Historic Property Inventory Form
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Internal Rating:
WEST VIRGINIA HISTORIC PROPERTY
INVENTORY FORM
Street Address
Common/Historic Name/Both
Field Survey #
Site # (SHPO Only)
Town or Community
County
Negative No.
NR Listed Date
Architect/Builder
Date of Construction
Style
Exterior Siding/Materials
Roofing Material
Foundation
Property Use or Function
UTM#
Residence
O
Commercial
O
Other
O
Photograph
Survey Organization & Date
Quadrangle Name
(2” x 3” Contact)
Part of What Survey/FR#
Sketch Map of Property
Or Attach Copy of USGS Map
N
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Parent category: Business