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OMB No. 100240018NFS Form 10900 (January 1992) Wisconsin Word Processing Format (Approved 1×92)RECEIVED 2280United States Department of Interior National Park ServiceNational Register of Historic

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Property owners or individuals seeking to have a property listed on the national register of historic places are required to file.

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Information such as the property's address, historical background, architectural details, and significance to American history must be reported on the national register of historic places.

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