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North C :i .roli_ na Dcpartm � nt of Cultu .r_ al, Resot.t .r_ cOf, <br /> DLvi. sion Of Archives and Flifitory <br /> STATE HISTORIC PRESERVATION OFFICE <br /> SURVEY AND PLANNING BRANCH <br /> 919 / 733 = 6545 <br /> STUDY LIST APPLICATION <br /> This application initiates preliminary consideration of a property for nctnl_ nation <br /> to the National Register of Historic Places . This does not mean that a property <br /> is being nominated to the Register at this time , nor does this application <br /> constitute a National Register nomination forin . Rather , it enables evaluation of <br /> a property to determine if at is likely to qualify for such listing . <br /> The evaluation *takes place at the quarterly meeting of the National Register_ <br /> Advisory Committee . If approved by the Committee , the property will be placed on <br /> the Study List . Applicants will be notified of the Committee ' s actions in <br /> waiting shortly after the meeting . Once a property is approved for the Study <br /> Dist , a formal nomination may be prepared . For a description of the nomi -- nation <br /> and listing process , see the enclosed National Register Fact Sheet 3 . " How <br /> 11,TSTORI' C PROPERTXES ARE LISTED IN 2111E NATIONAL REGISTER OF 11X STOR.IC PLACES . " <br /> Please type , if- possible , or print . All submitted materials become the property <br /> of the North Carolina State Historic Preservation Office and cannot be returned . <br /> 1. . HISTORIC NAME OF PROPERTY ( If historic name is not known , <br /> use current name or address ) <br /> 2 . LOCATION ( physical location , not mailing address ) <br /> A . Street or State Route / Highway <br /> BM Town or vicinity <br /> C . County <br /> 3 . LEGAL OWNER OF PROPERTY ( please indicate Mr . , firs . , Ms . , D .r <br /> other appropriate title ) <br /> i <br /> • D .�1Y - T zz•sE <br /> N TELEPHONE <br /> FIRM and / or ADDRESS <br /> City / State Zip Code <br />