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NPS Form 10-900 OMB No. 10024-0018 <br />(Oct. 1990) <br />OWnited States Department of the Interior <br />—Notional Park Service <br />National Register of Historic- Places <br />Registration, Form <br />This form is for use innominatingor requesting determinations for Individual properties and districts. See instructions in How to Complete the, <br />National Register of Historic Places Registration Form (National Register Bulletin 16A). Complete each item by marking 'Y' In the appropriate box or <br />by entering the information requested. It an item does not apply to the property being documented, enter "N/A" for . "not applicable." For functions, <br />architectural classification, materials, and areas of significance, enter only categories and subcategories from the instructions. Place additional <br />entries and narrative items on continuation sheets (NPS Form 10a00a). Use a typewriter, word processor, or computer, to complete all items. <br />1. Name of Property <br />historic name <br />other names/site number <br />2. Location <br />street & number 51387 Portae Road 0 not for publication, <br />city. or town South Bend 0 vicinity <br />state _Indiana code IN county St. Joseph code 141 zip code 46628 <br />3. State/Federal Aqency Certification <br />As the designated authority under the National Historic Preservation Act, as amended, I hereby certify that this El nomination <br />E3 request for determination of eligibility meets the documentation standards for registering properties in the National Register of <br />Historic Places and meets the procedural and professional requirements set forth in 36 CFR Part 60. In my opinion, the property <br />0 meets El does not meet the National Register criteria. I recommend that this property be considered <br />idered significant <br />0 -nationally 0 statewide n locally. (11 See continuation sheet for additional comments.) _- . <br />Signature of certifying officiaIMtle Date <br />State of Federal agency and bureau <br />In my opinion, the property 0 meets 0 does not meet the National Register criteria. (0 See continuation sheet for additional <br />comments.) <br />Signature of certifying official/Title Date <br />State or Federal agency and bureau <br />4. National Park Service Certification <br />I hereby certify that the property is: Signature of the Keeper Date of Action <br />El entered in the National Register. <br />F1 See continuation sheet. <br />EJ determined eligible for the <br />National Register <br />n See continuation sheet. <br />0 determined not eligible for the <br />National Register. <br />❑ removed from the National <br />Register. <br />El other, (explain:) <br />