �� ��„ "'�1,��'.! <br /> Applicant's Name &Company(if different): <br /> � <br /> ApplicanYs Mailing Address: �`".�- �� `�j �°; �`� �`,�•�' ���..`w,� '.��"�,.,�.,�}� w�, �. . , `, , , <br /> � ���.... <br /> App. Contact Info: Phone: �,,/g,�, � Fax: Email: <br /> Type of Property: Residential Commercial� Public or Other <br /> PROPOSED RESTORATION/RENOVATIONS/REPAIRS/RELOCATION/ ETC: <br /> Exterior Walls Signage <br /> Exterior poors Lighting ""'""'""°""""'°-- <br /> Windows _}�New Main Building Addition to Existing Buildin <br /> �_Porches New Accessory Bldg. gar , ,sii <br /> Awnings or Canopies �_New deck,ramp,patio,etc. <br /> Fencing Building, Demolition or Relocation • <br /> � Exterior Painting&Color Changes —�Generai Repairs(describe below) ���"' <br /> �Roofing Other'(describe below) <br /> Detailed description of proposed work: attach other sheets if p essary '�' '�-'�, �� i ��X� '". ��'�� v ,�" �s}y�'� <br /> '�' '� ,.d ,.� c <br /> P �a✓ a� .s. � <br /> , � , <br /> The Historic Preservation Board requires that the following information MUST be included with an application prior to the <br /> application being accepted by staff: <br /> • Detailed Plans,including a site°la�and elevation(s); <br /> � • Color and material samnles; <br /> �k • Manufacturer's sales literature; <br /> � • Photoaraahs:and <br /> � • Any ofher supqortina documentation to show that the proposed work is consistent with the adopted Department <br /> of Interior Standards. <br /> , �� ` � �/l�� �-l--/� �'.�l.a '�`� ��� <br /> SIGNATURE�OF THE OWNER and/or APPLICANT <br /> (Applicanf do NOT write BELOW this line) <br /> ACTION TAKEN: Date: �� <br /> ��'By Staff: Approved Denied Reason for Denial: <br /> L�J'By HPB: Approved � Approved with modifications noted below*and/or on attached sheets <br /> Denied <br /> � *HPB Condition(s)of Approval: <br /> , � f <br /> Signed: � �.� Date: J I �.? <br />