Application For Certificate Of Appropriateness

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Application for Certificate of Appropriateness
It is recommended that you or your representative be present at the meeting of the Commission
.
1. Property Address: ________________________________________________________
2. Landmark Status:
Local
Landmark
Designation
National
Register
of
Historic
Places
Within a Historic District
3. Name of Applicant:
Mailing Address: __________________________________________________________
City/State: _______________________________________
Zip Code: _________________
Office Phone: _______________________________________ Pager: _______________
Home Phone:_______________________________________ Mobile: ________________
Cell Phone: ________________________________________ E-Mail: ________________
4. Relationship of Applicant to Property: _______________________________________
Owner
Contractor
Architect
Lawyer
Other - Please specify: ___________________________________________________
5. Existing Building Use: _____________________________________________________
6. Proposed Building Use: ___________________________________________________
7. Nature of Proposed Change:
Addition
Window Configuration
Demolition
Sign Erection or Placement
New Construction
Alteration to Exterior:
Primary Structure
Accessory Structure
Fence
Other - Please Specify: ___________________________________________________
8. Accompanying Documentation:
Photos
How many? _________________
Drawings
How many? _________________
Plans
How many sets?

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