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Online Capital Needs Survey


Property Name (REQUIRED)
Is the property listed in the National Register of Historic Places?:

(If No, please complete a National Register Information Request form available from MHPC.)
Property Ownder
RESPONDANT INFORMATION (If different from above.)

Please identify the preservation and repair work that needs to be addressed at your historic property by checking all appropriate boxes. Prioritize the capital needs of your historic property, with (1) being the most immediate need and provide an estimated cost for the work.

Priority Area of Need (check all that apply) Est Cost

Please answer the following questions as applicable to the historic property:

Do you have an endowment or trust fund that supports the maintenance of the property? :
Does this property have a current Emergency Response Plan? :

Thank you for your help!

Maine Historic Preservation Commission, 
55 Capitol Street, State House Station 65,
Augusta, Maine 04333-0065
Phone (207) 287-2132
Fax (207) 287-2335