| OCR Text |
Show Form .4P....e0::300 \"8'1. ,0-14\ UNrrED STATES DEPARTMENT OF THE INTERIOR NATIONAL PARK SERVICE NATIONAL REGISTER OF mSTORIC PLACES INVENTORY -- NOMINATION FORM o SEE INSTRUCTIONS IN HOW TO COMPLETE NATIONAL REGISTER FORMS TYPE ALL ENTRIES -- COMPLETE APPLICABLE SECTIONS NAME HISTORIC AND/OR COMMON BLOCATION STREET 6 NUMBER STAiE •.J I -t L CODE ~ COUNTY CODE w .;~ t!~ V'-' re'-'v) EiCLASSIFICATION CATEGORY OWNERSHIP PRESENT USE STATUS _DISTRICT _PUBLIC _OCCUPIED -AGRICULTURE _MUSEUM .l.BUILDING(S) l .PRIVATE ..buNOCCUPIED _COMMERCIAL _PARK _STRUCTURE _BOTH _WORK IN PROGRESS _EDUCATIONAL _PRIVATE RESIDENCE ACCESSIBLE --ENTERTAINMENT _RELIGIOUS _SITE _OBJECT PUBLIC ACQUISITION _YES: RESTRICTED -...-IN PROCESS _BEING CONSIDERED :i YES: UNRESTRICTED _GOVERNMENT _SCIENTIFIC _INDUSTRIAL _TRANSPORTATION _NO -MILITARY ...AOTHER: BOWNER OF PROPERTY NAME l~ C\- cc:. ( ~ STREET 6 NUMBER CITY.lOWN _ VICINITY OF EilLOCATION OF LEGAL DESCRIPTION COURTHOUSE. REGISTRY OF DEEDS,ETC. ~ STREET & NUMBER CITY. TOWN . C I ~'1 . ~l r STATE ul-c~ Ovt..J!'~ ~ REPRESENTATION IN EXISTING SURVEYS TITLE DATE _FEDERAL ~TATE _COUNTY _LOCAL DEPOSITORY FOR SURVEY RECORDS CITY.lOWN STATE J. / Ut-t"-"\ tvc f?w...J" (.l;l.(..,. |
