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ADDRESS ! ADDITION 'f'
NAMES OF ORIGINAL AND SUBSEQUENT OWNERS ADDRESS Date Wh
Acquire
CLAWS
BASEMENT
BATA ROOM
1 -Story Dwlg.
Full
Built-in Tub;OM
2-Story Dwlg.
Shower Room
Leg Type Tub
Story and Half
r
a[-,e
Pedestal Lay.
1 -Story Duplex
Wall Lay.
Tile Wainseoating
2 -Story Duplex
Double Garage
Plaster It
Den
Apartment
Sealed & Pape ed
HEATING
Hotel Apt.
Steel Frame
Store Bldg.
Office Bldg
Gas ctove-0�
KITCHEN
Shop Bldg.
Gas Steam
Built-in CabinetL
Factory Bldg.
Furnace
2 -Story
(Other Out building)
'xplain i Rem.)
Garage Bldg.
Fireplace
Tile Drain f D
Garage Home
Floor Heaters
Wood Drain
Filling Sta.
Central f
Tile Wainscoatinal
Brick or Stone
—
Keen Cement "
Solid Concrete
Sealed & Papered
CONSTRUCTION
DRIVEWAY
Bath Room
Brick
Runners
Shower Room
Solid Concrete
OUT BUILDINGS
Frame
Veneer
Gravel
Siding ✓
Shi le
St
G o
Single Garage
Hollow Tile
Double Garage
Den
Concrete Block
Servants' Qtrs.
FENCE
Steel Frame
No. Rooms
Plumbing
Iron
Iron
Const.
1=Story
Plain Wood
Ornamental Wood
2 -Story
(Other Out building)
'xplain i Rem.)
FOUNDATION
Wire
ROOMS
Brick or Stone
—
Solid Concrete
Living Room
Cone. Blocks
CONSTRUCTION
r
_ _
Dining "
Wood Blocks
Box
MISCELLANEOUS,
Frame -VI
— ne
Hol
—
No. of Fireplaces—
Breakfast Rm.
Bedroom
E%TERIOR
—Cedar Closets
Book Cases
te
C v. Iron
Siding
Shingles
Windows 1..
UT hi
Library
ROOF
Sun Parlor
Stucco
... .
i 3..
Com. Brick
Face Brick
Inside Doors..
Outside Doors..
-
Room
Shingle V,Storage
Attic
Stone
Mill Work........
Slate
Paper
Mirror Doors......
Stairway ..........
Til
Ta an
C osition
Office
Stores
�O E <�
0
o
jJ u
1
in
O
I l l l l l l l l l l -
Base- STORIES CORNER OR INSIDE LOT FRONT
ment 1 2 3 4 S
FEET
DEPTH ;AREA
FRONT
C/% I , cr1 17 r.r%n
FINISH Base-
ment
Hardwood Floo
Pine Floors
BATH ROOM
_ Tile Floor
Inlay Linoleum
Plain Linoleum ---
ROOF
Shingle
Attic Fan .......
Bath Room
WALLS
Shower Room
Slate
Tile
Tar and Gravel
Galt'. Iron
Asbestos
Compos
Sleeping Porch
KIND WALLS
Siding ✓
Shi le
St
G o
Plastered
£htrk. and T.SL
Sealed and Pap.
Beaver Board
Plywood Panels
Powder Room
----
Den
Total Rooms
Each Floor
2M 12 -23 -40 -VP
PICTURE TAKEN
UNIT
PRICE I VALUE I +
REMARKS:
SIGNED
BLOCK — —_
IVALUATION SUMMARY
Base Rate 3 Ja I Class
Total Calculated F'tage
Perimeter /57
Square Feet
1st Floor�1"j
2nd Floor
Porches & Misc.
psC.C. P. — 17 -
if
if C. P. 144
So at
ASSESSED VALUE
Year Ground Imp. Total
2- r 2 D
1 7-6) 2,Y10 3140
1F_7SO-a[:Q
M 71
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DATE — 2___�>
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