LadiesRestroom013 1 |
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NPS Form 10-900 (Oct. 1990) United States Department of the Interior National Park Service National Register of Historic Places Registration Form OMB No . 10024-0018 This form is for use in nominating or requesting determinations for individual properties and districts. See instructions in How to Complete the National Register of Historic Places Registration Form (National Register Bulletin 16A). Complete each item by marking "x" in the appropriate box or by entering the information requested. If an item does not apply to the property being documented, enter "N/A" for "not applicable." For functions, architectural classification, materials, and areas of significance, enter only categories and subcategories from the instructions. Place additional entries and narrative items on continuation sheets (NPS Form 10-900a). Use a typewriter, word processor, or computer, to complete all items. 1. Name of Property historic name LADIES REST ROOM other names/site number _...:.1-=0""5'---'1-=s~t"'--'-A:..!v-=e"-'n,_.,u,_.,e:........:..N,.o'-'-r_,t"'-h,__..:..;N:L/.:._A,__ _________________ _ 2. Location street & number 105 1st Avenue North Nlffil not for publication city or town _.:::.Le::::.w~i "'-s"'-bu,_,_rg::;L.,_ _______________________ -l.l.JN/ liJ vicinity state _....:Ic.::e::.!n.!.!n.!.!e"'-s:::.;:::.;s.::::e.::::e _____ _ code ___TIL_ county --'M...,a...,r'-'s ...... h...,awl-"1 ___ _ code _ill_ zip code 37091 3. State/Federal Agency Certification As the designated authority under the National Historic Preservation Act, as amended, I hereby certify that this 00 nomination 0 request for determination of eligibility meets the documentation standards for registering properties in the National Register of Historic Places and meets the procedural and professional requirements set forth in 36 CFR Part 60. In my opinion, the property KJ meets 0 does not meet the National Register criteria . I recommend that this property be considered significant 0 nationally 0 statewide [X] locally. (0 See continuation sheet for additional comments.) Signature of certifying officialmtle Date Deputfo State Historic Preservation Officer, Tennessee Historical Commission State of ederal agency and bureau · In my opin ion, the property 0 meets 0 does not meet the National Register criteria. (0 See continuation sheet for additional comments.) Signature of certifying officialmtle State or Federal agency and bureau 4. National Park Service Certification I hereby certify that the property is: 0 entered in the National Register. 0 See continuation sheet. 0 determined eligible for the National Register 0 See continuation sheet. 0 determined not eligible for the National Register. 0 removed from the National Register. 0 other. (explain:) _____ _ Date Signature of th e Keepe r Date of Action
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Title | LadiesRestroom013 1 |
Transcript | NPS Form 10-900 (Oct. 1990) United States Department of the Interior National Park Service National Register of Historic Places Registration Form OMB No . 10024-0018 This form is for use in nominating or requesting determinations for individual properties and districts. See instructions in How to Complete the National Register of Historic Places Registration Form (National Register Bulletin 16A). Complete each item by marking "x" in the appropriate box or by entering the information requested. If an item does not apply to the property being documented, enter "N/A" for "not applicable." For functions, architectural classification, materials, and areas of significance, enter only categories and subcategories from the instructions. Place additional entries and narrative items on continuation sheets (NPS Form 10-900a). Use a typewriter, word processor, or computer, to complete all items. 1. Name of Property historic name LADIES REST ROOM other names/site number _...:.1-=0""5'---'1-=s~t"'--'-A:..!v-=e"-'n,_.,u,_.,e:........:..N,.o'-'-r_,t"'-h,__..:..;N:L/.:._A,__ _________________ _ 2. Location street & number 105 1st Avenue North Nlffil not for publication city or town _.:::.Le::::.w~i "'-s"'-bu,_,_rg::;L.,_ _______________________ -l.l.JN/ liJ vicinity state _....:Ic.::e::.!n.!.!n.!.!e"'-s:::.;:::.;s.::::e.::::e _____ _ code ___TIL_ county --'M...,a...,r'-'s ...... h...,awl-"1 ___ _ code _ill_ zip code 37091 3. State/Federal Agency Certification As the designated authority under the National Historic Preservation Act, as amended, I hereby certify that this 00 nomination 0 request for determination of eligibility meets the documentation standards for registering properties in the National Register of Historic Places and meets the procedural and professional requirements set forth in 36 CFR Part 60. In my opinion, the property KJ meets 0 does not meet the National Register criteria . I recommend that this property be considered significant 0 nationally 0 statewide [X] locally. (0 See continuation sheet for additional comments.) Signature of certifying officialmtle Date Deputfo State Historic Preservation Officer, Tennessee Historical Commission State of ederal agency and bureau · In my opin ion, the property 0 meets 0 does not meet the National Register criteria. (0 See continuation sheet for additional comments.) Signature of certifying officialmtle State or Federal agency and bureau 4. National Park Service Certification I hereby certify that the property is: 0 entered in the National Register. 0 See continuation sheet. 0 determined eligible for the National Register 0 See continuation sheet. 0 determined not eligible for the National Register. 0 removed from the National Register. 0 other. (explain:) _____ _ Date Signature of th e Keepe r Date of Action |