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.. :.�~it:.:.:a'�.._..:.,�.Ll .t,:- �.. t_ -� _...`..� t. :.f •� t..,�..'. L.ti�:l L, { ' r1 ; . i ( , <br /> .�. -.� ,..i... ..�:� .._ -• __. _. . <br /> are.�.�.r�r.rr..wrr..w�arrrw.r...w.rr.�rr +rvv..•.�.w..rrw.a+.wn.wrrr�tw_. rr.w.wr.�r.wr�+...w •. .r�..ww v..-....._.....,.. <br /> Art :ei Data <br /> r�r'a.��- r +.wrs+...arr.• � vrrr._rrr+_.�.rr...._nww�..r.....rr.+. r.r,..w...._+.�►.r+. •wr.�w.v.wrw.ru� .•.r <br /> Acrt a of Property <br /> UTM Refiliirer< ee <br /> (Place additional UTIM reituencea on a crintinuation sh0mW4 i <br /> zone is astir g Nonhing Eastinc <br /> i. . ; �e,* cr:rt ►'F +f3.tzo: S sw3et <br /> Verbal Boundary Deactiptlon <br /> (Oesaribe the boundarlas o! the property on a continuation sheet .\ <br /> Boundary .Justification <br /> (Explain why the boundaries were sekfcted an a continuation sheet . ) <br /> ....r,�.. ., .__ ._ ,_.._. . ._..�._� <br /> I I . Fenn P !M*ro d Bhp <br /> rrrr��+�..►.r...,.rr-.+•..+._.r.rr •.r_,.M..1rMw�,. f�••,. <br /> na►r►eltitie _ Patric1Z :7 . Dickinson ,- Consultant <br /> organization .__ —__ . w._ __ —. __. ._ -_._�._ . _ _ _ _.._. _._- ---_ __ _ c�&Z's <br /> Street & nurTnbe'r 0 G 'r? ttnt �'. �-�'_ � 4 3 G _.___. .. <br /> city Cr town _ . Ii 11^ >) orot_tc; 'ri ._. � � .. _ __. ` _.''Tr' _. _. _ ._ __ . ' p , 7 2 ? �3 <br /> starts z: �t7�e <br /> ww,rr.•..rw.rrw ,.......�.... w«�.....s++r.a.r....r....v.......+..+..+.�rr�o+�wr+....r.r.r-...w.�. <br /> Additt anal Documgntstkun <br /> Submit the k0owin+g items with the compi•sted turn ' <br /> Contiounflon Sr*eti!s <br /> Maps <br /> A ;� SGS map ( 7 • 5 or 15 minute sories) indicating the property ' s 1w.atien , <br /> A Sketch rnsp for � iStoiiC ur.'att'iC:1S �!'!� properties having large Crr? 0 Of `1U"tI(WO;; US M' nw <br /> pno!ttgraphs <br /> Representat je Mack and witiwe pi�totcri,rspihs of the property . <br /> Adwtk Mai hone <br /> (Check with 1. * SHP4 or FPO tor any/ aoditlanai Karns) <br /> ProjX Owner <br /> (Complete this item at the requast Of ,HPG or FP041 <br /> name Rouert `i c=olan ,anC �Di ,an� ° :iontcloraory <br /> i <br /> street & number 1020 �-Oa 11 ' s -. . Ill _14 o z c o. _ to l phai� _._. . >_0 1 � -��? G 9 _ <br /> ciw or town __._. ' ; flan e' _ Jtai� ._ t'_. . __w.. zi rc #: L 7? L . ._ .. . .�. _ <br /> �i{Qbl"YYt:tit dIJ;�3(tart Act �sillttRtlRL: Thts Infctinatim ; it; being �Otivclwl torjl�iiii;:lt�!�f:5 i.7 th4a ;� ' !'Sr12ft � R�t#;+ C 4 ( 3ttCtfi E ir2C&9 I'': "t3'SSSI ,:tc• <br /> properties for listing ar determine eligOility tqr listing , tc 4w ritwoperties and to arresnd iixist• r+ Cy 146Ponlovi1 e3wrjonsm to Wis rerJggt t4'1 majui, ed <br /> e b eneftt ir, accot•danca with ? ha National Ftiswric Prsissrvatimi Act ; as drt ,erctovIA! ( 16 !. : .r . C . 470 4t <br /> Estimated 5urdert Stoternent; i'''UGliv rer/ining bur jen i'cr t`As Form {zes estt,navo4d to 1%rPrjot4 i8 * 1 `; owru pa ! (Adiea^.TW 't; 1 .:.tUdIng tft',I5 l r 7K••J,WW6,r .• <br /> instructions . rnsaintainim, aria . and tit;r! ;triwQit!jj Liryti r �r 'i6��'tr1C,� tt {f1 t�'.r�rl >'�irdt;t 1rr�•° 1©} 'r. � f � �ir :t1t5 ; 11fC{ ft►i Fri1 { t*!�tKB )f ::i <br /> of ti^ig loft" tL the C �1184 gijn {1,11�2t {3ltV� SC'VtwGs l . i�oiza Sr � a I � t1Yii "'r1r`t �'C+ '. r'1 , P r a' � , . � r' Ri ' + � 1 r . {. S ' ' f ; •r;•, ; i o, t, t< `' : ',r <br /> rdt3riagdri!fi S: and E3uriget , Papar`v:?rtt Fite l :�rtir�"tv r' > tt}ec:t ; 1 �: a .�" j ,"Ja�� hirtcj%av , <br />