State Antiquities Landmark Nomination Form - Texas Historical Commission Page 4
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4State Antiquities Landmark Form
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9. Attachments (indicate which items are included in application)
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Current photographs, sufficient for THC staff to confirm the property’s eligibility (digital files not accepted in lieu
of prints)
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Maps
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Deed
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Proof of Publication
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Fiscal Impact Statement (Optional. For a building or structure owned by a political subdivision, the nomination may
be accompanied by a statement assessing fiscal impacts of the potential designation on the political subdivision. The
political subdivision may also supply a fiscal impact statement to be considered by the Commission).
□
National Register form (to be attached by THC staff)
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Archeological site data form
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Other supporting documentation (briefly describe) ____________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
10. Evaluation by THC Staff (for buildings and structures only)
□
Building/Structure is listed in the National Register of Historic Places
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Individually listed
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District (nominated in its entirety as an SAL)
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Contributes to significance of a listed district
Name of District __________________________________________________________________________
Certified by _______________________________________________ Date __________________________
11. Evaluation by THC Executive Director
□
The nomination is complete and acceptable.
□
The property retains integrity at the time of the nomination and is eligible for designation.
Signature: ___________________________________________________________ Date: __________________________
Texas Historical Commission
P.O. Box 12276
Austin, TX 78711-2276
Phone 512/463-6100
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