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Show EVALUATION SHEET Intensive Level Survey Utah Office of Preservation Number of Propert;i.es Surveyed: Addresses of Properties Surveyed: 12542 ~- '3<:& 6-j Survey Conducted For: (0 Date of Survey: t'2.~"5 l~772~ 'S. ~~ C<-9 -'?- E?cli 3a> e - Mw.vJ...---/~'3 j I'2.J2<e s. l2iSB ~- 8"+-) c;Zh~ ~k ClA~ ~~ -' f?fti * 7we- \~ ~. By: Evaluated By: Date: ..)5:.. Approved (0-2-93 Approved with Recommendations (see below) Returned for Corrections/Additional Information (see below) Checklist of items required for each surveyed property: 1. 1S... Completed state structure/site form (clearly handwritten or typed) )<. 2. Photographs (at least two color slides or black-and-white prints) 3. .lS..- Completed title search form 4. ~ Completed Biographical Research Form (or equivalent) for each principal resident from the historic period (or adequately documented history for non-residential buildings) 5. ~ Photocopy of USGS map with location of building marked 6. ..2S.- Photocopies of all research materials 7. ~ Separate file for each property (letter size) Recommended but not required: 8. ~ Measured drawing(s) of floor plan(s) and field measurements 9. ~ Sketch plan of the property (required if there are outbuildings) 10. f.- Photographs (B&W and slides) of all exterior elevations and significant architectural details on the exterior and interior 11. ~ Old photographs of the building Comments/Recommendations: - t:?¢iiL, 1vv.,(f'fOV~ r~cL-- 'i r~-b-..:h~ ~ ~O/}~ tyo~"-k~ C~[-k~ tUU~--hJ¥l\ tV.t-a.[J.~\ (~~ ~\f)' I I (rev_ 4/19/93) |
