BOROUGH OF WELLSBORO  14 CRAFTON STREET WELLSBORO, PA 16901 570.724.3186 FAX: 570.724.2323  HISTORIC ARCHITECTURAL REVIEW BOARD APPLICATION FOR CERTIFICATE OF APPROPRIATENESS  Ifthe proposed alteration is to bel located within the limits oft the Historic District, as defined by the Wellsboro Historic District Ordinance, this application must be submitted The owner, or an agent for the owner, must bej present at thei meeting oft the HARB at the time this application is being reviewed. Failure tol be represented will result in ALL APPLICANTS MUST COMPLETE Sections I,I II, and III.  and approved prior to receiving al building permit.  application approval being denied.  I. IDENTIFICATION:  Applicant: Phone: Contractor: Phone:  Address: Email: Address: Email: Address: Email:  Owner of property: Phone:  Ihereby certify that the alteration is authorized by the owner ofrecord and that Ihave been authorized by the owner to make application as his/her authorized agent.  Signature Date Print Name  Address  * Proud Home of Wynken, Blynken, and. Nod"    Application for Certificate of Appropriateness  (Page2)  ISITE LOCATION:  NO.  Street  III. DESCRIPTION OF WORK  Describe the characteristics of the alteration that is being proposed. Attach plans, pictures and elevations in sufficient detail to enable the Historical Architectural Review Board to determine that the proposed  alteration is appropriate to the slated purpose oft the historic District Ordinance.    Application for Certification of Appropriateness ACTION OF HARB  (Page 3)- (For Borough Use Only)  DATE  Disapproval:  Indication to applicant ofaction and recommendation-  Recommend Disapproval to Borough Council- Recommend Approval to Borough council-  Approval:  ACTION OF BOROUGH COUNCIL  Ihereby certify that a certificate of Appropriateness was Granted E 3 Denied 03  By Wellsboro Borough Council on the  dayof Secretary  Date  RECORD OF EVENTS  REVIEW BOARD Received by Secretary Information distributed tol HARB Discussed at meeting- BOROUGH COUNCIL Received Recommendation From HARB Disapproval: Letter to Applicant Approval: Certificate of Appropriateness  DATE  CODE ENFORCEMENT OFFICER  Building Permit Issued Building Permit #  Issued by: