Historical Restoration Certificate Award

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Please correct the fields below:

Please correct the field(s) marked in red below:

Building/Site Property Address:

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Building/Site Property Address:

Building/Site Property Owner Name:

*

Building/Site Property Owner Name:

Building/Site Property Owner Telephone:

*

Building/Site Property Owner Telephone:

Describe the exterior building improvements:

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Describe the exterior building improvements:

Type of Project:

Residential

Commercial

Industrial

Institutional

Other

If available, please send before and after photos of the nominated property:

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Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Nomination submitted by:

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Nomination submitted by:

Your address:

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Your address:

Your e-mail address or telephone:

*

Your e-mail address or telephone:

To receive a copy of your submission, please fill out your email address below and submit.
Email Address