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Show NFS Form 10-900 (Oct. 1990) Utah WordPerfect 5.1 Format (Revised Feb. 1993) United States Department of the Interior National Park Service National Register of Historic Places Registration Form i « _j This form is for use in nominating or requesting determinations of eligibility for individual properties or districts. See instruetiorrrlTrFToiv to Complete the National Register of Historic Places Form (National Register Bulletin 16A). Complete each item by marking "x" in the appropriate box or by entering the information requested. If an item does not apply to the properly being documented, enter "N/A" for "not applicable." For functions, architectural classification, materials, and areas of significance, enter only categories and subcategories from the instructions. Place additional entries and narrative items on continuation sheets (NFS Form 10-900a). Use a typewriter, word processor, or computer to complete all items. 1. Name of Property historic name Baxter. David and Drusilla. House__________________________________ other names/site number ________________________________________________________ 2. Location street & number 206 West 1600 North N/A not for publication city or town Orem state Utah ____ code UT county. Utah code 049 zip code N/A vicinity 84057-2647 3. State/Federal Agency Certification As the designated authority under the National Historic Preservation Act, as amended, I hereby certify that this _X nomination _request for determination of eligibility meets the documentation standards for registering properties in the National Register of Historic Places and meets the procedural and professional requirements set forth in 36 CFR Part 60. In my opinion, the property _X_meets _does not meet the National Register criteria. I recommend that this property be considered significant ...nationally _statewide _X_locally. (__ See continuation sheet for additional comments.) Signature of certifying official/Title Date Utah Division of State History. Office of Historic Preservation State or Federal agency and bureau______________ In my opinion, the property __meets _does not meet the National Register criteria. (_ See continuation sheet for additional comments.) Signature of certifying official/Title State or Federal agency and bureau 4. National Park Service Certification I he/eby certify that this property is: ^entered in the National Register. _ See continuation sheet. _ determined eligible for the National Register. _ See continuation sheet. _ determined not eligible for the National Register. _ removed from the National Register. _ other, (explain:)_________ Date |
