NPS
Form
10-900
(Oct.
1990)
United
States
Department
of
the
Interior
National
Park
Service
National
Register
of
Historic
Places
Registration
Form
OMB
No.
10024-0018
RECEIVED
2m
REGISTER
OFK'sFIFi
NATIONAL
PARK
SERVICE
This
form
is
for
use
in
nominating
or
requesting
determinations
for
individual
properties
and
districts.
See
instruction
in
How to
Complete
the National
Register
of
Historic
Places
Registration
Form
(National Register
Bulletin
16A).
Complete
each item by
marking
"x"
in
the
appropriate
box
or
by
entering
the
information
requested.
If an
item does
not
apply
to
the
property
being
documented,
enter
"N/A"
for
"not
applicable."
For
functions,
architectural
dassifications,
materials and
areas
of
significance,
enter
only
categories
and
subcategories from
the
instructions.
Place
additional
entries
and
narrative
items
on
continuation
sheets
(NPS
Form
10-900a).
Use
a
typewriter,
word
processor,
or
computer, to complete
all
items.
1.
Name
of
Property
historic
name
Nerdrum-Conrad
House
other
names/site
number
N/A
2.
Location
street
&
number
979 South
Fifth
Street
city
or
town
Coos
Bay
state
Oregon
________________________
fj
not
for
publication
___________________________________
E
vicinity
code
OR
county
Peoohutes
C0&S
code
017
zip
code
97701
3.
State/Federal
Agency
Certification
As
the
designated
authority
under
the
National
Historic
Preservation
Act,
as
amended,
I
hereby
certify
that
this X
nomination
__
request
for
determination
of
eligibility
meets
the
documentation
standards
for
registering
properties
in
the
National
Register
of
Historic
Places
and
meets the
procedural
and
professional
requirements
set
forth
in
36
CFR
Part
60.
In
my
opinion,
the
property
X
meets
__
does
not
meet
the
National
Register
criteria.
I
recommend
that
thi&
property
be
considered
significant
__
nationally
__
statewide
X
locally.
7y
c^rt^ft^
^~js£—
April
26.
2004
Signature
of
certifying
official/Title
Deputy
SHPO
Oregon State Historic
Preservation
Office
Date
State
or
Federal
agency
and
bureau
4.
National
Park
Service
Certification
I
hereby
certify
that
the
property
is:
Action
/
V/entered
in
the
National
Register
See
continuation
sheet.
determined
eligible
for
the
National
Register
See
continuation
sheet.
_determined
not
eligible
for
the
National
Register
jemoved
from
the
National
Register
_
other
(explain):