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<br />II: Cityo{ <br />Louisville <br /> <br />Landmark Designation <br />Nomination Form <br /> <br />(6/09) <br /> <br />DATE: <br /> <br />r/3 <br /> <br />LANDrf!tRK APPLlCA TlON FOR: <br />p'lndividual Site/Building Landmark <br /> <br />NOMINApON MADE BY: <br />lR-Owner <br />o Historic Preservation Commission <br /> <br />o Historic District <br /> <br />o City Council <br />o Third Party <br /> <br />Name: ;;c.'" IT ;;, c!"n..., MMt <br />Address: II () q L~ hVj e.. ~ <br />Phone: 3.'3'- nr-S:J77 Email <br />Relationship to Owner: <br /> <br />.Jc,cj.'/"l e >,~,-k.,.,c---- <br /> <br />LOCA TlON OF PROPOSED LANDMARK: <br />Address: /1 () 9 L.~ NYyC: Av€...... u <br />Legal Descript~n (Lot Number, Block Number, and Subdivision): <br />~()f{"" "3 j (I IJ/k 3 (fry' It.! //t....', f <br />Property Name (Historic and/or Common): <br /> <br />Former Addresses (If Known): <br /> <br />OWNER INFORMA TlON <br />(For district applications, please attach separate sheet) <br />Name: S (".o!1 tit'I'"/11 <br />Address: II 0 ? (. l.:::cy:; e ~ <br />Phone: 3,;;) -I/~ -I) 77 <br /> <br />BOUNDARIES and TYPE OF DESIGNA TION <br />Description of Boundary Determination: <br /> <br />Historic Preservation Commission <br />Planning Department 749 Main Street Louisville CO 80027 <br />303.335.4591 (phone) 303.335.4550 (fax) www.louisvilleco.gov <br />