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North F.lim_ni_ng 'Sttati on <br />Name of Property <br />10. Geoqraphical Data <br />Acreage of Property less than 1 acre <br />UTM References <br />(Place additional UTM references on a continuation sheet.) <br />W 1 1 1 1 1 1 1 1 1( 1 1 1 1 1 <br />Zone Easting Northing <br />2111111111111111111 <br />Verbal Boundary Description <br />(Describe the boundaries of the property on a continuation sheet.) <br />Boundary Justification <br />(Explain why the boundaries were selected on a continuation sheet.) <br />11. Form Prepared By _ <br />St. Joseph County <br />County and State <br />IN <br />3 W 111111111111111 <br />Zone Easting Northing <br />4 L_.i I I i I I I I I I I I I I i I <br />❑ See continuation sheet <br />name/title C��ny -.T��ne Crreiff . Consultinw, Historian <br />for Historic Preservation Commission of <br />organization South Bend 6c St.Jose*oh County date 19 March 1996 <br />street & number 1753 South Talbott <br />city or town Thdihnapol i a <br />Additional Documentation <br />Submit the following items with the completed form: <br />Continuation Sheets <br />Maps <br />telephone 317-637-6163 <br />state TN zip code 46225 <br />A USGS map (7.5 or 15 minute series) indicating the property's location. <br />A Sketch map for historic districts and properties having large acreage or numerous resources. <br />Photographs <br />Representative black and white photographs of the property. <br />Additional items <br />(Check with the SHPO or FPO for any additional items) <br />Property Owner <br />(Complete this item at the request of SHPO or FPO.) <br />name city of South .send Vj&tez•works <br />street & number Counter -City Bui d ng telephone 219-235-9332; <br />city or town South Bend state IN zip code AFM1 <br />Paperwork Reduction Act Statement: This information is being collected for applications to the National Register of Historic Places to nominate <br />properties for listing or determine eligibility for listing, to list properties, and to amend existing listings. Response to this request is required to obtain <br />a benefit in accordance with the National Historic Preservation Act, as amended (16 U.S.C. 470 at seq.). <br />Estimated Burden Statement: Public reporting burden for this form is estimated to average 18.1 hours per response including time for reviewing <br />instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding this burden estimate or any aspect <br />of this form to the Chief, Administrative Services Division, National Park Service, P.O. Box 37127, Washington, DC 20013-7127; and the office of <br />Management and Budget, Paperwork Reductions Projects (1024-0018), Washington, DC 20503. <br />L_J <br />