HomeMy WebLinkAboutCA2012-27Date
CERTIFICATE OF APPROPRIATENESS APPLICATION 4°
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Property Owner Name, Address & Phone Number
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2,_0 -523. MAIN
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Phone: t
Mobile: 21 p
Email:
Property Address include any suite number
I Applicant Name, Address & Phone Number I
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Phone: ('1 224: 2.3x5,n
Mobile Zi' 4. 45e7-7- • 99
Email: +-
Leaal Description h
Block _� Lott, IP -2- 4 3$�>
Subdivision� F e''(1�G('� ire,
Tenant Name/Occupancy/Use Z5�r'n
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Request/Description of Work to Be Done
Drawings/Sketches Attached Photo ra hs Attached
V/ Yes o No w, Current o Historic
Material Sam les Attached lease list
/ hereby certify that this information is correct to the best of my knowledge and that the said work will be done in conformance
with all submissions herein set forth, and in compliance with the City of Grapevine's Historic Overlay District Ordinances and
Building Codes. APPROVAL OF A CERTIFICATE OF APPROPRIATENESS DOES NOT CONSTITUTE APPROVAL OF
OTHER REQUIRED BUILDING PERMITS.
�---si ped x Nw, I Print Name hVh. 7
Ow er or C n ractor
Office Use
o Approved I o
o I Denied
Approved with Conditions:
X
Chair — Historic Preservation Commission
X
Building Official
X
Date
Historic Preservation Officer
THIS IS NOT A BUILDING PERMIT.
SEPARATE BUILDING PERMITMUST BE FILED AND APPROVED
..•, •
WORK.THE BUILDING DEPARTMENT BEFORE STARTING
City of Grapevine Historic Preservation Department — 636 South Main Street, Grapevine, Texas 76051 - (817) 410-3556
012512
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