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Show OMB No . 10024-0018 NPS Form 10-900 (Oct. 1990) Utah WordPerfect 5.1 Format (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 o r requesting determ inations of elig ib ility fo r individual properties or districts. See instructio ns in How to Complete the National Re9ister of Historic Places Form (National Reg ister Bulletin 16A). Com plete each Hem b y marking '. ' in the appropriate bo. or by entering the information requested . H an item does not apply to the property being d ocumented, enter "N/A" for "not applicable." For functions, architectura! classificatio n, materials, an d areas of significance , enter o nly categories and subcategories from the instructio ns. Pl ace additional entries and narrative items o n continuatio n sheets (NPS Fo rm 1Q.900a). Use a typewriter, word processor, o r computer to complete all item s. LName<ofProperiy historic name Clark Lane Historic District other names/site number ___________________________________________________________________________ ~ not for publication street & nunber __....::2:..:::0.:..7....: - 3::..:9:..::9_W""e::..:s:..::t....:S::..:t:::::ac.::.te:::....::a""n::::.d....:3::..:3:....:..:;No~r....:t:!!h....:2::..:0:..::O_W""e::..:s:..::t_ _ _ _ _ _ _ ____ city or town ____--'-F.::a""r"'m..:.;in"'q:>.. ;t:..:o;;.;n'--___________________________________________ ~ vicinity state Utah code --.!!.L county ____. .!D!::a!.!v.. :.i=.s_________ code -..::0~1l!-- zip code --,8;;...4:..::0.:;.25::......_ _ As the des ignated authority under the National Historic Preservation Act, as amended, I hereby certify t hat 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 CFR Part 60. In my opinion, the property ...Lmeets ___does not meet the National Register criteria. I reconmend that this property be considered significant nationally statewide .X locally. ( See continuation sheet for : 1°:'1iJ "·1 --- --- --- --- / , (J!/) 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 Regis ter criteria. continuation sheet for additional conments.) Signature of certifying official/Title (___ See Date State or Federal agency and bureau I hereby certify that this property is: ___ entered in the National Register. See continuation sheet . ___ determined eligib le fo r the National Register. See continuation sheet. ___ determined not eligible for the Nat ional Register. removed from the Nati ona l Register. ___ other, (exp la in: ), _ _ _ _ _ _ _ _ _ _ __ Signature of the Keeper Date of Action |
