APPLICATION TO REGISTER A HERITAGE PROPERTY


Please complete all information and return to:
Heritage Advisory Committee, 
Post Office Box 179, Port Hood, Nova Scotia BOE 2WO


Name of Property:

Location:

Present Owner:

Action Requested by:


EVALUATION CRITERIA:

1.	AGE of property?               CONDITIONS:



Estimation or Source of Information:

2.   ASSOCIATION with Individuals(s)?






Organizations:





Historic Event(s)?



3. ARCHITECTURE

TYPE OF CONSTRUCTION:

ARCHITECT:

BUILDER:



4. LANDMARK

Do you or your association consider this property
to be a landmark?    Why? (Explain in detail.)








5. PHOTOGRAPHS (Maximum 8)

* Photographs must show total building. 
(plus doors, windows and details. - optional)


6. ADDITIONAL INFORMATION

Do you know of any other source i.e. book, report,
newspaper article or individual that has additional
informtion about this property?




7. History of the building:
(attach additional information if applicable)








Application prepared by:

Address:



Phone:

Home:                        Work:

Date:                        Signature: