Laserfiche WebLink
<br /> <br />POPULATION <br /> <br /> <br />PR;~I;I~';t..~AMAGE '~SSESSMENT SI;M~RY <br /> <br />PART I - APPLICANT INFORMATION <br />NAME OF LOCAL CONTACT <br /> <br />PHONE NO. <br /> <br />" <br />" <br />i'r- <br /> <br />CATE- NO. OF <br />GORY SITES <br /> <br />e <t" <br />MAINTENANCE BUDGET <br />Approved$ eelenee. Approved $ Balenee $ <br />PART 11- COST ESTIMATE-SU~RY (COMPLETE SITE ESTIMATE BEFORE SUMMARIZING BELOW) <br />POTENTIAL LOCAL FUNDS FOR RECOVERY <br />FUND/ACCOUNT _' AVAILABLE BALANCE <br /> <br /> <br />..2? ,g-( ,) <br />DATE FY BEGINS <br /> <br />iji <br /> <br />TYPES OF DAMAGE <br /> <br />COST ESTIMATE <br /> <br />it, <br /> <br />8 <br /> <br />f'lo.~ fl',] h. t- ....+ V......:,,~ <br />s ;+-e.s. <br /> <br />/Oc. ~O 0 <br />, <br /> <br />~-r <br /> <br />., <br /> <br />,: <br />",' <br />?''- <br /> <br />l <br />1'1' <br />lj,.. <br />J. <br /> <br /> <br />TOTAL <br />lot. go Z) <br /> <br />PART III - DISASTER IMPACTS (USE SEI'ARATE SHEETS IF NECESSARY) <br /> <br /> <br /> <br />A. GENERAL IMPACT <br />1. Identify and describe damages which constitute I health Indlor safety hazard to the general publ ic. <br /> <br />2, Population adversely affected directly or indirectly by the loa of publiC facilities or damagea. <br /> <br />$/-....-1- e. A '} ... ...... Co I e. S. <br /> <br />3. What economic activities ere a <br /> <br />B. RESPONSE CAPABILITY: Ca, <br /> <br />000 E S <br />S +-c... + e. )/;, l r..J CL 'J <br />~ D ;,;, "P (;J;)J. ] / ~ e <br />- Fo...,ks. t-~e.(!,V-eC.J;6"'" <br />D e.{J. ~ t- L OCoJ /i-.fkivs <br /> <br />and without degradation of pUblic services? Describe. <br /> <br />i,. <br />i <br /> <br />~ <br /> <br />.' <br /> <br />C. IMPACT ON PUBLIC SERVICE <br />improvements. etc. Describe. <br /> <br />anent repain, impact on ongoing services and capital <br /> <br />NAME OF INSPECTOR <br /> <br />AGENCY <br /> <br />PHONE NO. <br /> <br />FEMA Form 90-80, JAN B4 <br />