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P <br />.T <br />-rl <br />un <br />I7 <br />of <br />.ui <br />'N <br />A <br />❑ <br />•nf <br />-v <br />(sting <br />Outstanding :Significant / Notable ❑Contributing <br />2. County <br />ST . 0.-OS ii-1.-\ <br />3. Survey No. <br />Ilstorlc Name <br />5. Townehlp <br />`17.0 9.d-CPcC-1 <br />Preliminary No. <br />dtlress -74/ O 70 e-rq- a <br />7. City SD v' : VA a� I)a <br />8. Quad Name <br />INDIANA HISTORIC SITES AND STRUCTURES INVENTORY State of Indiana Department Of Natural Resources Stele Form 16822/Revised 1987 <br />rnt Contact Prints Here ,,,P•'E "'' a, 9 jA I <br />a m <br />" ,y�� <br />V �X o 6 � xis <br />1 t <br />>mmon Name 10. Visible <br />O.Yes 0 No <br />11. Endangered Explain <br />❑Yes ANo �'3'P+\1;1 i P-iS- <br />)wnership <br />ubllc >311PrIvate <br />Owner's Address ll different) <br />Ise Present Past <br />dence t .g. <br />mercial 0 0 <br />0 0 <br />14. Category <br />JE(8ullding(s) <br />A District <br />❑Site <br />0 Structure <br />0 Object <br />15. Surveys / Legal Protections <br />G? BIRD -! LtF es <br />18. Location Notes I Legal Descrlptlon <br />a, IF SHernd,2Ler nostesE 2j <br />6 <br />/s-/067-o2ti�i(y ...isiFelr <br />17. Condition <br />0 Excellent <br />0 Good <br />0 Deteriorated <br />0 Ruins <br />18. Integrity <br />0 Unaltered <br />Q(Altered .l P/G 51 <br />-o Moved <br />0 0 <br />Date moved <br />Ime Period(s) <br />1900 (14t5-2f7 <br />20. St lefe) <br />FaWtet- '1Ofvi - U-.F'1SS1u4L?SU. <br />21. Architect / Builder <br />22. SPECIFY ALTERATIONS <br />)vats <br />Replacement Additions Other <br />rFR'b.. <br />AwN.U(4< <br />23. DESCRIPTION <br />24. SITE PLAN <br />9S a' <br />/ `'ilr <br />/. <br />` <br />/� <br />dation <br />lass a c-1-1: s 1 A l t xi 1 • C:r A 4 t. $ R a-ry 12.L)S <br />E7A3i- .. 10cs?. Co(LN\C <br />`„ <br />' <br />` <br />Az. <br />oA), <br />,es co1JG12 .•a-D,o- .�ooe <br />1ngs .SOl.1O 1�RN€L- StWat-F Lr;Ft= aUt7 e• 1/1 Dgt- RA, <br />ScDe Lk zrt%tS I fPtp �.tcakkj- <br />1r N / <br />dal Outbuildings 4) 'F E /JG <br />i. of Contributing Resources 26. No. of Nomcontrlbuting Resources <br />27. Environment }' 41 SP'p `�T' <br />eas of Significance: <br />Agriculture <br />Architecture <br />Arl <br />Commerce <br />Communications <br />Community Planning <br />Conservation <br />Economics <br />Education <br />Engineering <br />Entertainment ,/ recreation <br />Ethnic heritage <br />Exploration 1 settlement <br />Health / medicine <br />Indian <br />Industry <br />Invention <br />Landscape architecture <br />Law <br />Literature <br />Military <br />Performing arts <br />Philosophy <br />Politics 1 government <br />Religion <br />Science <br />Social history <br />Transportation <br />Vernacular) Construction <br />Other <br />29. Historic Context(s) / Statement of Significance / Additional Descrlptlon: <br />ATTACH NEGATIVE <br />ENVELOPE HERE <br />' <br />30. FOR STATE OFFICE USE ONLY <br />NR <br />SR <br />E <br />NE <br />0 SEE CONTINUATION SHEET <br />31. UTM <br />1 I a EN <br />I I I I I t I I I I I <br />I <br />ormat ion Sources <br />veyor ( <br />S'4-s (Wp <br />Affiliation <br />INV V <br />Date <br />3-4004; <br />Iced by <br />Affiliation <br />Date <br />Iced by <br />Affiliation <br />Date <br />