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State of California - The Resources Agen4.,
DEPARTMENT OF PARKS AND RECREATION
OFFICE OF HISTORIC PRESERVATION
HISTORIC RESOURCES INVENTORY
IDENTIFICATION AND LOCATION Ser. No.
1. Historic name National Register status
Local designation
* 2. Common or current name
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* 3. Number & street Cross--ccorrridor
City Vicinityonly Zipq�L01 County
4. UTM zone A B C D
5. Quad map No. Parcel No. Other
DESCRIPTION
6. Property category 7y:��j24 If district, number of documented resources
* 7. Briefly describe the present physical appearanc" f the property, including condition, boundaries, related features, surroundings, and (if appropriate)
architectural style.
8. P finning ag
\fit _•�\ /l.. _% . i �/
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Type of ownership
11. Present use
12. Zoning I
13. Threats
Send a copy of this form to: State Office of Historic Preservation, P.O. Box 942896, Sacramento, CA 94296-0001
* Complete these items for historic preservation compliance projects under Section 106 (36 CFR 800). All items must be completed for historical resources
survey information.
DPR 523 (Rev. 6/90) "D C' -
ao-aa
HISTORICAL INFORMATION
*14. Construction date(s) `q a 5 )4 Original location
15. Alterations & date
16. Architect
17. Historic attributes (with number from list) (—
Builder
S16NIFICANCE AND EVALUATION
18. Context for evaluation: Theme Area
Period )lOD— 19 HO Property type
Date moved
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Context formally developed? t_-/q,D
*19. Briefly discuss the property's importance within the context. Use historical and architectural analysis as appropriate. Compare with similar
properties.
20. Sources C L- U
C_ J
21. Applicable National Register criteria
22. Other recognition
State Landmark No. (if appllicable)
23. Evaluator
Date of evaluation
24. Survey type (�d
25. Survey name i ++—
*26. Year form prep red
By (name) o
Organization
Address
City & Zip
Phone
* Sketch map. Show location and boundaries of property in
relation to nearby streets, railways, natural landmarks, etc. t
Name each feature.
,r State of California —The Resc Agency Ser. No.
!r DEPARTMENT OF PARKS AN[ CREATION HABS HAER_ NR SHL Loc
UTM: A B
HISTORIC RESOURCES INVENTORY C D
IDENTIFICATION
1. Common name:
2. Historic name:
3. Street or rural address: `7 t 4 4 3� i T N�—
Cit
Zip County
4. Parcel number: t7 3.2 0-5 +- 67 6 QAU2I L l- ? 1 *
/B, `/ - 1.15♦1
5. Present Owner: Address:
City Zip _Ownership is: Public __ Private
6. Present Use Z p - ' '� ° ^. �r a Original use:
DESCRIPTION
7a. Architectural style:
7b. Briefly describe the present physical description of the site or structure and describe any major alterations from its
original condition:
$. Construction date:
Estimated 43-2 Factual
9. Architect
10. Builder
11. Approx. property size (in feet)
Frontage _ Depth
or approx. acreage
12. Date(s) of enclosed photograph(s)
DPR 523 (Rev. 4/79) [33 e0-8+3
13. Condition: Excellent Good _ Fair Deteriorated No longer in existence
14. Alterations:
15. Surroundings: (Check more than one if necessary) Open land _Scattered buildings Densely built-up
Residential Industrial Commercial Other:
16. Threats to site: None known —Private development Zoning Vandalism
Public Works project Other:
17. Is the structure: On its original site? Moved? Unknown?
18. Related features:
SIGNIFICANCE
19. Briefly state historical and/or architectural importance (include dates, events, and persons associated with the site.)
20. Main theme of the historic resource: (If more than one is
checked, number in order of importance.)
Architecture Arts & Leisure
Economic/Industrial —Exploration/Settlement
Government Military
Religion Social/Education
21. Sources (List books, documents, surveys, personal interviews
and their dates).
22. Date form -p-�rr''epared
By (name)Y
Organization V
Address:
CityZip
Phone:
Locational sketch map (draw and label site and
surrounding streets, roads, and p ominent landmarks):
NORTH
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