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<br />COUNTY
<br />4,'J 1-11(- UF~
<br />
<br />I NAME OF APPLICANT
<br />ISA!' f'11(,U[:... ('OUI/~;/
<br />
<br />FEDERAL MERGENCY MANAGEMENT AGENCY
<br />PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE
<br />
<br />PART I APPLICANT INFORMATION
<br />[NAME OF LOCAL CONTACT
<br />I DEAN f3()E tJLC!(
<br />
<br />PART II SITE INFORMATION
<br />
<br />SHEET ~ OF 3. SHEETS
<br />DATE
<br />", 27, <(u
<br />
<br />PHONE NO.
<br />/:"s- 3'731
<br />
<br />KEY FOR DAMAGE CATEGORY (Use appropriate letters in the "category" blocks below)
<br />
<br />a. DEBRIS 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. PUBL-IC RECREATION
<br />
<br />SITE CATE. LOCATION (Use map location, addre8$, etc.)
<br />NO, GORY
<br />
<br />I
<br />
<br />3
<br />
<br />FALL Cr2EE:k ..(GaID Sc,..,I..;' N.)' "to L.'(r)c..SAf'I Mt(..UEL Cr,)u.,."y A,ltJ)&.C llJrl!"tIIJ!" 11~f')
<br />
<br />DESCRIPTION OF DAMAGE
<br />/tJi?l""J or FAIL <'/lFf!J< A,/P (<JNYR !a"r~t1'C
<br />
<br />/:>JvcJtrEJJ F'Jt.OA-l
<br />
<br />':'\'~ i
<br />
<br />e.","!"1I6ff.l('1
<br />
<br />P!-v>co,vE MCAJ"'tf:! wf"l
<br />>7!> (I"'/JO,< P"IM"'(-[)
<br />
<br />tit It .1":"')"1 '/ 70
<br />
<br />t~ejC.e OIlJ&I/V,A4. .r:-j.jJ\..J
<br />pI/eve"] PJ.!i1lI.4('!JU'''';
<br />
<br />:;r
<br />
<br />('O'.HI1,/ f20""O
<br />
<br />IMPACT;
<br />
<br />("'C'AI)../' Y ):\),Aj)
<br />
<br />~ 7l" (1-0,' "r 4(((;J.J)
<br />
<br />% COMPLETE
<br />
<br />/6cJ X
<br />
<br />COST ESTIMATE
<br />
<br />f)IJ7,(lIrt ION ~F
<br />
<br />3o~cJ:-
<br />
<br />SITE CATE. LOCATION (Use map location, addreB8, etc.)
<br />NO. GORY
<br />
<br />f3
<br />
<br />8
<br />
<br />SPcCI~ ('''I-n~ ("~IO $1,7$ 3 - $1,7, P )U.~ N!I(,"Ec C"'">ltY B,lIPH lOCA1ION ,.,~~
<br />
<br />DESCRIPTION OF DAMAGE
<br />FfIJ11/J(, ("ILi/FlltS {1/lIiCCj W~llrY ('/NA(J~E
<br />
<br />1<> ,."NPU': 1'/lf:
<br />
<br />VOl.J/I16 c,.
<br />
<br />RUI'I--CHT
<br />(*n~'" IV! !-!lOlIO <.
<br />
<br />I.{ ~.,t,'I.i. wAS BY-P"'H!~Ic;. C".q\/f/:fl
<br />'PRof1t[If,~.s - (MI}/O,l J",\""",,-':.E'"
<br />
<br />4~)P r",...,c..iL"; ''';~
<br />
<br />f"\,' t d
<br />
<br />~"v ~!'!"I
<br />
<br />reAl' MOl"
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />/)/.J7-RV(i/{))J tlF t't!'fAlfY QUA)) f1 "/'1 llO.tl 01" A(( cSS )
<br />
<br />I~O %
<br />
<br />1 ('(.: (;
<br />
<br />SITE CATE-
<br />NO. GORY
<br />
<br />LOCATION (Use map location, address, etc.)
<br />
<br />:f'"
<br />
<br />:;r;, X (C',J""/(-~C1 ye:;:;,/
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<br />E>
<br />
<br />RIO
<br />
<br />pel
<br />
<br />(OPt) cRt;OE;l<.
<br />
<br />CRIP
<br />
<br />DESCRIPTION OF DAMAGE
<br />
<br />{ '//.17 ItlC-
<br />
<br />('4t IIFnr
<br />
<br />W Aj /.1..\'4 i.~1.'
<br />
<br />l.{l!)I. ," 'F;:
<br />
<br />k-'~l t I;
<br />
<br />[,j,).,!
<br />
<br />"t l) P I ,-) (..
<br />
<br />(""~IY 'I 1<0"1>
<br />
<br />,- ii P
<br />
<br />IMPACT:
<br />
<br />.()./_r~"(.Jt"..t I(':,.U
<br />
<br />(:' ~
<br />
<br />-'-:... '.I -'.... ~.'
<br />
<br />fJ( A !)
<br />
<br />:: {~~.
<br />
<br />k
<br />, .:'~
<br />
<br />% COMPLETE
<br />"
<br />/6<.i ~
<br />
<br />COST ESTIMATE
<br />
<br />r'" l :',::) ~', :;.-
<br />
<br />2 ('//
<br />./ ~-
<br />
<br />SITE CATE- LOCAT10N (L'st? map location, address, etc.)
<br />NO. GORY
<br />
<br />DESCRIPTION OF DAMAGE
<br />
<br />IMPACT:
<br />
<br />% COMPLETE
<br />
<br />COST ESTIMATE
<br />
<br />NAME OF lNSe.ECTOR
<br />/' -" J
<br />....1" ~ ,\ ~~
<br />
<br />AGENCY
<br />,:// --
<br />/, U.(
<br />
<br />PHONE NO.
<br />OFFICE
<br />
<br />, "
<br />
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