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NURtht_�-16cRT`( PHkK _ <br />Name of Property <br />10. Geographical Data <br />Acreage of Property a-ruwa%k �.-I <br />UTM References <br />(Place additional UTM references on a continuation sheet.) <br />1 I I I 1_ I J JLIJ <br />Zone Easting <br />2 L_I I L .L i L -L _I J <br />Si .. 7) SU(f CZUN <br />County and State <br />I I I I 1 11 3 LJ <br />Northing Zone Easting <br />1 1 1 1 1 1 1 41 tJ LII <br />I I See continuation sheet <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 C LcX - - JUN 1, Cs( l <br />organization ik(Sl'JR" J-alf <br />street & number t7S3 �bl�itt T61C 3� i <br />city or town l N D IP�N A Poo S <br />Additional Documentation <br />Submit the following items with the completed form: <br />Continuation Sheets <br />Maps <br />W <br />Northing <br />L,I,I i I_1 <br />date 1 aoJOs <br />telephone3\7 - 6 37 - (9163 <br />state IN zip code UG RD- s <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 TbluN of <br />street & number 300 ism-rq MA(Q S-TPIZ - telephone S?c(-6S� - m7 <br />city or town N0 R-TH' 1,03M - Y state (N zip code 4 6 S S <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 at 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 />