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Show Researcher: Date: Tom Carter Mn SP-17-23B Utah State Historical Society Historic Preservation Research Office Structure/Site Information Form ""^l IDENTIF CATION Street Address: Name of Structure: Present Owner: Owner Address: • Original Owner: |\J AGE/CONDITON/USE Original Use: Present Use: D D D D Plat A Bl. 6 Lot 4 Max Blain Spring City, Utah Peter Justesen i V) ' S^Vacant D Religious D Other Integrity: D Site D Ruins D Unaltered HiMinor Alterations D Major Alterations Preliminary Evaluation: Final Register Status: D V D D D National Landmark D National Register D State Register Significant Contributory Not Contributory Intrusion D District D Multi-Resource D Thematic Photography: Date of Slides: Date of Photographs: Views: Front D Side D Rear D Other D Views: Front D Side D Rear D Other D Research Sources: ui 2 O o o D D D D D D D Abstract of Title Plat Records Plat Map Tax Card & Photo Building Permit Sewer Permit Sanborn Maps D D D D D D D City Directories Biographical Encyclopedias Obituary Index County & City Histories Personal Interviews Newspapers Utah State Historical Society Library D D D D D D D S. Demolition Date: Occupants: D Park D Industrial D Agricultural Building Condition: 3 Construction Date: agricultural Single-Family Multi-Family Public Commercial D Excellent w Good D Deteriorated T. R. UTM: Tax#: granary LDS Church Archives LDS Genealogical Society U of U Library BYU Library USU Library SLC Library Other Bibliographical References (books, articles, records, interviews, old photographs and maps, etc.) I |
