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Cv 2,
<br /> 1
<br /> NlS70RIC RESOURCE EVALUATION FORM
<br /> ....:......: .. . .
<br /> Pro e Name: Location: '.. '
<br /> �:Owner::..:.;..°:::,:.:: . Tax Reference:
<br /> Address:' '` ;;: ` OR Number� `'
<br /> RESOURCE`1'YpE: :.: ' .` .;°:...:± ,,..,,t:.'::.:::`>`...:::'';.:. .,.,,.. ._.... .. ;:AGE:;`':: . .:.... .....
<br /> Nationa!R ister/Stu List 10.0 Pre 1800 10.0
<br /> Archaeoio ical Site/Cemeta 7.5 1801-1865 7.5
<br /> Buildin Com lex 5.0 1866-1885 5.0
<br /> Individual Buildi 2.5 Score 1886-1930 2.5
<br /> Other Resource 1.0 Pos11931 1.0 Score
<br /> Post 1959 0.0
<br /> , . .. .:......:.......... ... ..
<br /> HIST.URIC..SIGNI�ICANCE: :::;: :.:...;.:,:':.;.:_:;':'..'::.::..:`:.::.-: :; : ,: .: : .:...:::::...: .
<br /> Associations wiih a Naiional State Lacai Local Nane
<br /> person,event,group (1+} (1+) (3-4) (1-2) '
<br /> or instituUon af significance Score
<br /> 1 b.0 7.5 5.0 2.5 0.0
<br /> ARCHI7ECTURAL 51GNIFICANCE: :
<br /> Builder/Architect, Very Signiffcant Natable Minor None
<br /> period,siyle,ar Genre Si nificant Score
<br /> 10.0 7.5 5.0 2.5 0.0
<br /> ... ...
<br /> ,....... .
<br /> �NVIRONMENTAL 5iGN1EICANCE: ':':•.:' : ;: .. .., . .. . ,,..:.:.......:.:...,;:.:.:.::::: .. ..:.,,:. :... ....,.. .. .., .. . .
<br /> Resemblance ta historic Very Significant iVotable Minor None
<br /> landscapes and land use Si nificant Score
<br /> atterns 10.0 7.5 5.0 2.5 Q.Q
<br /> ,
<br /> CpNTRIB.UTING FEATURES::.::.. :: .:..: .::...::.''..`°;,::..:.:.:.:: . ' ::..:: .,.. :.. ....::.::.::,._ ...:;:':::,.: ;.;.;:: ..: :.::. .. . .: .,: :.. :. .,.:.:.:.
<br /> Diverse,additiona)elsments related to hisiory,
<br /> landscape,or Very Notable None
<br /> architecture that contribute to knowledge of the site and enhance Significant
<br /> its historic or cultural signiflcance. �xamples:statuary, machinery, Score
<br /> fences,outbuifdin s fami{ histories and memorabilia,etc. 10.0 5.0 0.0
<br /> .
<br /> INTEGRITY: ::::::: . ::: >...:`::.::.`: `..::°. ,:.`.:.`;:..`.: .. . , .:..... . ;. .. ,::;s..`;.::::..:., ` ..;` `:. .' ..•. .:, ,.: .. .. ..._.
<br /> Conditian Excellent Good �air Poor Ruin Score
<br /> 10.0 7.5 5.0 2.5 0.0
<br /> Alterations None Minor Sotne Si nificant Ma'or Score
<br /> 1 0.0 7.5 5.0 2.5 0.0
<br /> ---- _ - _ -- - - -_ -`Y��; -
<br /> _ - _';'O�T'.'�::P':;;. -
<br /> ;:-T A O NT
<br /> 5:����;:�'...:'�;;:�^-:�
<br /> �:-�;�,:;::::;::;:::::;
<br /> Has the Structure Been Moved? Yes No Sco `�� � �
<br /> ��<......:::..:..:...::.
<br /> _..., ;:...
<br /> ,.r..,=:::::::-�...:.
<br /> , ;•�-=;4:.:�.::•::r:....... 1..::-....e.... .. . .,. ...:.:
<br /> a.a 5.0
<br /> Is the Structure At Risk? Yes No 3core
<br /> 5.0 0.0
<br /> MITIGATINti.CIRCUMSTANCES: -10fo.+10 ..,. ;... , ` . .. .. ,. Score
<br /> 2
<br /> 9/27/2010 Draft Orange County Design Standards 54
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