Orange County NC Website
NPS Form 10 -900 OMB No. 10024-0018 <br />(Oct. 1990) Attachment 5 7 <br />United States Department of the Interior <br />National Park Service <br />National Register of Historic Places <br />Registration Form <br />This form is for use in nominating or requesting determinations for individual properties and districts. See instructions in How to Complete the <br />National Register of Historic Places Registration Form (National Register Bulletin 16A). Complete each item by marking "x" in the appropriate box <br />or by entering the information requested. If an item does not apply to the property being documented, enter "N /A" for "not applicable." For <br />functions, architectural classification, materials, and areas of significance, enter only categories and subcategories from the instructions. Place <br />additional entries and narrative items on continuation sheets (NPS Form 10- 900a). Use a typewriter, word processor, or computer, to complete all <br />items. <br />1. Name of Property <br />historic name Pope, Captain John S., Farm <br />other names /site number <br />2. Location <br />Street & number 6909 Efland -Cedar Grove Road <br />city or town Cedar Grove <br />State North Carolina <br />N/A ❑ not for publication <br />® vicinity <br />code NC county Orange code 135 zip code 27231 <br />3. State /Federal Agency Certification <br />As the designated authority under the National Historic Preservation Act, as amended, I hereby certify that this ® nominatior <br />❑ request for determination of eligibility meets the documentation standards for registering properties in the National <br />Register of Historic Places and meets the procedural and professional requirements set for in 36 CFR Part 60. In my opinion, <br />the property ❑ meets ❑ does not meet the National Register criteria. I recommend that this property be considered <br />significant <br />❑ nationally ❑ statewide ® locally. (See continuation sheet for additional comments.) <br />Signature of certifying official/Title Date <br />or Federal agency and bureau <br />In my opinion, the property ❑ meets ❑ does not meet the National Register criteria. (❑ See Continuation sheet <br />for additional comments.) <br />Signature of certifying official/Title Date <br />State or Federal agency and bureau <br />4. National Park Service Certification <br />I hereby certify that the property is: <br />❑ entered in the National Register. <br />❑ See continuation sheet <br />❑ determined eligible for the <br />National Register. <br />❑ See continuation sheet <br />❑ .determined not eligible for the <br />National Register. <br />❑ removed from the National <br />Register. <br />❑ other (explain:) <br />Signature of the Keeper <br />Date of Action <br />