Historic Plaque Program Application





Name of Applicant(s):                                                                                                                  


Applicant Mailing Address:                                                                                                       


Phone Number:                                                                                                                              




Address of Historic Structure:                                                                                                    


Date of Construction:                                                                                                                    


Historic Function:                                                                                                                          


Current Function:                                                                                                                           


Complete the above application and please attach a Written Description of the Structure (the narrative should explain the archaeological, historical, architectural, or cultural significance of the proposed landmark) and one (1) photo of the front elevation and a historical photo is available.


If you have any questions regarding the Historic Plaque Program or need an appointment to submit your application, please contact the Planning & Zoning office at: (352) 528-3060, Option #3.