Historic Structure Program Application

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 *
Should be Empty: