|
<br />~
<br />.~
<br />
<br />m
<br />
<br />I" .....cI
<br />
<br />
<br />
<br />€ OF
<br />
<br />SHEETS
<br />
<br />FEDERAL EM_ENCY MANAGEMENT AGENCY
<br />PReliMINARY DAMAGE ASSESSMENT SITE ESTIMATE
<br />
<br />PART I - APPLICANT INFORMATION
<br />NAME Of LOCAL CONTACT
<br />leA Pe rS I>
<br />
<br />PHONE NO.
<br />
<br />./
<br />
<br />
<br />2.4- [1 - 72.. 1"2..
<br />
<br />KEY FOR DAMAGE CATEGORY (U,e approprl4te iette,.. in the "cate,ory" block. beJow)
<br />
<br />.. DEBRIS REMOV Al
<br />b. PROTECTIVE ME ASUAES
<br />c. ROADS AND BRIDGES
<br />
<br />d, WATER CONTROL FACILITieS
<br />eo PUBLIC BUILDINGS
<br />f. PUBLIC UTILITIES
<br />
<br />9- FACILITIES UNDER CONSTRUCTION
<br />h. PRIVATE NON-PROFIT
<br />I. PUBLIC RECREATION
<br />
<br />SITE CATE- LOCATION (U.e map location, addre... etc.)
<br />NO. GORY
<br />
<br />,
<br />
<br />c
<br />
<br />.I-7o
<br />
<br />Sir-,
<br />
<br />ey.$
<br />
<br />::J:s/q"
<br />
<br />DESCRIPTION OF DAMAGE
<br />
<br />RI"'~""
<br />
<br />€-'rOJ.lnJ
<br />
<br />r04Jrl de. /"
<br />
<br />t;;),..-e.e
<br />
<br />.seG-t, I1n S
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />mlnl""'''/
<br />
<br />IJI7/e5'3
<br />
<br />r~
<br />
<br />
<br />,.5
<br />
<br />o
<br />
<br />200 00
<br />
<br />SITE CATE- LOCATION (U.e map location, tJddre... ete.)
<br />NO. GORY
<br />
<br />I B .I-7o
<br />DESCRIPTION OF DAMAGE
<br />
<br />slr,
<br />
<br />....!>
<br />
<br />L/q,...,
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />mln./.,..,.,1 #>,.,L t
<br />SITE CATE- LOCATION (UI map location, oddre.., etc.)
<br />NO, GORY
<br />
<br />100
<br />
<br />J~t;. 00 0
<br />
<br />2-
<br />
<br />c-
<br />
<br />I-7()
<br />
<br />D
<br />
<br />
<br />v-e,I"~I.....
<br />
<br />C),4,."
<br />
<br />
<br />(,3"!:.
<br />
<br />DESCRIPTION OF DAMAGE
<br />
<br />p,,,,,-e- r tt,~~b.(."rol"j_t;o -er.J Je, b4hh-.
<br />c7v1"" khlnJ.h~.J-,e.., ahvt. (1)-1 J.J 5b n~'6'"t
<br />
<br />lias W4'~h~.t
<br />'Vo I'-7o
<br />
<br />r.,...J"",,/
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />1r#?~"0
<br />
<br />Y elh- I c:tlqy,
<br />
<br />
<br />/s-
<br />
<br />ISO 000
<br />
<br />SITE CATE- LOCATION (U.e mdp location, dddre.., etc.)
<br />NO. GORY
<br />
<br />2..- 13
<br />
<br />I -70
<br />
<br />D
<br />
<br />
<br />8~ .e
<br />
<br />(5l t/oer ~ / d..,
<br />
<br />cJ; ~n n
<br />
<br />
<br />6'l.t
<br />
<br />DESCRIPTION OF DAMAGE
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />7~..... F~, c ye, s '6r~(/'{-lIn
<br />NAME qF I~ECTOR 'ft....A~
<br />q...r -.. ~ r~
<br />,1 ,~. /7 ,__
<br />
<br />(1,1 L}S-6
<br />AGG~d
<br />
<br />/00
<br />PHONE NO.
<br />OFFICE
<br />
<br />h'-t'1100
<br />
<br />I HOME
<br />
|