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NPS Form 10-900 OMB No 10024-0016 <br />(Oct. 1990) <br />United States Department of the Interior <br />National Park Service <br />National Register of Historic Places <br />Registration Form <br />This form is for use in nominating or 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 "x" in the appropriate box or <br />by entering the Information requested. If 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 10.900a). Use a typewriter, word processor, or computer, to complete all items. <br />1. Name of Property <br />historic name W AI -K& Z F t £LD S(tS,Lti�N Ol cS`c� <br />other names/site number I `I I <br />2. Location <br />street & number 1 3 O S �v-OkWG- P\JLNU, ❑ not for publication <br />city or town 'Ci>61A-01A ` 4iD ❑ vicinity <br />state I N D J`1 N Ps codeI N county ST, TO SI'FH code 14 1 zip code <br />3. State/Federal Agency Certification <br />As the designated authority under the National Historic Preservation Act, as amended, I hereby certify that this ❑ nomination <br />❑ 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 />❑ meets ❑ does not meet the National Register criteria. I recommend that this property be considered significant <br />❑ nationally ❑ statewide ❑ locally. (❑ See continuation sheet for additional comments.) <br />Signature of certifying o6icial/Tille Date <br />State of Federal agency and bureau <br />In my opinion, the property ❑ meets ❑ does not meet the National Register criteria. (❑ See continuation sheet for additional <br />comments.) <br />Signature of certifying official/Title <br />State or Federal agency and bureau <br />4. National Park Service Certification <br />I hereby certify that the property is: <br />❑ entered in the National Register. <br />❑ See continuation sheet <br />❑ determined eligible for the <br />National Register <br />❑ See continuation sheet. <br />determined not eligible for the <br />National Register. <br />❑ removed from the National <br />Register <br />other. (explain.) <br />Date <br />Signature of the Keeper <br />Date of Action <br />