JEFFERSON COUNTY HISTORIC SITES PRESERVATION COUNCIL LOCAL HISTORIC SITES APPLICATION

A determination by the County Board that a structure, site or district is historic is for recognition purposes only and does not obligate the owner or occupant to maintain or preserve the structure, site or district in any particular manner or in any way limit or restrict the construction, demolition, reconstruction or exterior alteration of such structure, site or district.

Today's Date:

Applicant Email:

Applicant Phone:

Site/Property Name

Parcel Number (format: 123-4567-7654-321)

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Click here: http://apps.jeffersoncountywi.gov/jc/JCLRS

Site URL:

Social Media URL:

The Site is:

Private

Public

If the site is open to the public, please list hours of operation:

Is the site open for tours? If so, please list tour days/hours:

Is the site Handicap accessible?

Historic Designation

Local

State

National

Significance of the Property:
Why do you think that this property should be listed as a Jefferson County landmark?
Please check one or more of the boxes below and briefly explain why the property is important.

The property illustrates an important aspect of local history through its:

Ethnic History

Industrial or Commercial History

Social or Political History

Agricultural History

Natural/Environmental History

It is directly associated with a person or people who made important contributions to:

Social or Political History

Industrial or Commercial History

Agricultural History

Transportation History

It is architecturally or artistically distinctive because it:

Is an important example of architectural style

Is an important example of vernacular (commonplace) architecture

In an unusual or important kind of building or structure

Has an unusual method of construction

In an important work of art

Is the work of a master architect or builder

Please Provide a Brief Description of the History of the Property (1500 character limit) (for statements of historical fact, please indicate sources of information – keep in mind that our evaluation may depend solely on the information you submit).

List Sources of Information

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I hereby authorize Jefferson County and its assigns all rights to the attached information. (Note: We do not release the locations of sites located on federally recognized tribal lands).