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<br /> <br />./ <br /> <br />CATE- NO.OF <br />GORY SITES <br />L' / <br />IE. Z. <br />.!3 3 <br />E.- ,. <br /> <br />FEOEA~EAGENCY MANAGEMENT AGENCY . <br />PRELlMINA..... DAMAGE ASSESSMENT SUMMARY <br />PART I - APPLICANT INFORMATION <br />NAME OF ,DeAL CONTACT <br />h . r; <br />MAINTENANCE BUDGET <br />aelance $ Approved $ Belance $ <br /> <br /> <br />PHONE NO. <br />1'1 -37".3/ <br />DATE FY BEGINS <br /> <br />PART II - COST ESTIMATE-SUMMARY (COMPLETE SITE ESTIMATE BEFORE SUMMARIZING BELOW) <br />POTENTIAL LOCAL FUNDS FOR RECOVERY <br /> <br />TYPES OF DAMAGE <br /> <br />COST ESTIMATE <br /> <br />FUND/ACCOUNT <br /> <br />.' AVAILABLE BALANCE <br /> <br />t!A'" (t/~,o., . . <br />, i::I~s ~~./.... 9c1-~c.... <br />/ft;JI"/J#t.e [ /4~~s r /4,.1 <br />~'~..! sk"'....;,If--<. <br />~ ve..#;..er <br />'pJI!M~"// pIV"'~1 '%.eeJ' <br />INd Co/~/~~;k. <br /> <br />'17000 <br />) <br />7: Pt70 <br />" <br /> <br />$ ~ 000 <br /> <br />I~ (]OO <br />" <br /> <br /> <br />TOTAL <br /> <br />A, GENERAL IMPACT <br />1. Identify and describe damages which constitute 8 health and/or safety hazard to the general public. <br /> <br />PART 111- DISASTER IMPACTS (USE SEPARATE SHEETS IF NECESSARY) <br /> <br />2, Population adversely affected directly or indirecny by the loss of public facilities or damages. <br /> <br />3. What economic activities are adversely affected by the loss of public facilities or damages? <br />PiS!' liCe/chery O/k'-ra.1io/l5 9- !I(/IJf.E, cam,o!]rol./.ncl <br /> <br />8, RESPONSE CAPASI LITY: Can the applicant respond and recover from the damages Quickly and without degradation of public services? Describe. <br /> <br />Yes) ,; rGpalrs arv /?7cu:1e.Sto:te ..9GV101s'J$t~-t /JOt <br />he a(/o.//~A; .rC/1'" wo/'k. - <br /> <br />C. IMPACT ON PUBLIC SERVICES IF DECLARATION IS NOT MADE: e.g., Deferral of permanent repairs, impact on ongoing services and capital <br />improvements, etc, Describe. <br /> <br />/ /ht; S_IS~ Ac;tcht;y opere; IiD/;S ' ,f,AJ//!- lJe E/}c/a/J.!ierer/ I j:: , <br />repCt//'5 1701- c.J-5ec led <br /> <br />2. ,Jqccess Ie At/likr ca;nesrOI//JcI J/;n/'h/ WII-)~t/1- repaIrS. <br /> <br /> <br />FEMA Form 90-80, JAN 84 <br /> <br />PHONE NO. <br /> <br />