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I _ <br /> i j " • <br /> , ,� � • APPLICATION FOR A HfSTORiC DISTRICT , <br /> "CERTIFiCATE OF APPROPRIATEtVESS" � � ._ _ <br /> � � <br /> ey sta�Applicafion#.�i Pl� `�D,�L. Corrtributing.,`,Ye�/No Date Submiffed: `i� � <br /> � _ (Appl�can�Please prov�de rnformatron beiween fhe doub/e l�nes) <br />'I, • c a �j Z� ��l f�,�-� � <br /> Property Address or Location: -- <br /> . 'A ` �c t �c� (�Fs� <br /> �Owne�s Name. <br /> � � '�� Phone• � � <br /> ��v` � <br /> Appiican#'s Name&Company(ifdiiferent): �� � � — <br /> Applicant's Mailing Address: ��� <br /> App. Contac!Info: Phone: �(7������: • Emaii: <br /> . - <br /> I Type of Pr�perty: Residential�, C�mmercial_� Publi�or�ther _ <br /> I • ON/RENOVATIONS l REPAIRS!RELOCATION/ETC: � <br /> PROPOSED RESTORATI <br /> Exterior Walls� � Signage _ <br /> Exterior poars • ug�ng <br /> Windows � _ New Main Building or Addition to F�dsting Buildng <br /> Por�ches � � NewAccessory.Bldg.(garage,carport,shed) <br /> Awnings or Canopies New deck,ramp,patio.etc. , <br /> Fencing Building,Demolition or Relocation <br /> . Exterior Painting&Color Changes Generai Repairs(describe beiow) <br /> . � ��,Raofing : . . Other(describe below) . , � , . <br /> � Detailed description of proposed work: -(attach other sheets if necessary) ��`�� �•z'��L. � <br /> o�`v,�'1' . . :. ......... . ...: . .. . <br /> . ..... ... ... ....-- __.. ,...... ._ _ .... .. .. . <br /> . - � - _ �,. � .�� - � . .. . __------ --�---..... <br /> � ..- : t;��,:. - - <br /> The Historic Preservation Boar+d requires that the fodowing inform on MUST be included with an application�prior to the <br /> appiication being accepted by statf: . <br /> • Detailed Plans.including a site olan and elevation(sl: . <br /> . Color and material samales: <br /> . Manufacture�s sales iiterature; <br /> . Photoaraphs:and .. <br /> • My other sunnor�na dacumentation to show that the praposed woric is consistent with'the adopted Deparhnent <br /> tnterior S � <br /> , , . � , �� <br /> NATU E OF E OW an„or APP CA T <br /> " (Applicarrt do NOT write BELOW fhis line) <br /> � ACTION TAKEN: Date: ��� ����`, a-� l� - <br /> ❑By Staff: Approved Denied Reason for Denial: <br /> t�J By HPB: Approved ✓ Approved with modifications noted below'and/or on attached sheets <br /> Denied <br /> 'HPB Condition(s)af Approvai: <br /> f� / ' / <br /> Signed: i�--- !n, �r/L- <---�—'" Date: '����/ Y <br /> ; <br /> �,' . <br />�� � <br />