Fresno County Historical Landmarks & Records Commission
Historic Places Application

IDENTIFICATION
 1.  Common name: ______________________________________________________________

 2.  Historic name:_____________________________________________________________

 3.  Street or rural address: __________________________________________________

     City________________________  Zip _____________  County ___________________

 4.  Parcel Number:_____________________________________________________________

 5.  Present Owner:_____________________________________________________________

     City___________________  Zip__________  Ownership is: ___Public  ___Private

6.  Present Use_________________________________________________________________

    Original Use________________________________________________________________

DESCRIPTION
7a.  Architectural style: ______________________________________________________

The architectural style should be identified from a list of accepted style
identifications from the following list.

 Adobe           Arts & Crafts  Art Deco          Austrian Succession
 Baroque         Beaux Arts     Byzantine         Cape Cod
 Chateauesque    Classical      Revival           Colonial  Craftsman
 Dutch Colonial  Eastlake       Egyptian          English Tudor
 Four-Square     French Tudor   Georgian          Gothic
 Half-Timber     International  Islamic           Log Cabin
 Mediterranean   Mission        Monterey          Normandy
 Prairie         Pueblo         Ranch             Richardsonian
 Romanesque     Second Empire  Spanish Colonial  Stick
 Swiss Chalet    Victorian

7b.  Briefly describe the present physical description of the site or structure and describe any major alternations from its original condition.  Descriptions should include such characterizing details as exterior material, roof shape and material, number of rooms, interior materials, fireplaces, and other parts which may represent a specific style.  Include additional elements of the site such as detached garage, barn, tankhouse, outhouse, corral, entrance gate, pond, canal, storage shed, kiln, packing shed, gardens, arbors, landmark trees, and others.
 
 
 

 8.  Construction date:   Estimated _______   Factual ______

 9.  Architect _________________________________________________________________

10.  Builder   _________________________________________________________________

11.  Approximate property size (feet) ____Frontage _____Depth of approx. acreage

12.  Condition: __Excellent __Good __Fair __Deteriorated __No longer in existence

13.  Alterations:_______________________________________________________________

14.  Please enclose a photograph, black & white if possible.

     Date(s) of enclosed  photograph(s):

15.  Locational sketch map.  (Draw and label size and surrounding streets, roads,
     and prominent landmarks.)

     __________________________________North____________________________________
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     |West                                                                  East|
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                                          South
 

16.  Surroundings: (check more than one if necessary)
                   __Open land   __Scattered buildings __Densely built-up
                   __Residential __Industrial          __Commercial
                   Other:______________________________

17.  Threats to site: __None known  __Private development __Zoning
                      __Vandalism   __Public works project
                      Other:________________________________________

18.  Is the structure: On its original site?______ Moved?______ Unknown?________

19.  Related Features:__________________________________________________________
 

SIGNIFICANCE
20.  Briefly state historical and/or architectural importance (include dates,
     events, and persons associated with the site.)
 
 
 
 
 
 
 
 
 
 
 
 
 

21.  Main theme of the historic resource:  (If more than one is checked,
     number in order of importance.)
          ___Architecture            ___Arts & Leisure  ___Economic /Industrial
          ___Exploration/Settlement  ___Government      ___Military
          ___Social/Education        ___Religion

22.  Sources (List books, documents, surveys, personal interviews and their dates).
 
 
 
 
 
 
 
 
 

23.  Date form prepared: _______________________

       By: (name)_______________________________________________________________

       Organization:____________________________________________________________

       Address:_________________________________________________________________

       City:____________________________________________  Zip___________________

       Telephone: _________________________               Fax:__________________

       E-mail: ____________________________
 

24.  Signature of owner                                   Date:

       ____________________________________               ______________________
 
 

Please forward completed application to:
Laurel Prysiazny, Secretary of HLRAC
Historical Landmarks & Records Advisory Commission
Fresno County Library
2420 Mariposa Street
Fresno, CA   93721

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