Historic Preservation Commission


	City of Green Bay Historic Preservation Commission Nomination Form Historic Preservation Plaque Award Please submit one form for each nomination

Check one category
	Contributes to Green Bay's Identity in a unique way	Significant socially or architecturally
	Endangered Historic Property	Hidden Element of Green Bay's History
	Adaptive Reuse

Personal Award
Name of Recipient
Address
City/State/Zip
Phone

Building/Site Award
Building Address
City/State/Zip Code
Contact or Phone at site to request a site visit
Name of Building/Site Owner
City/State/Zip
Phone

Nomination Submitted By
Address
Phone

Attach additional information/comments
Mail to: Historic Preservation Commission 100 North Jefferson Street - Room 200 Green Bay, WI 54301-5026