Historic Structure Program Application
Property Owner Name
*
First Name
Last Name
Your E-mail Address
*
Your Phone Number
*
-
Area Code
Phone Number
Historic Property Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Approximate Year Built
Architectural Style (if known)
Is the structure appropriately maintained?
*
Yes
No
Are the grounds appropriately maintained?
*
Yes
No
Has the structure been maintained in accordance with historical standards?
*
Yes
No
Description of the structure
*
Please click the box to verify that you are human
*
Submit Application
Should be Empty: