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<br />/' <br /> <br /> , SHEET .5 OF 7 SHEETS <br /> FEDERAL EMERGENCY MANAGEMENT AGENCY DATE <br /> PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE ?-27-& <br />,./ PART I APPLICANT INFORMATION <br /> COUNTY I NAME OF APPLICANT 'NAME OF LOCAL CONTACT PHONE NO. <br /> ~Hd ~U# C;U4~./ ...A>--:r~ P"'Ld7/_ 6'79'-083/ <br /> PART II SITE INFORMATlow' <br /> KEY fOR DAMAGE CATEGORY (Un approprlat.letterf In the "con,ory" bloc'" hlow) <br /> 8. DEBRIS REMOVAL d. WATER CONTROL FACILITIES g. FACILITIES UNDER CONSTRUCTION <br /> b. PROTECTIVE MEASURES .0 PUBLIC BUilDINGS h. PRIVATE NON-PROFIT <br /> c. ROADS ANCJBRIDGES f. PUBLIC UTILITIES I. PUBLIC RECREATION <br /> SITE CATE. LOCATION (U.. mop location. oddreu, ere.) <br /> NO. GORY <br /> /7 C c://? 6HA~~.a/ 5~ tf)he h?/~ //tPdh-vu/ ../' c;Ho?~y ~a./ /2:9" <br /> DESCRIPTION OF DAMAGE <br /> /fed~sC&>--J /9/ ~y ~A ?6 ~ ~n:je 6'7 /ed'- ~ 4'",,/ /~ ~ M~, <br /> 5/k /),;P/ ro/ec/e.:/, <br /> IMPACT: " COMPLETE COST ESTIMATE <br /> Koa'/r~,;"ee/ ~, /a:> ~OOC> <br /> SITE CATE- LOCATION (U.e mop location. addre... etc,) <br /> NO. GORY <br /> /8 C- 04 U,<<41Y ~m/ Z4j /us/ eas/- "'~ ?l5. *. <br /> DESCRIPTION OF DAMAGE <br /> ~;",......- :SaPN-;1.. ,,/ ""j?', k#//s C7-?./ r/,:''''~ tb41 .6~'7e... c# /Ge/- ~ ~,,/ <br /> /~ fre/- 4// e, 5'/ '7.?r /a~ch/ <br /> IMPACT: % COMPLETE COST ESTIMATE <br /> ~J""'-~hJ~ /a::;> ~ <br /> SITE CATE- LOCATION (UN map location, addrwn. etc.) <br /> NO. GORY 0" UH/1/y -fbd .33> @ ce:i;;'1r~~ /79' t?n:/ ~d.",ld Oed (h$r,;,,? <br /> 1'1 c.. <br /> DESCRIPTION OF DAMAGE I <br /> 52? ,4d d'/;.:t;:;;t~ &.,oIlS 4/c&sA~ CJHr- {""7~' /t1;,y Cn>pA'7 .r-,?cuu:-e-/ <br /> S//er--j$'7r~/?/ h//T~ U,Uo?7 ~ rnd,!-'k~ .r-~-/.,/ <br /> IMPACT: % COMPLETE COST ESTIMATE <br /> ,-fCq/ ~n.y c~~ '7c7J.r 7eq /~,j 1'~ t?~.se~ <br /> c-~",. <br /> SITE CA TE~ LOCATION (v.. map location, addre.... de,) <br /> NO. GORY Or? u.-/y Rod c;7, S "7,;b$.?4 /' U4'ny ~iV/' z~ t?.c/ PNlh~i e/M4M,6/i;. <br /> g; C. <br /> DESCRIPTION OF DAMAGE ' <br /> ~ p~e w/rh C4>7Cr",ka.kk"",,$ 4~ "Z:.e//s ).y;f~ U>7?/"k?'~ h/~"J ...""~ <br /> L/;~hM= 'n1 kn.L ~ #<fl"~ /S he..... a~..'H;I /t?t' ..~.r 5.&# '-K"'~ r;// Ad/.7 h4~.. <br /> (os/- PGh.>n&n1~_ /05 .";,,.- Zk.-h u;>'crde.. .t5'"""':j,e.- <7/ .>4h7C as ~p,/'''a/ 29.&/ <br /> #/7;7 ~ .EO ~ Iv'~. n-,6",~"",,,,~;/ &?",//,....M~ .....-_.a/ 'J?''7''''&~ /?N'~~ e. reb""; /;1. <br /> IMPACT' ~ ,,/, k 7fh ~. k,,1 " COMPLETE COST ESTIMATE <br /> RPdcI,s ch. . Kc.s/~ ,? ""'-A'1& :s .:;?re "z ce u.. ~9~ <br /> z-/I- ~~ #' M!r~ V,TA a~Hene n~'c/e~/~? N'.4V~ve. 0 <br /> NAME OF INSPECTOR AGENCY PHONE NO. <br /> .J"",~hlp" A./. X;uy ?#J/A, CoI"",,"'{' p.'-</,:S,~ OFFICEU4-44C!8 I HOME '!!~-~: <br /> ~ / ",....., I .n I L h ..I..../' L/ /_ --r-.. . -'- ~ ~~ -I ~ ~,'"' <br />