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SALEM REDEVELOPMENT AUTHORITY
DESIGN REVIEW BOARD
Application for Design Ay2rovvajl -/ IOTHER THAN SIGNS
1. Date of Application 1 `7 . 1/`1
2. Location of Building (/�/ ��
Number and Street
2Pro sed work impacts upon _Derby Square Historic area, _Museum area,
'0 sed
Mall, North residential area, _Peripheral area,
Significant historic bldg. (Itemize)
3. Owner Qglh ! " bn L
v Telephone Number
Name
Address
4. Architect*/Engineer*/ Other
e� Shy
4-1-Ne
/
YNr b (�
Address Telephone Number
5. Type of Improvements New construction _Alteration _Demolitloa
_Site work Addition
:. -- Other - r , f u
reQ
6. Reason for Request' _Security Chano of use _Energy c use-
Change of image Safety _Change of bu
** Other
7. Level of Approval Requested Concept _ Schematic design'''
Final design Field decision
Applicant must attach 3, copies of all schematic submissions (or in the case of
originals, models, or mock ups, the original and two photos of the submission)
24 hours prior to the regularly scheduled DRB meeti-ig to SIU staff_
(Do not.write belov this line)
of DRB members in tendance I The vote was unanimous_ Yes
Number %o action, advisory or
DRB recommended action: _Approval as submitted _
Resubmit to DRB TO action, inadequate
submission
Approval subject to the follosiug:
DRB comments are attached.
A licensed professional architect or engineer isrequired
on a building less
required for all construct-
^ other than ordinaryrepairs (p• 71 S.B.C_) or pe
35,000 cu. ft. enclosed space.
*--If, in the applicant's view, the change is re significant economic supplied
information including financial figures where applicable should be supplied . .
a separate attached sheet which will allow the Board to evaluate the proposa:
intelligently.