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State of California — The Reso,-"'s Agency Ser. No. —
DEPARTMENTOFPARKSANI ;REATION HABS HAER_ NR
UTM: A B
HISTORIC RESOURCES INVENTORY C D
IDENTIFICATION
1. Common name:
2. Historic name:
3. Street or rural address: �/`� M I T
r.ity S Zip County
4. Parcel number:
7-3z -
SHL Loc
!Au-DIL-L-,1-Rf5Orr 3` 4' L. I -z
5. Present Owner: Address:
City
Zip _Ownership is: Public _.Private
6. Present Use: Original use:
DESCRIPTION
7a. Architectural style:C,11vL�l�S�u w
7b. Briefly describe the present phy 'cal description of the site or structure and describe any major alterations from its
original condition: 0-71-49
� 9
8. Construction ate:
Estimated Factual
i
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) 0 0 C tV G �
13. Condition: Excellent _Good /z 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.)
Locational sketch map (draw and label site and
surrounding streets, roads, and prominent landmarks):
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 prepare
By (name)
Organization 3
Address:
City Zip
Phone:
IDENTIFICATION AND LOCATION
1. Historic name
* 2. Common or current name
* 3. Number & street
City
4. UTM zone
5. Quad map No.
State of California - The Resources Agenc,
DEPARTMENT OF PARKS AND RECREATION
OFFICE OF HISTORIC PRESERVATION
HISTORIC RESOURCES INVENTORY
Vicinity only
A B C
Parcel No Other
Ser. No. -
National Register status
Local designation
Cross-�coorrn':Il r
Zip l County L i�
D
DESCRIPTION
6. Property category lilA If district, number of documented resources
* 7. Briefly describe the present physical appeara of the property, including condition, boundaries, related features, surroundings, and (if appropriate)
architectural style.
8.A Planning agoaqcy
9. Owner & address
--1-LJ
10. Type of ownership
11. Present use
12. Zoning —
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)
ao-aa
HISTORICAL INFORMATION y�
*14. Construction date(s) a Original location
15. Alterations & date
16. Architect
17. Historic attributes (with number from list) iC;/ -1 — "
Builder
Date moved
SIGNIFICANCE AND EVALUATION , Q
18. Context for evaluation: Theme �� l'� • /�/h Area -�
Period ) �t0 —1Q ti Q Property type 7 Context formally developed? ✓YLO
*19. Briefly discuss the property's importance within the context. Use historical and architectural analysis as appropriate. Compare with similar
properties.
20. Sources C ��
21. Applicable National Register criteria
22. Other recognition
State Landmark No. (if appllicable)
23. Evaluator
Date of evaluation
24. Survey type
25. Survey name (�
*26. Year form prepar 6
By (name)
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.