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aG°�f���C�l�`����1 6��� Q f���`�0�8� �@��(���� <br /> 6GC��3`��[���f��� �f� b�p���[�f�8�������99 _ <br /> �y sta�`•Applfcafiora #. ��e��a�ba��i�go Yes/�o ���e �u�r�atted°� <br /> .� (ApplJcaeat Please pnovide infoera�rafiora bePvveen fhe doub/e lines) <br /> O . Y'^ ,/ (i/(/ � <br /> � �PropeP4y Address or L9cagion:�' �'T� - �� �- — <br /> p �, '"/ > �-.�� r a�� �- /- �5`7 �1 (e�-�) <br /> ��re�e�'� �9arn�: �' ►r1 o�C� [ lT t"4-y Pfi�ne: <br /> , <br /> �+PPliean�°s ii9ar�e� �ornpany Qif differeng): <br /> Ca 1 <br /> �PPlican$°� 61�ailing,4ddres�: �,.�a-,,,-•,, � c:i.w �.k c'.-��.c�w C�cQG�.�..��-� <br /> �PP. �or�tacg Gnfo: Phon�:�)�3� ��I-0'��q ��x:gl3 7g�10� 3 Email: I � � . C,�.�t� e I�tV `(t,h0�hoc7��� <br /> T e ofi Pro erY : Residential�_ �����Peia9 Public or Ofher� � <br /> yP P Y <br /> PF�O�OSE� ��5�'��dA,�l'➢OR9��EP��i�.�a�'1�6�R� / 9�EPA9@�S !�3E���e4T°V�QV/ ��'Ce <br /> Exte�ior 9�/alls �����9� <br /> Fcxterior i�oors • Ligh4ing <br /> �NVlndowis��C ���� P�ew ft�lafn�uilding or Addition to Existing Building <br /> Porches �-~_. _ iVew Accessoey Bldg.(garage,carpor�,shed� <br /> Awa�ings o�Cano�ies i�ew►deck,rarnp, patio,etc. <br /> Fencing �uilding, Demofition or Reloca4ion <br /> Exterior Painting d, Colo�CB�anges General Repairs(describe below) <br /> �Roofing Other(describe belowD <br /> ��ec-� ���� �� <br /> f3e4ailed�d�scrip6ors of proposed worlc: (attach othe�sheets ef�ecessary) _. <br /> �,L; t�,�-c:.M.c-�-�Z•r�z.� � <br /> 'Tl�e h9is4oric Presenration Board requires that 4h�foelowing inforrnation 6Vi�D��be included with an applica4ion pr+o�'fo 4he <br /> a�piication being accepted by s4aff: <br /> o De4ailed Plans, including a site ian an�elevation(s): <br /> o Color and material samples; <br /> o P+Aanufac4urers sales li4eratureo <br /> o Photoaraohs: and <br /> o Any o4her supportina documenta4ion to show 4ha4 4he pro�osed work is consis4ent wi4h ttie adopted ��paPte�en� <br /> of Bnterior Standards. <br /> L, � , <br /> S RIATURE OF l�i-IE NEF2 and/or �4PPLICAN� <br /> (,4pplicanf do NOT�rite BELOW this line) — <br /> �C�O�B� `b'�9��6�9: �a4e: � �� <br /> / ' <br /> ❑�y Staff: ,4ppr�ved �enied 6��ason fo���nial: _ <br /> �6y H��: ,4pproved � Approved vuiQh modifications no4ed below'� and/or on attached shee4s <br /> penied <br /> ;' FiP� Condifion(s)ot App�'ova9: <br /> Signed: � �n � f/' Date: �� - � S"-� �, <br /> i ` <br />