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+ ciation ame of Property 10. Geographical Data Acreage of Property 2.2 UTM References (Place additional UTM references on a continuation sheet.) Zone Easting Northing 2 LL I I I I I I I I I I I I I I I Verbal Boundary Description (Describe the boundaries of the property on a continuation sheet.) Boundary Justification (Explain why the boundaries were selected on a continuation sheet.) 11. Form Prepared By name /title Glory -June Greiff, Consultirr, ;iistoriar_ for. South Bend and St. Joseph County organization u, c +nrin (; ti sc ion street & number — 1753 South Talbott city or town. Ind i ane.poli s Additional Documentation Submit the following items with the completed form: Continuation Sheets Maps St. Joseph County III County and State 31 1 1 I l i l i i l l l l i l l i Zone Easting Northing 41(IIIIIII- IlilillI ❑ See continuation sheet date ' 1 21,Tnrch 1999 telephone 317 -63-7 -6163 state IN zip code 46225 A USGS map (7.5 or 15 minute series) indicating the property's location. A Sketch map for historic districts and properties having large acreage or numerous resources. Photographs Representative black and white photographs of the property. Additional items (Check with the SHPO or FPO for any additional items) Property Owner (Complete this item at the request of SHPO or FPO.) name Ethel Anderson street & number 1636 Lincolr_vray 1'dest telephone 219 -232 -6360 city or town South Bend state IN zip code 46628 Paperwork Reduction Act Statement: This information is being collected for applications to the National Register of Historic Places to nominate properties for listing or determine eligibility for listing, to list properties, and to amend existing listings. Response to this request is required to obtain a benefit in accordance with the National Historic Preservation Act, as amended (16 U.S.C. 470 et seq.). Estimated Burden Statement: Public reporting burden for this form is estimated to average 18.1 hours per response including time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding this burden estimate or any aspect of this form to the Chief, Administrative Services Division, National Park Service, P.O. Box 37127, Washington, DC 20013 -712 and the Office of Management and Budget, Paperwork Reductions Projects (1024- 0018), Washington, DC 20503.