| OCR Text |
Show UNITED STATES DEPARTMENT OF THE INTERIOR NATIONAL PARK SERVICE NATIONAL REGISTER OF HISTORIC PLACES INVENTORY· NOMINATION FORM (Type all entries - complete applicable sect ions - use continuation sheet) 1. NAME COMMON AND/OR HISTORIC NUMERIC CODE (Ass/lined by NPS) 2. LOCATION STATE ICOUNTY ,-c2d~ L~k STREET AND NUMBER (or Di s trict-Site boundaries) OWNER'S NAME AND ADDRESS (StTeet, number , town, state) ;' ftc Pr--P9h!j c:rJB?t A> 7~ f!{). tit;' rI..f ItZ ~ 6~ V''& /,;.eL /;j z:t-.l-- J) S ("~ a/ a ACCESSIBL E TO PUBLIC REMARKS: APPROX. ACREAGE 5. REPRESENTATION IN EXISTING SURVEYS NAME ANC ,.DATE OF SUR' VE Y .... .. < NAME AND ADDRESS OF ORGANIZATION (Federal, State, Local, Etc .) RETAINING SURVEY RECORDS A. A. , B. , C. C. 6. CLASSIFICATION MAJOR SIGNIFICANCE IN CATEGORY .~ DISTRICT , SITE BUll-DING STRUCTURE Or,;. LEVEL OF SIGNIFICANCE " ,- ~ HISTORY ARCHITECTURE ARCHEOLOGY CULTURE OBJEC T (Other) o o ~ o NATIONAL STATE LOCAL 0-. o o |
