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-�i f��3e stle. ,Pty Jame of Property 10. Geographical Data Acreage of Property 47 .St _ Jn spilt County TN County and State UTM References (Place additional UTM references on a continuation sheet.) 1 I I_ I I I 1 I 1 1 I I I I I I I I I 3 Zone Easting Northing Zone Easting 2 LTJ I l i l 1 1 1 1 i l l l 1 1 1 4 1 1 1 I- I 1 I 1 1 ❑ See continuation sheet 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 Gl n_ -June Greiff. Consulting Historian organization street & number 17E3 South Talbott city or town Indianapolis Additional Documentation Submit the following items with the completed form: Continuation Sheets Maps I I I I I I I I Northing I I I I I I I 1 date 30 November 1998 telephone 317-637-6163 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 ti -is item at the request of SHPO or FPO.) name V..1 ; va} at h T.niilipr street & number S1 SR7 pnr+a kc- Rnnri city or town Sn11+h ppra telephone R19-277-8063 state TN 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 20013-7127; and the Office of Management and Budget, Paperwork Reductions Projects (1024-0018), Washington, DC 20503.