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Historic District Resource Assessment (RA) Form
|For SHPO Use Only |SHPO Concurrence?: Y / N |Date: |
|Survey Date | |
|Current/Common Name | |
|City, Zip Code(s) | |
|County | |
|Subdivision(s) | |
|UTMs (NAD 83, UTM Zone 11 North) |
|Coordinate # |Easting |Northing |
|# |(enter additional points as needed) | |
|# | | |
|# | | |
|# | | |
|USGS Info |Township: |Range: |Section: |USGS 7.5’ Map & Date: |
|Total Acres in the District | |
|Ownership |Private |Public-Local |Public-State |Public-Federal |Multiple |
|Should the district’s location be kept confidential? |Yes |No |
National Register Eligibility
|Is the district listed in the |Yes |No |If yes, provide:|Date Listed: |NRIS #: |
|National Register? | | | | | |
|If not already listed, complete the information below: |
|Eligible Under: |Criterion A |Criterion B |Criterion C |Criterion D |
| |Not Eligible |Unevaluated | |
|Area(s) of Significance | |
|Period(s) of Significance | |
|Total Resources: |Contributing: |Non-contributing: |
|Integrity – Does the resource possess integrity in all or some of the 7 aspects? |
|General Integrity: |Intact |Altered |Moved |Date(s): |
|Location |Design |Materials |Workmanship |Setting |Feeling |Association |
|Condition of District? |Good |Fair |Poor |
|Explanation | |
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|Threats to Resource? | |
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District Inventory
|SHPO Resource # |name |Address |Year Built |Contributing? |
|and/or Trinomial | | | |(Yes or No) |
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Narrative Eligibility Justification
Provide a detailed explanation of the district’s eligibility for the National Register, including supporting historic information, methods for evaluation under the four criteria, a discussion of the seven aspects of integrity, and conclusions about eligibility.
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Written Description
Provide a written description of the district, including all character-defining features or elements. Be sure to describe accessory resources as well.
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1. References
List references used to research and evaluate the individual property.
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District Location Map
Use a USGS quadrangle map at large extent to show general area of historic district, including district boundary.
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2. Site Plan Map
Use aerial imagery, drafting software, or a hand-drawn sketch (to scale) showing, at minimum, all contributing and non-contributing resources and their spatial relationship to one another.
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Photographs
Include as many photographs as needed to accurately depict the district, including examples of representative properties or property types, streetscapes, landscapes, etc.
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Elevation: Direction facing: Photographer: Date:
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Elevation: Direction facing: Photographer: Date:
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