Statewide Survey of Historic Properties
Control Number:
U
/
/
Status County No. Site No.
Quadrangle Name:
Tax Number:
State Historic Preservation Office
South Carolina Department of Archives and History
8301 Parklane Road
Columbia, SC 29223-4905
(803) 896-6100
Intensive Survey Form
Identification
Historic Name:
Common Name:
Address/Location:
City:
County:
Vicinity of:
Ownership:
1
2
3
4
Private
Corporate
City
County
Historical Use: 1 single dwelling
2 multi dwelling
5 State
6 Federal
0 Unknown/Other
Category:
1
2
3
4
3 commercial
4 other
Current Use:
1 single dwelling
2 multi dwelling
Building
Site
Structure
Object
3 commercial
4 other
SHPO National Register Determination of Eligibility:
1
2
3
4
Eligible
Not Eligible
Contributes to Eligible District
Contributes to Listed District
5
6
7
8
Potentially Eligible
Listed
Determined Eligible/Owner Objection
Removed from NR
Other Designation:
Property Description
Construction Date:
Stories:
Construction Method:
Commercial Form:
1
2
3
4
5
0
1
2
3
4
0
Historic Core Shape:
Exterior Walls:
1
2
3
4
5
1
2
3
4
5
6
Alteration Date:
Rectangular
Square
L
T
U
6
7
8
0
H
Octagonal
Irregular
Other:
Roof Features
Shape:
Materials:
1 Story
1 ½ Stories
2 Stories
2 ½ Stories
3 Stories
Other:
Weatherboard
Beaded Weatherboard
Shiplap
Flushboard
Wood Shingle
Stucco
Masonry
Frame
Log
Steel
Other:
7 Tabby
8 Brick
9 Brick Veneer
10 Stone Veneer
11 Cast-Stone
12 Marble
13 Asphalt roll
14 Synthetic siding
15 Asbestos shingle
16 Pigmented Structural Glass
17 Other:
Foundation:
1
2
3
4
Not Visible
Brick Pier
Brick Pier with Fill
Brick
5
6
7
8
Stuccoed Masonry
Stone Pier
Stone
Concrete Block
9 Slab Construction
10 Basement
11 Raised Basement
12 Other:
Porch Features
Width:
Shape:
Significant Architectural Features:
.
Page 2
South Carolina Statewide Survey of Historic Properties
Intensive Survey Form
Site No.:
Alterations:
Architect(s)/Builder(s):
Historical Information
Historical Information:
Source of Information:
Photographs
Roll No. Neg. No. View of
Use Grid for Sketching
Program Management
Recorded by:
SCDOT
Date Recorded:
//
Attach Photographs Here