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LITTLE ROCK
HISTORIC DISTRICT
FROM
APPLICATION FOR A
T-034 P.01
CERTIFICATE OF APPROPRIATENESS
Application Date: 3�►o G4
I . Datc of Ptlblic I•Icaring, (lay oI'
1. Address oi' Properly: -9 --!*�
200- - at
3. I,cwal Descrip(iott of Property: LOT15 4.L 11 �-7.
4. Prol)crly Ow(ter (Ncu»c, A(Iciress, Plzonc, Fax): C1490, t R. J�)Afi�-EZ
�. Owner's Age -tit:
6. Project I escripli0n (addifiozla.l pages may be added); M�D1CL ' US`I' I�o� f Cl~It
7. Fmimatcd C wt of Improvelllent is
r�
Signiat.urc of Owner or Agent:
Kittle. Rock Historic Dislt'icf Commission Action (u) be completed by s(all):
Denied Dcicrred _ Approved , Approved with C;onditiolls
Stall Signature:
NO'1'K Should there be changes (design, lnalenals, sin, ctc).1' ocll 111e i pproved COA, applicaffl shall uotify
Lununission stall and lake appropciatc :zrtiat►s. Approval by the Commission clous not excuse applic•al11 or properly
Irolll volllpll;zlt("C Willi olher applicable codes, ordillanc•es or policies of' tile city tlllless spited by tile Commission or
stall. Responsibility for idell(dying'such codes, orditlam-cs of policies msts Willi the applicalit, owner or agent.
Lildc Rock idistoric l spiel Commission' ♦ 1)cptz.rUticW of Housing; and Neighborhood 1'rogranls
500 W. KAlmn Strect, #120W t Little Rock, Alt 72201 ♦ 111innc.: 501�918-5830 ♦ Fax: 5017371-4.872
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