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<br />FEDERAL E GENCY MANAGEMENT AGENCY
<br />PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE
<br />
<br />PART I - APPLICANT INFORMATION
<br />NAME OF APPLICANT NAME OF LOCAL CONTACT
<br />Col". :J::,,"V. 0+ f/,"/'WC oS i?,b- +- -<Y".o"J"..
<br />
<br />PART II - SITE INFORMATION
<br />KEY FOR DAMAGE CATEGORY (Uu appropriDte lette,..ln the "catewary" block. below)
<br />
<br />SHEET 3-. OF/3.... SHEETS
<br />DATE
<br />Ji:C.e 2~ "if
<br />
<br />COUNTY
<br />6unnIS'!JV'I
<br />
<br />
<br />PHONE NO. '2 .. ~
<br />2-4ft-7~~l
<br />
<br />., DEBRIS REMOVAL
<br />b, PROTECTIVE MEASURES
<br />c. ROADS AND BRIDGES
<br />
<br />d. WATER CONTROL FACILITIES
<br />e. PUBLIC BUILDINGS
<br />f. PUBLIC UTI LITlES
<br />
<br />g. FACILITIES UNDER CONSTRUCTION
<br />h. PRIVATE NON-PROFIT
<br />i. PUBLIC RECREATION
<br />
<br />SITE CATE- LOCATION (UH mtIP location, addl"Uf, etc.)
<br />NO. GORY
<br />
<br />/
<br />
<br />c
<br />
<br />l/o.r1;U~
<br />
<br />fA.S.
<br />
<br />DESCRIPTION OF DAMAGE
<br />sl,'J~ rl!!,,^.v~1
<br />
<br />.'
<br />
<br />M,~"""" eroSID....
<br />
<br />f
<br />,L dI!!Jr,',
<br />. .( I,il
<br />
<br />""'...0....1 "I
<br />
<br />.on ;;1'" $;
<br />r-_~,.
<br />
<br />_C; /,' ""..:;;.
<br />
<br />:S?dl"'" <
<br />
<br />L,. ?_ r','L,
<br />
<br />.7 r'-~_.
<br />
<br />n'
<br />
<br />... C~./ 4/".", ''':'f~
<br />
<br />IMPACT:
<br />;vt /.. ()"..-
<br />
<br />I-,a.fi:<
<br />
<br />d/!!Ii
<br />
<br />" COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />'?o
<br />
<br />/0"') 000,
<br />
<br />SITE CATE. LOCATION (Ulle map location, oddre.., etc.)
<br />NO. GORY
<br />
<br />2.
<br />
<br />,
<br />
<br />s. tI.
<br />
<br />'1'b
<br />
<br />f'
<br />
<br />4-'i?'!:...
<br />
<br />6' ~
<br />
<br />DESCRIPTION OF DAMAGE
<br />
<br />mOunt-"".. slld.,,,,
<br />and d""""'4"'" r,,~J"'4r
<br />
<br />";'- to y,;?qJ.""4'j
<br />.s"r1-4ce.
<br />
<br />t.i f2-~ 'tt-o '1''''5
<br />
<br />~nce.,
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />w
<br />
<br />ptlJ?'~ 4/
<br />SITE CATE. LOCATION (Uu mop location, addre.., etc.)
<br />NO. GORY
<br />
<br />/0
<br />
<br />.5"0 000
<br />
<br />3
<br />
<br />s
<br />
<br />
<br />2-0
<br />
<br />-I--
<br />
<br />DESCRIPTION OF DAMAGE
<br />
<br />fi (J C- t'r:- slu!' e
<br />.J2.,rY' be,..., lr--eH"t"
<br />,
<br />
<br />~.nJ,
<br />
<br />rIver
<br />
<br />erod,.....:J
<br />
<br />"'h~O
<br />
<br />rocxl......4 ;;
<br />
<br />rn , rJ 'hl ",/
<br />
<br />/D
<br />
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />SITE CATE. LOCATION (Use map location, addre.., 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 />J. kI. c:.JJ ~
<br />
<br />AGENCY
<br />Ff.iW;\
<br />
<br />PHONE NO.
<br />OFFICE
<br />
<br />I HOME
<br />
<br />(.. A <.//...,";
<br />
<br />~7Jn J-./
<br />
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