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53 <br /> ORANGE COUNTY LOCAL LANDMARK APPLICATION <br /> PART 1 DATE OF APPLICATION September 22, 2022 <br /> Please type, if possible, or print. All submitted materials become the property of the Orange Count <br /> Historic Preservation Commission and cannot be returned, <br /> 1. HISTORIC NAME OF PROPERTY (if historic name is not known, use current name or address) <br /> David Faucette House (aka Maude Faucette House or"The Elms") <br /> 2. LOCATION (physical location, not mailing address) <br /> A. Street or State Route/Highway 2421 Bane Road, Efland, NC <br /> B. Township Cheeks <br /> C, Crossroads ComunityNicinity Hall's Mill <br /> 3. LEGAL OWNER OF PROPERTY(please indicate Mr., Mrs,, Ms., Dr., or other appropriate title) <br /> DAY-TIME <br /> NAME Robert Golan and Diana Montgomery u_ TELEPHONE 984-484-4495 <br /> FIRM and/or ADDRESS <br /> 2421 Bane Road <br /> Efland <br /> NC 27243 <br /> CITYISTATE ZIP CODE <br /> E-MAIL ADDRESS robgol()-mindspring.com <br /> BRIEF STATEMENT OF SIGNIFICANCE <br /> On a separate piece of paper, please provide a brief statement or summary outlining the historical, <br /> architectural, cultural and/or landscape elements that make the site significant. (This statement should be <br /> expanded for question #5 of Part 2 of the application.) <br /> See Attached National Register Nomination <br /> *Please submit current photographs of the property including all elevations of the main house and any <br /> other important buildings Please also include general photographs of the property and include any <br /> important landscape features. (if you wish to use digital photography, please submit hard copy printouts.) <br /> "Please also submit a sketch plan of the property showing the footprint of all key buildings and the <br /> location of all driveways or farm roads. <br />