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<br /> NORTH CAROLINA HISTORIC STRUCTURE SHORT DATA SHEET • •)-' • ? i31.'•i
<br /> READ and USE the instruction manual to complete this form. Filt it out as completely and consistently as possible. PLEASE NOTE:
<br /> not all variables are provided for each `""" •'
<br /> p question and reference to the instruction manual will be necessary..In all cases:
<br /> , r_Y.■r1 C I i
<br /> 0 or 00 denotes an undetermined or not applicable response „: f fit.:>9i
<br /> 9 or 99 denotes a variable other than those provided , :� .;•
<br /> OR
<br /> SURVEY SITE NUMBER i P ' (To be filled in by S & P Branch unless otherwise specified)
<br /> --_1a/1� f , , ,
<br /> 1. SITE NAME: S?rnf'1 / ) A l J- -t'./(3 -i--- (Y1/.i tr.£q is-ii;;
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<br /> 3. ABBREVIATED LOCATION DESCRIPTION OR STREET ADDRESS: `/// 3 L,/ /I i / I'' `- !e/ R ci • .;: ,i.,;,,b
<br /> :, ft71:!
<br /> 4. NEAREST TOWN/COMMUNITY: , ., -,,'•i'`''`
<br /> 5. COUNTY: 6 J 6. DATE RECORDED IN FIELD: MONTH /r • DAY a 5 : '''YEAR .q ._
<br /> 7. FIELD RECORDER(S): r l_ 4, //, A 1 Z'. i,lai 'i. !,.i
<br /> 8. TAX PARCEL # (PROPERTY ID): (optional) - ', ';;q.*;•,,
<br /> } I P ! .
<br /> 10. OWNER NAME: r •� ice; ' ..1) �1 1 rip ( ;:•i.
<br /> 11. OWNER ADDRESS: �// .� 4)/'I 7/ 't /c�_!•d R(3 il,-1'
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<br /> .2 ,( /-71-. I'/ / :1-.61.:'p.i liia
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<br /> i• 141:bii:. _
<br /> Telephone: . i,:
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<br /> 13. USE: Original Primary: 70 f so 1 Other: '}'•
<br /> Present Primary : kV. ( 0 Other: ! -.•!-,,• ,.
<br /> Resid: Farm Resid: Non-Farm Farm Bldg School Office Bank General Retai[i'Store Industria
<br /> 0101 0102 0201 0301 0401 0402 0501'' ; ' 0601-061
<br /> Transportation Post Office Church Clubhs/Lodge Museum ' Cemetery Unoccupie
<br /> 0801-0831 0902 1001 1501 1701 . 1802•, 2001
<br /> 14. CONDITION: i59. Excellent Good . Fair Deteriorated :l;;a.:Ruin Unexpose
<br /> 1 2 3 .•a:_.
<br /> 4 . ; 5 6
<br /> •ARCHITECTURAL DATA •.+,``F•,. ,.1 ••
<br /> 19. EXPRESSION: Exterior 3 Interior High/Academic National/Popular Regional/Vernacular '. ;.d'.,.:
<br /> 1 2 . .3•,,t$i 7.;,,
<br /> I/��Gr :;Yli:ki .
<br /> 21. GENERAL STYLE GROUPS: Exterior: First t) I Second 1 .3 - Third•:£;: i?',1-- �,,;
<br /> Interior: First __ _
<br /> Second _ TEiird' =TE`:` ,il,
<br /> Geo Geo/Fed Fed Fed/Gk Rev Gk Rev Italianate Goth Rev 19-2.c Trad/Vern:', Queen Anne
<br /> 01 02 03 04 05 06 07 , ' 09`:'"'h'1'4-i; 111h.
<br /> Neoctas Rev Col Rev Misc Vic Standard Com/Indust Beaux-Arts Tudor-Rev:g. : Bungalow Art Deco
<br /> . 12 13 15 16 21 22... ,. ;:;:
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