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- T[h- r-tz t7 -F re+ - -- -- <br />Jame of Property <br />10. Geoqraphical Data <br />Acreage of Property 47 <br />UTM References <br />(Place additional UTM references on a continuation sheet.) <br />1 W 1111111111111 <br />Zone Easting Northing <br />21111111111111111 <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 />name /title fflar_y -.Tune Greif Consulting Historian <br />organization <br />street & number 1763 South Talbott <br />city or town Indianapolis <br />Additional Documentation <br />Submit the following items with the completed form: <br />3111111111111111 <br />Zone Easting Northing <br />41-1 -1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <br />❑ See continuation sheet <br />date 30 1 ovember 1998 <br />telephone 317- 637 -6163 <br />state IN zip code 46225 <br />Continuation Sheets <br />Maps <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 V1 Ji T.nii'hpr <br />street & number .rl ';P7 Pnr•f-a c Rnn r1 <br />city or town grntth Apnri <br />telephone ?19 -277- 8063 <br />state T \T zip code 46628 <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 et 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 />4t. .Tose))h Coun TY <br />County and State <br />