Ladies Rest Room: history and property description

              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street & number 105 1st Avenue North Nlffil not for publication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