HomeMy WebLinkAboutCA2010-34CERTIFICATE OF APPROPRIATENESS APPLICATION APR 2 7 2010
Property Owner Name, Address & Phone Number Applicant Name, Address & Phone Number
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Phone: 277Phone:
I `t _ .
Mobile: Mobile
Email: Email:
Property Address include any suite number Legal Description
Block Lot
Subdivision f
Tenant Name/Occupancy/Use
Request/Description of Work to Be Done
04
Drawings/Sketches Attached
Yes ❑ No
Material Sample(s) Attached
Photo ra hs Attached
Current ❑ Historic
/ 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 OFA CERTIFICATE OF APPROPRIATENESS DOES NOT CONSTITUTE APPROVAL OF
OTHER REQUIRED BUILDING PERMITS.
Signed x y Print NameIle
rz
Owher or Contractor
p r" X44 Office Use
❑ Approved ❑ Approved with Conditions:
❑ Denied
X X
X
Chair — Historic Preservation Commission Historic Preservation Officer
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Building Official
THIS IS NOT A BUILDING PERMIT.
A SEPARATE BUILDING PERMIT MUST BE FILED AND APPROVED BY
THE BUILDING DEPARTMENT BEFORE STARTING WORK.
City of Grapevine — P O Box 95104 — Grapevine, Texas 76099 - (817)410-3585 - fax (817)- 410-3125
010110
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PURSUAN
DATE BY
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DEVELOPMENT SE ACES
CONTACT BUILDING iNSPECTIONS
POR PERM! T INFORMATION