Great Basin Heritage Area Partnership Grant Application Historic Resources Questionnaire
If a project involves an historic resource (site, building, etc.), please complete the following:
Name of Site: Click here to enter text.
Street Address: Click here to enter text.
City: Click here to enter text.
Date of Construction/Use: Click here to enter text.
1.
Is the project site recognized for its architectural/cultural/historical significance by any of the
designations programs listed below? Check “eligible” if the site has not been designated, but
has been determined eligible for designation by the Nevada or Utah State Historic Preservation
Office (SHPO).
National Historic Landmark
Yes
☐
No
☐
Eligible
☐
Individually Listed in National Register of Historic Places
☐
☐
☐
Contributing Property to National Register Historic District
☐
☐
☐
State Designation Program
☐
☐
☐
Local Designation Program
☐
☐
☐
Other: Click here to enter text.
☐
☐
☐
Year Listed
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2. If applicant does not own the property, describe the owner’s involvement with the project and
include a letter of consent from the owner.
3. Describe the project site and explain its significance (architectural/cultural/historical/natural
resource).
4. Describe the site’s current use.