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.r.:~~i l: 4~f ... r.J <br />c_Block_Addition <br />DCT. ELiG. <br />iiTJ?T.;::T: i;O:~iRLEIE IRIS S~iEET FOR EACH DET. SOT ELIG. <br />RESOURCE PLUS EITH'cR AN ARCHAEOLOGICAL OR \OMI?:ATED <br />HISTGP.ICAL/A.FCHI'iECTURyL CGii?O::E\7 FOFP1. LISTED DATE <br />I. IDE\TIFICATION: 1)Fesource So, j G/~~J~>~ 2)Temp//. /No. jj~~ QQ <br />3)Resource Fame G)v)Fr~E;'r =)?roject Same f~A~C~[,C/~SS 7~A TuL!<'I~G ~7S~YG'0~1^ <br />S)Cacegory: Arch. Site_ Hist.;Archit. Structure -, Hist./Archit. District_ <br />6)(For Arch. si[e)Zn a District:yes_no_;v11a''r'',e -/ ~`,/~,~ ,~~~..[~~- "~J <br />II. LOCATION: 7)Toeanship/ /3S ;Range Qrv; S{'I/ ~ of /Y~ ~ of /Y~~L of~: of <br />Section; P.K. Y"~I~ 8)County ~[~(~o~/SpGY')` <br />9)USGS QUAD SQyY1Q/'SP_f S~15_;Date ~/~i7 Attach photocopy <br />portion of Quad'. Clearly shoe site. 10)Other maps <br />11)Dimensions mX m 12)Area sq.m(e4047~) acres <br />13)UT?1 Reference: (One UT`1 centered on resource may be given for resource under 10 acres.) <br />A.I~~;~ :_~ ~, (Cf Ci ~ ~ ~mE;~ .:.~' :,~ i, /~ / ~7 ~/~mN. B.~.~~:~ ~ ~ ~ ~ ~E;~ ~ ~ ~ ~ ~mN. <br />C.~~;~ ~ ~ ~ ~ ImE:L i ~~ ~ ~ ~ ~mN. D.~J:~ ~ ~ ~ ~~ ~+E;~ ~ ~ ~~ ~mN. <br />.)Address <br />III. ?LAVAGEMENT DATA: 15)Field P.ssessment <br />16)Qcmer/Address <br />Eligible ~^]ot Eligible_`eed Data_ <br />17)Gov't Involvement: Co unty_State~Federal_Private_: Agency <br />1B)Disturbance:none_light noderate heavy total_;'cxplain <br />14)Threats to Resour.:e:Idater Erosion Idind Erosion_Animal Activity Neglect Candalism_ <br />Recreation Construction ;Cocmnes <br />20)*]anagement Recommendations <br />0. REFERENCE: 21)State/Fed. Permit Nos. <br />22)Photo Nos. <br />Report Title~•~ <br />- Z4)Recorder ~~ <br />25)Reeorder Affiliation <br />~: <br />on~ file at <br />~ % L.ic <br />' ~ -- ::CT FOR FT=LD LS= I L <br /> <br />25)Recording Dace_ <br />i_~ 27)Phone No. <br />%o m ::o: cl? <br />