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Show OMS No. 10024-0018 NPS Form 10-900 (Oct. 1090) Utah WordPerfect 5.1 Formal (Revised Feb. 1993) 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 of eligibilrty tor individual properties or districts. See instructions in How to Complete the National Register of H;storic Places Form (National Register Bulletin 16A) . Complete eaen item by marking 'x' in the appropriate box or by entering the information requested. If an "em does not apply to the property being documented, enter ON/ 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 (NPS Form 10-9OOa). Use a typewriter , word processor, or computer to complete all items. 1. Name .·of Property historic name Clark Lane Historic District other names/site number ___________________________________________________________________________ 2. Location street & nuniler __. .:2;.:0,"-7.. .;-3"-,9:. :9. . ;.:.:.;We"-,s:. .: t,-S::. t:.;:a:. .: t.:.e. .:a:.:.;n:.: .d-.:3: . :3:. . :.:.;No,, ,r. .:t"-'.h-.:2: .;:0:. : :O_W;.:.:e"-'s:. .: t_ _ _ _ _ _ _ __ city or town ____......:.F..::a~r.:::m:..!.i~ng:1.t~o:.:.n!...-____________________________________________ state Utah code ---.!:!L county _______D~a~v~i:.=s:._._________________ code 011 ~ not for publication vicinity zip code 84025 ~ As the designated authority under the National Historic Preservation Act, as amended, I hereby certify that this __X_nomination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 eFR Part 60. In my opinion, the property .L.,meets _does not meet the National Register criteria. I recorrrnend that this property be considered significant nationally statewide X locally. ( See continuation sheet for 1 add it iona cJ~ts.) --- y/} ?- / 1,/J!/) /,1 --- V" , --- --- ji // certifyin 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. continuation sheet for additional corrrnents.) Signature of certifying official/Title (___ See Date State or Federal agency and bureau 4~ Nat ional ·Park >Service .·Certification .. . . . ........ I hereby 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:) ______________ Signature of the Keeper Date of Action |
