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Show (Expires 5/31/2012) OMB No. 1024-0018 NPS Form 10-900 United States Department of the Interior National Park Service National Register of Historic Places Registration Form This form is for use in nominating or requesting determinations for individual properties and districts. See instructions in National Register Bulletin , How to Complete the National Register of Historic Places Registration Form. If any item does not apply to the property 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 certification comments, entries, and narrative items on continuation sheets if needed (NPS Form 10-900a). 1. Name of Property historic name .Green Ra~-Beck House other names/site number 2. Location D ____D_f_ap"-e_f______________________ U street & number city or town state not for publication 12542 S. 900 East code Utah UT county code Salt Lake 035 vicinity zip code 84020 3. State/Federal Agency Certification As the designated authority under the National Historic Preservation Act, as amended , request for determination of eligibility meets the documentation standards for I hereby certify that this X nomination _ 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 L meets __ does not meet the National Register Criteria. I recommend that this property be considered significant at the following level(s) of significance: - national - statewide ....X..Iocal Date S~~~~~~i~9~~i ~i~ ~~fo~ / of,r,rce ~ *~~\.~ '"R-e?"t::.(\l~ State or Federal agency/bureau or Tribal Government! In my opinion , the property _ meets _ does not meet the National Register criteria . Signature of commenting official Title Date State or Federal agency/bureau or Tribal Government 4. National Park Service Certification I hereby certify that this property is: _ entered in the National Register _ determined eligible for the National Register _ determined not eligible for the National Register _ removed from the National Register _ other (explain:) Signature of the Keeper Date of Action |
