National Register Forms Template

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National Register Forms Template NPS Form 10-900 OMS No. 10260018 (Rev. Aug. 2002) United States Department of the Interior National Park Service NATIONAL REGISTER OF HISTORIC PLACES REGISTRATION FORM This form is for use in nominating or requesting determinations for individual properties and districts. See instructions in How to Complete the National Register of Historic PlacesRegistrationForm (National Register Bulletin 16A). Complete each item by marking "x" in the appropriate box or by entering the information requested. If any item does not apply to the properly being documented, enter "NIP." for "not applicable." For functions, architectural classification, materials, and areas of significance, enter only categories and subcategories from the instructions. Place additional entries and narrative items on continuation sheets (NPS Form 10-900a). Use a typewriter, word processor. or computer, to complete all items. ...........................................................................................................................................................................................I.Name of Property historic name Gala Site other nameslsite number 44B00048;01 1-5155 ........................................................................................................................................................................................... 2. Location street & number State Route 220 not for publicationX city or town Gala vicinity NIA state Vir~inia code & county Botetourt code 023 zip code 24085 .............................................................................................. ..........................................................................................................................................................................................3. StatelFederal Agency Certification As thedesignated authority under the National Historic Preservation Act, as amended, I hereby certify that this X nomination request for determination of eligibility meets the documentation standards for registering properties in the National Register of Historic Places and meets the procedural and professional requirements set forth in 36 CFR Part 60. In my opinion, the property X meets -does not meet the National Register Criteria. I recommend that this property be considered significant -nationally -statewide &locally. (-See continuation sheet for additional comments.) - Sianature- of certifvina. ... official date / Virginia Department of Historic Resources State or Federal Agency or Tribal government In my opinion, the property -X- meets -does not meet the National Register criteria. ( -See continuation sheet for additional comments.) Signature of commenting officialflitle Date State or Federal agency and bureau ............................................................................................. .......................................................................................................................................................................................4. National Park Service Certification I, hereby certify that this property is: enteredin the National Register -See continuation sheet. -determined eligible for the National Register Signature of the Keeper -See continuation sheet. determinednot eligible for the National Register removed from the National Register Date of Action -other (expiain): Gala Site Botetourt County, Virginia ============================================================================================== 5. Classification ============================================================================================== Ownership of Property (Check as many boxes as apply) Category of Property (Check only one box) _X_ private ___ building(s) ___ public-local ___ district ___ public-State _X_ site ___ public-Federal ___ structure ___ object Number of Resources within Property Contributing Noncontributing __0__ __0__ buildings __1__ __0__ sites __0__ __0__ structures __0__ __0__ objects __1__ __0__ Total Number of contributing resources previously listed in the National Register __0__ Name of related multiple property listing (Enter "N/A" if property is not part of a multiple property listing.) ___N/A___ ============================================================================================== 6. Function or Use ============================================================================================== Historic Functions (Enter categories from instructions) Cat: _ Domestic _________________ Sub: __ Village site _______________ ___Funerary _____________ ____ ____Graves/Burials _ __________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ Current Functions (Enter categories from instructions) Cat: __ Industry _________________ Sub: ___ Energy Facility ___________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ============================================================================================== 7. Description ============================================================================================== Architectural Classification (Enter categories from instructions) ___ N/A __________________________________ _________________________________________ _________________________________________ Materials (Enter categories from instructions) foundation ___ N/A _____________________________ roof _________N/A ___________________________ walls ________ N/A ____________________________ other ________N/A ____________________________ Narrative Description (Describe the historic and current condition of the property on one or more continuation sheets.) Gala Site Botetourt County, Virginia ============================================================================================== 8. Statement of Significance ============================================================================================== Applicable National Register Criteria (Mark "x" in one or more boxes for the criteria qualifying the property for National Register listing) ____ A Property is associated with events that have made a significant contribution to the broad patterns of our history. ____ B Property is associated with the lives of persons significant in our past. ____ C Property embodies the distinctive characteristics of a type, period, or method of construction or represents the work of a master, or possesses high artistic values, or represents a significant and distinguishable entity whose components lack individual distinction. __X_ D Property has yielded, or is likely to yield information important in prehistory or history. Criteria Considerations (Mark "X" in all the boxes that apply.) ____ A owned by a religious institution or used for religious purposes. ____ B removed from its original location. ____ C a birthplace or a grave. ____ D a cemetery. ____ E a reconstructed building, object, or structure. ____ F a commemorative property. ____ G less than 50 years of age or achieved significance within the past 50 years. Areas of Significance (Enter categories from instructions) ___ Archeology – Prehistoric ______ ______________________________ ______________________________ ______________________________ Period of Significance ___3000 – 1000 B.C.; A.D. 900 - 1607__________________ Significant Dates _____N/A_________________________ Significant Person (Complete if Criterion B is marked above)___N/A________________________ Cultural Affiliation ___Late Archaic; Late Woodland__________________________________________ Architect/Builder ___N/A_______________________________________________________________ Narrative Statement of Significance (Explain the significance of the property on one or more continuation sheets.) ============================================================================================== 9. Major Bibliographical References ============================================================================================== (Cite the books, articles, and other sources used in preparing this form on one or more continuation sheets.) Previous documentation on file (NPS) ___ preliminary determination of individual listing (36 CFR 67) has been requested. ___ previously listed in the National Register ___ previously determined eligible by the National Register ___ designated a National Historic Landmark ___ recorded by Historic American Buildings Survey # __________ ___ recorded by Historic American Engineering Record # __________ Gala Site Botetourt County, Virginia Primary Location of Additional Data _X_ State Historic Preservation Office ___ Other State agency ___ Federal agency ___ Local government ___ University _X_ Other Name of repository: _Smithsonian Institution_________________________ ============================================================================================== 10. Geographical Data ============================================================================================== Acreage of Property __18_______ UTM References (Place additional UTM references on a continuation sheet) Zone Easting Northing Zone Easting Northing Zone Easting Northing Zone Easting Northing 1 17 604685 4172043 2 17 604985 4172009 3 17 605002 4171646 4 17 604583 4171706 ___ See continuation sheet. Verbal Boundary Description (Describe the boundaries of the property on a continuation
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