HomeMy WebLinkAboutWaterloo Historic Preservation Commission-1/25/2016 Campbell Baking Co.CERTIFIED LOCAL GOVERNMENT
NATIONAL REGISTER NOMINATION
EVALUATION REPORT FORM
As a participant in the Certified Local Government Program (CLG), the Historic Preservation Commission is required to review and
comment on proposed National Register nominations of properties within its jurisdiction. The State is required to provide the CLG
with a 60 -day period for the review prior to a State Nominations Review Committee (SNRC) meeting. This form must be received by
the State Historic Preservation Office (SHPO) five days in advance of the State Nomination Review Committee (SNRC) meeting.
(Please print clearly)
Historic Property Name: G (,rn he II N Ki
Address: 5 (.66W\X l lci\,,
Certified Local Government Name: We_, (\,t7n
Date of public meeting for nomination review:
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Applicable Criteria: (Please Check the Appropriate Box)
tl Criterion A (Historical Events)
❑ Criterion B (Important Person)
❑ Criterion C (Architecture)
❑ Criterion D (Archaeological)
Please check the following box that is appropriate to the nomination (Please print clearly).
al The Commission recommends that the property should be listed on the National Register of Historic Places.
❑ The Commission recommends that the property should not be listed in the National Register for the following
reasons:
❑ The Commission chooses not to make a recommendation on this nomination for the following reasons:
❑ The Commission would like to make the following recommendations regarding the nomination: (use additional
sheets if necessary) :
Official Signatures Required Below
Historic Review Board Chair or Representative
Print Name:..: -_—'227‘4,/,44P Approved
Chief Elected Official
Print Name: (1 Cl r t
Signature:
Not Approved
/) b Approved ❑ Not Approved
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Professional Evaluation
Print Name: Approved n Not Approved ❑
Signature: