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Jacob Jacksor Farm Orange r'ounty, NC <br /> Name of Property County ant. tte <br /> 42 <br /> 1 o. Geographical Data <br /> Acreage of Property 63.15 <br /> UTM References <br /> (Place additional UTM references on a continuation sheet.) <br /> 1 W ! ! 14111111I1I11 3 1 1 # # 1 # 11 # 1 # 1 11 # <br /> Zone Easting Northing Zone Easting Northing <br /> z W Ill # illl , Il # tl # a W IltlJllll � llll � <br /> ®See continuation sheet <br /> Verbal Boundary Description <br />( (Describe the boundaries of the property on a continuation sheet.) <br /> Boundary Justification <br /> (Explain why the boundaries were selected on a continuation sheet.) <br /> 11. Form Prepared By <br /> name/title Betsy Gohdes-Baten <br /> organization date 10/4193 <br /> street & number 2737 Circle Drive telephone 919/489-6368 <br /> city or town Durham state NC zip code 27705 <br /> Additional Documentation <br /> Submit the following items with the completed form: <br /> Continuation Sheets <br /> Maps <br /> A USGS map (7.5 or 15 minute series) indicating the property's location. <br /> A Sketch map for historic districts and properties having large acreage or numerous resources. . <br /> Photographs <br /> Representative black and white photographs of the property. <br /> Additional items <br /> (Check with the SHPO or FPO for any additional items) <br /> Property Owner <br /> (Complete this item at the request of SHPO or FPO.) <br /> name Marie B. Hollandsworth/Ann H. Myers <br /> street & number 805 Purdue Street telephone 919/867-147 <br /> city or town Raleigh state NC zip code 27609 <br /> Paperwork Reduction Act Statement: This information is being collected for applications to the National Register of Historic Places to nominate <br /> properties for listing or determine eligibility for listing, to list properties, and to amend existing listings. Response to this request is required to obtain <br /> a benefit in accordance with the National Historic Preservation Act, as amended (16 U.S.C. 470 of seq.). <br /> Estimated Burden Statement: Public reporting burden for this form is estimated to average 18.1 hours per response including time for reviewing <br /> instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding this burden estimate or any aspect <br /> of this form to the Chief, Administrative Services Division, National Park Service. P.O. Box 37127,Washington, DC 200137127; and the Office of <br /> Management and Budget. Paperwork Reductions Projects(1024-0018),Washington, DC 20503. <br />