Brevard Heritage Council, Inc.

Established 1988
   Established 1988
Home Awards Survey Form
Brevard Heritage Council

Home Awards Team Survey Date: _____________
Area: ___________________

Nominated By: __________________________ Phone: __________________

The Brevard Heritage Council annual Architectural Awards will be presented May 18,2011.
Recognition will be awarded to owners, of buildings over 50 years that have been renovated in a manner, which compliments the historic significance of the property.

Contact Person: _____________________________________________

Address: ____________________________ Telephone:__________________
              ____________________________                         
 
Site Name: ___________________

Instructions to Locate: ___________________________________________________________

Present Use: ___________________________________________________________________

Original Use: __________________________________________________________________

Date of Construction: ___________________
County Survey Reference Page(s): _________________________

Architectural style: ______________________________________

Architectural Significance: _______________________________________________________

Construction Integrity: ___________________________________________________________

Original Elements Still Intact: _____________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Paint Color(s): ________________________________

Additions/ Enclosures in compliance with style and materials of original edifice:
______________________________________________________________________________
______________________________________________________________________________

Alterations/Replacements:
____________________________________________________________________________________________________________________________________________________________
Describe Shutters, Screens, and Burglar Bars: ________________________________________
Landscaping: __________________________________________________________________
Additional Information:
__________________________________________________________