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<br />
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<br />
<br />FEDERAL ElaENCY MANAGEMENT AGENCY
<br />PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE
<br />
<br />PART I APPLICANT INFORMATION
<br />NAME OF LOCAL CONTACT
<br />J..L!,..vCcJ Rp..v /1/("
<br />PART II - SITE INFORMATION
<br />,.KEY FOR DAMAGE CATEGORY (Use Gppropriate lelt.,..in the "cofe,ory" bloclt. below)
<br />
<br />-
<br />
<br />(
<br />
<br />SHEET OF SHEETS
<br />DATE
<br />6-27- 9~
<br />
<br />
<br />e. DEBRIS REMOVAL
<br />b. PROTECTIVE MEASURES
<br />c. ROADS AND BRIDGES
<br />
<br />d. WATER CONTROL FACILITII!!:S
<br />e. PUBLIC BUILDINGS
<br />f. PUBLIC UTILITIES
<br />
<br />g. FACILITIES UNDER CONSTRUCTION
<br />h. PRIVA,E NON:PROFIT
<br />I. PUBLIC RECREATION
<br />(!.49.rrn'?-y te~,Ad /~
<br />
<br />SITE CATE- LOCATION (U.emapiocotion,addn".dc.) y.,Li,.,......., .j lJ~k.p.,.....
<br />NO. GOAY ~.........cL .......,d..K CI?~~,K,
<br />
<br />5 c.....
<br />DESCRIPTION OF DAMAGE 5';;"" S!'t7/ /.- /Pt7-",d....-"'V F/Po_
<br />IS A,( ~o ~O_~ b"/)~/'s R-PA-<oe-'AL 7"/''';'''' -<'/<"'<"'''s T",
<br />",,/ si'R.plch of.' ~oAd.
<br />
<br />
<br />s.,.,;p.R~U'"" .lh.J" ~A "/? T6t'4'-t!.
<br />13.- '/"no.,., ..<'-..- .4/,/,R""'IAf41-'<:..
<br />
<br />IMPACT: "COMPLETE COST ESTIMATE
<br />A '1(1- R~",
<br />C. 3~ 14_
<br />SITE CATE- LOCATION(Uu,"oplocCltion.oddnl...etc.) 41"'~~~e-- J4rfi"'.pT P.4J,S RO'.ddt"("t?U'H~ /?o4tf,?S A'Hd
<br />z' GIY 13"'4"~~ cte......1( TC' (-<It.... "",<<7"10... j
<br />
<br />DESCRIP;IONOFDAMAGE ~<Llv"'A'r <!dQ/<l',,~ ",,,,,,,,../., /,.,~v';l' ? ""1'"",...,.... "4'JF''''~/L_ to':
<br />IT"rU?j' /"""SrA,Ltf..AT/,,~ e:>F ..<1""",/"-",,,,y (!t;>L..-..""f. ,E......IJ"'''.k-<-P/,T P"',(~4''''J ,.e,.dcl
<br />P"""-"''f'" .0/,1 1>...i3ti'IS ('/..pA~"'r. "'-R4"'.p,L.' SwRtt'.cC/'>j? A/<",<-,d~ /p.p,j'-'f'.
<br />5'~f..ar.e 4n' Se.r~,fICCf"-?tI,/_? e-c/-dr~~ C.4erS.pd' .AI /eJ'v"" $7R..p7(:~ t:9,c 5Q~.tL- k?a..lJd,
<br />
<br />IMPACT:
<br />
<br />,. COMPLETE
<br />
<br />"'''
<br />
<br />COST ESTIMATE
<br />:a..O
<br />..'"
<br />
<br />,
<br />"
<br />
<br />SITE CATE- LOCATION (Us. map location, G(ld,..... .tc.) If' ~ t.u~
<br />NO. G!.Y eli"_ r-~..,. ("~'c.,.. t;.cuJ'J, t=:~AI.
<br />
<br />DESCRIPTION OF DAMAGE ft.,c.vs ",p -Hvb And 1;>.,.,6>,(>/$ AJ.--<l &v-4r....-c t:-<--/!:1Jh-ecf <:9qr-
<br />A ~"'c/ sTIP-erc.A- "" t:. RC',od<O</Ay' e"'~""t<....~,,-t- F'.o,-~q",'f 04 <<s..."7 P~~..,./J4L
<br />pc:"ap (;'''';l.''''''tf, PR..-vPHr-,;"'-e __.4,cr"'~s ",fC. /)..p~RIs. /?.prl>OV.AJ ci,CiH'r
<br />SPv-<, ~ s ;-r~.
<br />
<br />f<>rkpj- PASS
<br />I'/a. ",*",:L,..s~
<br />
<br />~"'A b C"""~.,.,..'(
<br />
<br />I~...O IS)
<br />
<br />IMPACT:
<br />
<br />
<br />COST ESTIMATE
<br />a.
<br />
<br />~
<br />
<br />SITE
<br />
<br />Nt
<br />
<br />CATE.
<br />G~Y
<br />c..-
<br />
<br />LOCATION (UM map locotion. tuldreB" etc.) e p U 11 i "1 ~ to ..0 b 4 '7
<br />To /)'CK-<'.eJ,LL.4 (llP'p...K -d"t!. rh<p""s ~"'.NcH.
<br />
<br />C.
<br />1)1-{
<br />
<br />-'"'fiL~
<br />
<br />t:"la..o.......
<br />
<br />Hi
<br />
<br />'Sc;..7-,
<br />
<br />DESCRIPTION OF DAMAGE C../...-I'tf!; f!,1...C/t'4t;-'" (!.,bUS.p<f tIP",,,,<:f ~.of/'''4'7 ",:>1"-
<br />Al:>I>''1-/';''~,4<.. S.,./:. r ~/i"'Ts F",,~. 4i?eI ~ //"'.4"'7' p.,/)/?/s CO/"''''",,__/,
<br />R(1,dcf""A"f Sq~t:Ac.., ....,P..,{S f?-<,p,od~"c/,
<br />
<br />-:20'0 Ff!>~-;-~
<br />~tf'.4""'L
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />;;to
<br />C. i)
<br />
<br />COST ESTIMATE
<br />At (7t!ff:)
<br />/C1_e>
<br />
<br />N~ME OF INSPECTOR
<br />Nt? -- 51' " JI> -I> <-
<br />
<br />AGENCY
<br />plf....,..
<br />
<br />PHONE NO.
<br />OFFICE
<br />..11"- <1</].1'
<br />
<br />I HOME
<br /><19"'- P#?/7
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