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<br />
<br />FEOERAL EMERGENCY MANAGEMENT AGENCY
<br />PRELIMINARY DAMAGE ASSESSMENT SUMMARY
<br />
<br />PART I - APPLICANT INFORMATION
<br />NAMe OF LOCAL CaNT ACT
<br />
<br />DATE
<br />
<br />IV/LOUPe::
<br />
<br />PHONE NO.
<br />
<br />,
<br />J,;--i
<br />r
<br />
<br />PART II
<br />
<br />MAINTENANCE BUOGET
<br />Balance $ Approved $ aelance $
<br />COST ESTIMATE-SUMMARY (COMPLETE SITE ESTIMATE BEFORE SUMMARIZING BELOW)
<br />POTENTIAL LOCAL FUNDS FOR RECOVERY
<br />FUND/ACCOUNT .' AVAILABLE BALANCE
<br />
<br />DATE FY BEGINS
<br />
<br />j
<br />,;\,'
<br />
<br />-~;;
<br />"'
<br />'(,
<br />
<br />CATE.
<br />GORY
<br />
<br />NO. OF
<br />SITES
<br />
<br />TYPES OF DAMAGE
<br />
<br />COST eSTIMATE
<br />
<br />A
<br />D
<br />
<br />I
<br />/
<br />
<br />f)e.81ti J'
<br />j. evee- Re s 704"'7';,-./'
<br />
<br />,,~u,l" I
<br />
<br />I~ 75~5(70
<br />2.7C SOt)
<br />"
<br />
<br />
<br />DO()
<br />
<br />
<br />TOTAL
<br />
<br />PART III - DISASTER IMPACTS (USE SEPARATE SHEETS IF NECESSARY)
<br />
<br />A. GENERAL IMPACT
<br />
<br />,. Idp~:;";;e:rdd.m~~;;h c:Ct"te;:~h '~~o~:;;~7;~he :era'h";;. /~ "" Y'" ~ ~
<br />H~'f!.N".d ~ -r,h~ 'i't",,-..-/ JP~~hC. .
<br />
<br />2.pOPp:n:ua.;;;~~tj~v:::Erecuv;':i~;;'~:;;"i1i:';/Z";'-7 (cI,~.(..//V o~ I~';';'''r-~''
<br />-I4-e 1I~"'l!.^..1 ik;;."/;,;?"..".... S~.c",/.7'~~7_I()'S4.... .//
<br />Ii> ItllP4!.-, Sqv,l/w r;s~ '" A:; Y ~ "" ./-./ l~' ~ Wl4~.. {;;....; / keltr.-~
<br />19~ "f:(V~/ ~ "H~:,K.../. ,.
<br />3. What econom.ic activities are adverseiY.8fftfCted bV the...J.OS$~f #blic facilities or damages? /' /' '.1 ~ ~~J9W.,($ t
<br /><;1.~c"".1 dCO..o_,e "ACT'...(/',-...so "'!'$OC~"'~<l.... _, _/'/
<br />.(;5~-r ,."".1 t.IJ~t:A f=.... ,;t-e.fv~ r-.,.....'-~;.~ ~~ TY.c.~.l:
<br />
<br />B. RESPONSE CAPA8Il.lTY: Can the.>>licant respynd ~d ~over from'l! damages,,-Auij)'lv and withoy deg.-.,.j.on of pU~f ~rvic'lS7 Describe.
<br />I1Jneel 0#'1 T4~ ..,.." .,....,./. es:7'/-~'" l.. 9.0S"",!..L,.fCt II! VWO/"., 1J7':
<br />w: fJ /i-f-c.ir "f-t':./ CP/.iA"- ~//A.~SI^~i7./' 0 ~~ /t~~~~-;'
<br />67/ d~-""J'-eJ <'H ,. SO ~"'7" -I'e- / ~
<br />
<br />C. IMPACT ON PUBLIC SERVICES IF DECLARATION IS NOT MADE: e.g., Deferral of P5'"anent repairs, jmpact on ongoing services and capital
<br />imprnvements,~tt:. ~ibe. (,'1 I"t/-e- 7t;; ~~S-t'6'\..~ d,....~e.r OV~I\.. ,q-
<br />/J-"jll, C"""V-- IU Oil c:L . r.;40 d ,,/../ ~
<br />tV r. ...... L /1:' el/ ee,<<~ I~e.<e- (t!..~~"-h"60
<br />o.c "r_'e.1'tJo.. _~O . f ~ .'
<br />I I CI....JI(./; IU.J. (JvH Z d' /?c!!C~.r5'I:-y. ~J It," .5e~C-e.>'
<br />~.r.1 "~Ilif/;;::l.fc; lL.ef!'fI',{,~"'~. 6~ h w, I / /,'r~ (~
<br />~ 'C it' '1d S'(pWIW.f;r ~ p~~ ,
<br />N~F INSPECT AGENCY./"":
<br />'011;/4) .s 0 II~ S (,./0- '.J' (!1
<br />FEMA Form 90-80, JAN 84 4#7
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