| OCR Text |
Show A? Researcher: e, ~ . ~x Date: ? - r - ? 8' I' Site No. ~p [L....L. V'_ _ __ Utah State Historical Society Historic Preservation Research Office Structure/Site Information Form 1z o Street Add ress: Plat o Name of Structure: Present Owner: T. R. UTM: Owner Address: Tax#: ~. u: i= z w 9 2 w UJ ::J . ....z o i= is z o o .... w CJ C 3 UJ ::J S UJ 4 oz - S z w ~ ::J o o o Original Owner: . .original Use: Present Use: o Single-Family o Multi-Family o Public o Commercial Construction Date: o Park o Industrial o Agricultural II Site o Ruins • o o o Occupants: o Vacant o Religious o Other o Unaltered o Minor Alterations o Major Alterations Preliminary Evaluation: Final Register Status: Significant Contributory Not Contributory Intrusion o National Landmark o National Register o State Register 0 District 0 Multi-Resource 0 Thematic Photography: Date of Slides: - Views: Front 0 Side 0 Rear 0 Other 0 Date of Photographs: Views: Front 0 Side 0 Rear 0 Other 0 Research Sources: o o o o o o o Abstract of Title Plat Records Plat Map Tax Card & Photo Building Permit Sewer Permit Sanborn Maps o o o o o o o Bi bl iograph ical References City Directories Biographical Encyclopedias Obituary Index County & City Histories Personal Interviews Newspapers Utah State Historical Society Library o o o o o o o LOS Church Archives LOS Genealogical Society U of U Library BYU Library USU Library SLC Library Other (books, articles, records, interviews, old photographs and maps, etc.): ~~~ . hi. ~/97..z Lot S. Demolition Date: Integrity: Building Condition: o Excellent o Good o Deteriorated BI. 5 Architect/Builder: Building Type/Style: w Building Materials: ::J I- Description of physical appearance & significant architectural features: a: oW (Include additions, alterations , ancillary structures, and landscaping if applicable) I- ~ o a: <I: i > a: o lf/) r Statement of Historical Significance: o o o o o Aboriginal Americans Agriculture Architecture The Arts Commerce o o o o o Communication Conservation Education Exploration/Settlement Industry o o o o o Military Mining Minority Groups Political Recreation o o o o Religion Science Socio-Humanitarian Transportation |
