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Application to Establish a Local Historic Landmark <br />Property Address for Proposed Landmark <br />Street Number Street Name <br />City Zip Code Parcel ID (Office use only) <br />Primary Property Owner(s) <br />Name Phone # Primary E-mail <br />Address (if different than above) <br />Owner Consent <br />Do you own the landmark or have 50% of the owners of the subject property consented? <br />Yes.No. <br />Legal Description <br />Have you obtained a legal description/survey depicting the legal boundaries of the proposed landmark? <br />Yes.No. <br />Landmark Information Please describe the proposed landmark’s (1) historical and/or cultural significance, <br />(2)educational value, and/or (3) suitability for preservation. <br />Additional space on next page.