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Show Researcher: Date: iom Lart:er Rite Mo 50A JUrt Utah State Historical Society Historic Preservation Research Office Structure/Site Information Form IDENTIFICATION" * Street Address: Name of Structure: Present Owner: Owner Address: Plat A Bl. 12 Lot 2 Helen May Madsen T. R. UTM: Spring City, Utah Tax #: Helen Madsen Granary Original Owner: ^J AGE/CONDITON/USE Original Use: Present Use: D D D D Construction Date: Single-Family Multi-Family Public Commercial O Excellent Es Good D Deteriorated CO Demolition Date: agricultural Occupants: 0 Park O Industrial D Agricultural ffif'Vacant D Religious D Other Integrity: Building Condition 3 @1920 S. 0 Site D Ruins H Unaltered D Minor Alterations D Major Alterations Preliminary Evaluation: Final Register Status: D Significant B^ Contributory O Not Contributory D Intrusion D National Landmark D Natjonal Register D State Register D District D Multi-Resource D Thematic Photography: ^^ DOCUMENTATION Date of Slides: 6/14/78 Views: Front B^Side D Rear D Other D Date of Photographs: Views: Front D Side D Rear D Other D Research Sources: D Abstract of Title & Plat Records of Plat Map D Tax Card & Photo D Building Permit D Sewer Permit D 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 LDS Church Archives LDS Genealogical Society U of U Library BYU Library USD Library SLC Library Other Bibliographical References (books, articles, records, interviews, old photographs and maps, etc.): See Pitman, "Folk Housing," pp. 225. izj RECEIVED vi sEP2J>^9 ^ NATIONAL REGISTER |
