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City,/- <br />gm Louisville <br />DATE: <br />Landmark Designation <br />Nomination Form <br />(6/09) <br />LANDMARK APPLICATION FOR: <br />Individual Site /Building Landmark ❑ Historic District <br />r' /\ 1s iN <br />j uY X3.,.,17 <br />NOMINATION MADE BY: <br />Qwner ❑ City Council <br />❑ Historic Preservation Commission ❑ Third Party <br />Name: C`11e -A pp ;- <br />Address: i0 GC1 ri-L/&l U T <br />Phone: 3.56 1 -- 00 S,' mail <br />Relationship caner: <br />LOCATION OF PROPOSED LANDMARK <br />Address: - - Ala , a '�` c, <br />Legal Description (Lot Number, Block Number, and Subdivision): <br />Ls-TS C-J31/ <br />Property Name (Historic and /or Common): <br />;le• CJe'i i `s <br />i-ormer Addresses (ir Known): <br />OWNER INFORMATION <br />(For district a plications, please arracn separate sneer) <br />f�lamo• 5' l �VE f Pff Address: /0 -j(, cu /V c% 7 <br />Phone: <br />BOUNDARIES and TYPE OF DESIGNATION <br />Description of Boundary Determination: <br />ffob 1 —CI 6 <br />Historic Preservation Commission <br />Planning Department 749 Main Street Louisville CO 80027 <br />303.335.4597 (phone) jU:i- .1.10.400u (rax) www.iuuiwviiia u.yuv <br />