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Colorado Inventory Form <br />MANAGEMENT DATA FORM <br />(page 3 of 4) <br />S tat e Sit e Numb e r _-=5:..:L""()f>",e7:l,,-,-,,,-I_O_'1_~_1 __ _ Temporary Si te Number __ -'-7-'-? ____ _ <br />IV. NATIONAL REGISTER ELIGIBILITY ASSESSMENT <br />32. Colorado Historical Society context (RP3) theme(s) ______________ _ <br />Specify ______________________________ ___ <br />33. Applicable National Register Criteria <br />A. associated with events that have made a significant contribution to the <br />broad pattern of our history <br />B. associated with the lives of persons significant of our past <br />C. embodies the distinctive characteristics of a type, period, or method of <br />construction, or that represent the work of a master, or that possesses <br />high artistic values, or that represent a significant and distinguishable <br />entity whose components may lack individual distinction <br />D. has yielded, or may be likely to yield, information important in history <br />or prehistory <br />does not meet any of the above National Register criteria <br />34. Condition <br />a. Architectural/Structural b. Archaeological/Paleontological <br />Exce 11 ent <br />Good <br />Undisturbed <br />Fair <br />Deteriorated <br />Ru ins <br />--Light disturbance <br />--Moderate disturbance <br />--Heavy disturbance <br />--Total disturbance <br />35. Descri be conditi on ____________________________ _ <br />36. Is site vandal ized? yes __ no Des c rib e -;-;-:c-:-:c:--::---::-:-=:-,--:-;c::-;;;-;::c::-:;;:-;-;-:-:::-r-::c:c::;;-;-________________________ (if yes, complete "Vandalism Form") <br />37. Field Assessment <br />Eligible Not Eligible X Need Data <br />Statement of Significance/N.R~ <br />Justifi ca tion _______________ _ <br />38. If in an existing National Register District, <br />if the site contributing __ or not contributing __ <br />39. Is there National Register District Potential yes __ no Di scuss ____ _