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<br /> <br />; '_ '~'I -;, <br /> <br />/1.. fE <br /> <br />. <br /> <br />,Z,c::. <br />i}.;; 7/1'<1' <br /> <br />s <br /> <br />.,: .,:~ Y <br /> <br />.. <br /> <br />" <br /> <br />.mo,c,c/-7-r: _ <br /> <br />1~~::~~~'~~~L_ <br /> <br />T I 'c...Pi'!.': ,'. f . rl"~;:' ")\1 <br />r...,.' ....F L' ''':;Al c.:'" .:....:.T <br /> <br />_J_;C-f?U._ /kdN <br /> <br />I-~'~~~/~<;/ <br /> <br />... f' ~RT II - SITE 1.....FOri.MATION <br />K L Y 1- J~o. --D-A~"'AG-f.CA TEGO-RY lese ~p~~.p-~ia-ie-r;::;~,& in -th~;--;:(-;t~~;;;;" bl~ck;t;r-;;;;')- ----- <br /> <br />. <br />a. [jEeRIS REMOVAL <br />b. PROTECTIVE MEASURES <br />c. ROADS AND BRIDGES <br /> <br />d. WATER CONTROL FACILITIES <br />8. PUBLIC BUilDINGS <br />f. PUBLIC UTILITIES <br /> <br />g. FACILITIES UNDER CONSTRUCTION <br />h. PRIVATE NON-PROFIT <br />i. PUBLIC RECREAT'lON <br /> <br />SITE CATE- LOCATION (U,e map locotion, addrf>IJS, dc,) <br />Nv GORY <br /> <br />~7 t <br /> <br />s:i/ <br /> <br />/3 /hLJ 0 .394 <br /> <br />S;-re <br /> <br />A/Or .z:;;;SPE~.o <br /> <br />DESCRIPTION OF DAMAGE <br />.,t COrY'7.i?JAJED /ky /3 - ftJ/' '1;2 <br />h'0v /3 /;h/' rei <br /> <br />I/r.-.>v.3Qd /J'}p '7::;'11) <br /> <br />.I;z/Z/(; 7)/rc.1! t/)1'5/./~'1r - K6P/1I/?EO <br />//0": 0 ;J/>-';f VV/lS#ryO (9ur 8", /.-)/tUffJ>5 k-<?/t:' k,v'H? <br />Twu r2uLvt?;efS tJ/I~#co OJ/T- 2c/l'</lccD <br /> <br />IMPACT: <br /> <br />% COMPLETE <br /> <br />COST ESTIMATE <br /> <br />7G/YJPO.e/tR y .z;voPGe A-ni);0 <br /> <br />/60 <br /> <br />//000'-00 <br />J <br /> <br />SITE CATE. LOCATION (U.e mop location, oddre.., etc.) <br />NO, GORY <br /> <br />DESCRIPTION OF DAMAGE <br /> <br />IMPACT: <br /> <br />% COMPLETE <br /> <br />COST ESTIMATE <br /> <br />SITE CATE. LOCATION (Use mop locaHon, oddre.., etc.) <br />NO, GORY <br /> <br />DESCRIPTlON.OF DAMAGE <br /> <br />IMPACT: <br /> <br />% COMPLETE <br /> <br />COST ESTIMATE <br /> <br />SITE CATE- LOCATION (Use map locotion, addrel6, etc.) <br />NO. GORY <br /> <br />DESCRIPTION OF DAMAGE <br /> <br />IMPACT: <br /> <br />% COMPLETE <br /> <br />COST ESTIMATE <br /> <br />NAME OF INSPECTOR <br />V/'~r- aL.e <br />, <br /> <br />Agf-. . NCY <br />Cot" V'fP" <br /> <br />4,J) \/ <br /> <br />PHONE NO. <br />OFFICE <br />~d- =:;/'/0 <br /> <br />I 'J'~7/<,:?Q 79 <br /> <br />/ <br />