Fillable Local Landmark Designation Nomination Form 1. Name 2. (City of Whitewater)

Fill Online, Printable, Fillable, Blank Local Landmark Designation Nomination Form 1. Name 2. (City of Whitewater) Form

Use Fill to complete blank online CITY OF WHITEWATER (WI) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Local Landmark Designation Nomination Form 1. Name 2. (City of Whitewater)

On average this form takes 26 minutes to complete

The Local Landmark Designation Nomination Form 1. Name 2. (City of Whitewater) form is 3 pages long and contains:

  • 0 signatures
  • 78 check-boxes
  • 66 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Whitewater

BROWSE CITY OF WHITEWATER (WI) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
City of Whitewater –Landmarks 312 W. Whitewater St. Whitewater, WI 53190 262-473-0144
____________________________________________________________________________________
Local Landmark Designation Nomination Form
__________________________________________________________
1. Name
Historic____________________________________________________________________________________
and/or common_____________________________________________________________________________
2. Location
street & number____________________________________________________________________________
city, town_________________________________________congressional district____________________
state_________________________ zip code________________ county _____________________________
3. Classification
Category Ownership Status Present Use
____district ____ public ____occupied ____ agriculture ____ museum
____building(s) ____private ____unoccupied ____ commercial ____park
____structure ____both ____work in progress ____ educational ____private residence
____site Public Acquisition Accessible ____ entertainment ____religious
____object ____in process ____yes: restricted ____ government ____scientific
____being considered ____yes: unrestricted ____ industrial ____transportation
____no ____ military ____other:
4. Owner of Property
Name_______________________________________________________________________________________
street & number_____________________________________________________________________________
city, town______________________ vicinity of_________________ state_________________ zip_________
5. Location of Legal Description (In County Courthouse)
courthouse, registry of deeds, etc.___________________________________________________________
street & number_____________________________________________________________________________
city, town__________________________________________________ state____________________________
6. Representation in Existing Surveys
Title_________________________________________________________________________________________
Date__________________________ ____federal ____state ____county ____local
depository for survey records ________________________________________________________________
city, town___________________________________________________ state___________________________
7. Description
Condition Check One Check one
____excellent ____deteriorated ____unaltered ____original site
____good ____ruins ____altered ____moved (if so, date moved ___________________)
Describe the present and original (if known) physical appearance_____________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
8. Significance (Continue on separate sheets if necessary)
Period Areas of Significance-Check and justify below
____prehistoric ____archeology-prehistoric ____community planning ____landscape architecture ____religion
____1400-1499 ____archeology-historic ____conservation ____ law ____science
____1500-1599 ____agriculture ____economics ____literature ____sculpture
____1600-1699 ____architecture ____education ____military ____social/
____1700-1799 ____art ____engineering ____music humanitarian
____1800-1899 ____commerce ____exploration/settlement ____philosophy ____theater
____1900- ____communications ____industry ____politics/government ____transportation
____invention ____other (specify)
Specific dates______________________________ Builder/Architect___________________________________________________
Statement of Significance
(Give specific sources for all statements of fact.)
9. Major Bibliographical References
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
10. Geographical Data
Acreage of nominated property _________________________
Quadrangle name ________________________________________ Quadrangle scale _______________________________
UMT References
(Optional)
Zone Easting Northing Zone Easting Northing
A __________________________________________________ B __________________________________________________
C __________________________________________________ D __________________________________________________
E __________________________________________________ F __________________________________________________
G __________________________________________________ H __________________________________________________
Verbal boundary description and justification __________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
11. Form Prepared By
name/title ________________________________________________________________________________________________________
organization__________________________________________________________________date_______________________________
street & number________________________________________________________ telephone______________________________
city or town__________________________________________________________________state_______________________________
12. Municipal Data
Zoning District: ______________________ Aldermanic District: _____________________
Parcel Number: ________________________________________________________________
Commission Actions
Hearing Approved: ____________________ Hearing Date Set: _______________________
Landmark Designated (Date): ___________________ Number: ________________________
Certified By: ___________________________________________________________________
Commission Chairman
Date: _________________________________________________________________________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Local Landmark Designation Nomination Form 1. Name 2. (City of Whitewater)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 17 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document