STATE OF FLORIDA

S5partment of tate

DIVISION OF ARCHIVES. HISTORY
AND RECORDS MANAGEMENT


Bureau of Historic Preservation


HISTORIC SITES INVENTORY

County

Entry No. Date


1. NAME
COMMON:
/H,5 Hours-
AND/OR HISTORIC:


12. LOCATION
STREET AND NUMBER:

CITY OR TOWN:
.57. 14US-US-t 4;
STATE CODE COUNTY: CODE
Fof dI- 57z J 0 ST Jo
3. CLASSIFICATION
CATEGORY OWNERSHIP STATUS ACCESSIBLE
(Check One) TO THE PUBLIC

] District K Building D Public Public Acquisition: Occupied Yes:
O Site E Structure Private O In Process ] Unoccupied E Restricted
E Object D Both D Being Considered Q Preservation work ] Unrestricted
in progress C

PRESENT USE (Check One or More as Appropriate)
E Agricultural O Government E Park E Transportation [O Comments
Commercial E Industrial O Private Residence O Other (Specify)
O] Educational E Military O Religious
O Entertainment E Museum O Scientific
!4. OWNER OF PROPERTY
OO.N4R'S NAME
// oqI C e E. Jlmes s. L4//i S LE
STREET AND NUMBER:

CITY OR TOWN: STATE CODE


5. LOCATION OF LEGAL DESCRIPTION
COURTHOuSE, AEGISTAQ OF DEEDS ETC

STREET AND NUMBER:
C^DorA 9- R- Do YA
CITY O OWN: STATE CODE



6. REPRESENTATION IN EXISTING SURVEYS
TITLE OF SURVEY:

DATE OF SURVEY: )? / Federal State O County O Local
DEPOSITORY FOR SURVEY RECORDS:

OFF'ae ep AP ^fte^^-OC P' o H sro~le jPEGss^v4T/o ^ __
STREET AND NUMBER:
/Ps / pEPr. o, /A;^ Oi .
CITY OR TOWN: STATE: CODE

LV ^ ^/A/^'T-2DA /____________________^ I *_________________


DS-HP-101
1-23-70


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17. DESCRIPTION


CONDITION


|I Excellent


' Altered


(Check One)
0 Good O Fair ] Deteriorated


(Check One)
O Unaltered


] Ruins [ Unexposed


(Check One)
D Moved X Original Site


DESCRIBE THE PRESENT AND ORIGINAL (if known) PHYSICAL APPEARANCE

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9. MAJOR BIBLIOGRAPHICAL REFERENCES


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10. GEOGRAPHICAL DATA
LATITUDE AND LONGITUDE COORDINATES LATITUDE AND LONGITUDE COORDINATES
DEFINING A RECTANGLE LOCATING THE PROPERTY 0 DEFINING THE CENTER POINT OF A PROPERTY
R OF LESS THAN TEN ACRES
CORNER LATITUDE LONGITUDE LATITUDE LONGITUDE
Degrees Minutes Seconds Degrees Minutes Seconds Degrees Minutes Seconds Degrees Minutes Seconds
NW o o o /"
NE 0 o
SE o o
s 0I Q
APPROXIMATE ACREAGE OF NOMINATED PROPERTY:
LIST ALL STATES AND COUNTIES FOR PROPERTIES OVERLAPPING STATE OR COUNTY BOUNDARIES
STATE: CODE COUNTY CODE


STATE: CODE COUNTY: CODE


STATE: CODE COUNTY: CODE


STATE: CODE COUNTY: CODE


II. FORM PREPARED BY
NAME AND TITLE:


ORGANIZATION DATE


STREET AND NUMBER:


CITY OR TOWN: STATE CODE


12.PHOTO REFERENCE
PHOTO CREDIT: A ) j
DATE OF PHOTO:
NEGATIVE FILED AT:


IDENTIFICATION
DESCRIBE /IE N, DIRECTION E T
/ / / / /-. K)




MAP REFERENCE
SOURCE:


SCALE:
DATE:
REQUIREMENTS
TO BE INCLUDED ON ALL MAPS
1. Property boundaries where required.
2. North arrow.
3. Latitude and longitude reference.
101c




S *


L SIGNIFICANCE
PERIOD (Check One or More as Appropriate)
O Pre-Columbian I 16th Century J 18th Century O 20th Century
O 15th Century O 17th Century p 19th Century

SPECIFIC DATE(S) (I Applicable and Known)
AREAS OF SIGNIFICANCE (Check One or More as Appropriate)
Aboriginal E Education E] Political O Urban Planning
] Prehistoric ] Engineering 1 Religion/Phi- O Other (Specify)
O Historic l Industry losophy
] Agriculture E Invention O Science
Q Architecture Landscape O Sculpture
O Art Architecture E Social/Human-
E Commerce ] Literature itarian
E[ Communications E Military ] Theater
EO Conservation ] Music E Transportation

STATEMENT OF SIGNIFICANCE







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