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APPLICATION FOR CHANGE WITHIN THE ST. CROIX HISTORIC & ARCHITECTURAL CONTROL DISTRICTS St. Croix Historic Preservation Committee Department of Planning and Natural Resources V.I. State Historic Preservation Office Fort Frederik Museum 198 Strand Street St. Croix, Virgin Islands 00840 Tel: (340)719-7089 Fax: (340)719-8343 DISTRICT: Christiansted [ ] Frederiksted [ ] Zoning___________________ PLEASE PRINT Applicant’s Name:_____________________________________________________ Use: (Applicant is the person presenting the application at the meeting) Business Name, if Applicable:___________________________________________ ( ) Commercial ( ) Residential Applicant’s Mailing Address:________________________________________ ___ ( ) Combined Other:___________ ____________________________________________ Email Address: ______________________________ Telephone Number: __________________________Fax:_____________________ Property Owner’s Name:_______________________________________________ Approx. Date of Bldg.:_________ TYPE OF CHANGE(S) APPLIED FOR: Physical Address of Changes (NOT Mailing Address):_____________________________________________________________ 1. [ ] Erection of sign/relocation/addition 9. [ ] Porches, roof & balconies, alterations and addition 2. [ ] New paint color/change/repaint 10. [ ] Installation of lighting fixtures/change/addition 3. [ ] Repair of rubble masonry walls 11. [ ] Air-conditioning & other mechanical systems 4. [ ] Cleaning and repair of brick walls 12. [ ] Landscaping or other site improvements 5. [ ] Cleaning and repair of stone structural 13. [ ] Building additions elements or walls 14. [ ] New construction 6. [ ] Alterations of wood structural elements 15. [ ] Significant interior changes or exterior wood sheathing 16. [ ] Demolition (partial or full) 7. [ ] Alterations of windows and/or doors 17. [ ] Waiver of off-street parking 8. [ ] Cleaning, repair or addition of archi- 18. [ ] Solar Panel Installation tectural metals, including protective 19. [ ] Other _____________________________________ grillwork Certification for Applications that are: Federally Funded [ ] Yes [ ] No Enterprise Zone [ ] Yes [ ] No Revenue Enhancement Act [ ] Yes [ ] No Tax Act [ ] Yes [ ] No Describe work planned in detail below (Use additional sheets, if necessary). Include one (1) set of photographs of building, showing its principal street façade, and three (3) sets of drawings or other graphic documentation. If applicant is not the owner of the property, see reverse side for “Property Owner’s Authorization”. Connect With Us On Facebook (Application – Page 2) PROPERTY OWNER’S AUTHORIZATION – Copy of deed, lease or sufficient proof of legal interest is required by the applicant for application to be processed. I certify that I am the owner of the aforementioned property and that I authorize the proposed changes previously noted and all of the information provided is correct and work will be done in accordance with the Historic Preservation Committee’s approval. ______________________________ Signature of Property Owner Date Print Name Property Owner’s Mailing Address: _________ Property Owner’s Telephone Number: Fax Email address: NOTE: APPLICATIONS MUST BE SUBMITTED TWO (2) WEEKS PRIOR TO MEETING DATE. Meetings are held on the first Friday of each month, unless otherwise announced. ALL DOCUMENTS SUBMITTED AS A CONDITION OF AN APPLICATION TO THE HISTORIC PRESERVATION COMMITTEE SHALL BECOME THE PROPERTY OF THE HISTORIC PRESERVATION COMMITTEE AND SHALL NOT BE RETURNED. APPLICATION IS NOT CONSIDERED COMPLETE UNTIL ALL DOCUMENTS ARE SUBMITTED. APPLICANT MUST BE PRESENT AT MEETING. APPLICANT’S SIGNATURE: DATE: Person presenting application at meeting Rev. 10/13