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<br />"'" <br /> <br />I; <br /> <br /> . <br /> . .. SHEET d OF 2- SHEETS <br /> FEDERAL EMERGENCY MANAGEMENT AGENCY DATE <br /> PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE C. -C::7-M <br />~ PART I - APPLICANT INFORMATION <br />COUNTY I NAME OF APPLICANT I NAME OF LOCAL CONTACT PHONE NO. <br />MW,.",L ~Ph' CCU'-?"y vb'77es Z/~.:s 879-0881 <br /> PART II - SITE INFORMATIOl\( <br />KEY FOR OAMAGE CATEGORY (U.e approprlote Iette,..ln the "cate,or)''' blocJr. below) <br />e. DEBRIS REMOVAL d. WATER CONTROL FACILITII5S g. FACILITIES UNDER CONSTRUCTION <br />b. PROTECTIVE MEASURES e. PUBLIC BUILDINGS h. PRIVATE NON-PROFIT <br />c. ROADS AND BRIDGES f. PUBLIC UTILITIES I. PUBLIC RECREATION <br />SITE CATE. L.OCATION (UM mQP location, tJddre... etc.) <br />NO. GORY <br />13 C- &,,,, &#//1-I'fi,Il/ z."0 ,?t/e.r n$k t:/=L db,,,,'? /2 m/b A/>> c/' ~/7 ~/' ~4u-~ <br />DESCRIPTION OF DAMAGE <br />"I 3/1 c<<"'e.rl- "',,/ 5 fl cu/v1!d PNL'eV/ "fP //},/ wa;/Ifl/s. b~>~ 44*'- ~6'c/ ,tk" JVa"k"/ov.r <br />gt7fie/ c/ ~//""""'~U<S .:S<<~kec/ /C?d -./ ~1'u--ed d;../c6c/ r%..,. h~N(3e~ c..-/veoi d"'/~ <br />nvre /I;~"'-r ,L;//. <br />IMPACT: % COMPLETE COST ESTIMATE <br />~.w/; ....~,~ Z~ ~~ e~ckt:/ "'~""''l 6r'~ C7/7d 50 $.35:, 000 <br />rco",___'" /'??a&/ L '. <br />SITE CATE- LOCATION (U.e-nuJp location, addre... etc.) <br />NO. GORY <br />pI e. a~-f'~5z./"'r/,/p//Creei 5h?/& /?"'~ C/ %s..f{;J <br />DESCRIPTION OF OAMAGE :.L , <br />"fiJClr/ h/~t!?HI- /;-; O<<q;;e,-PUS qr~ a,6-y ij~ nu/~ A-r' C"-'73'3L ~~ C'~~ /' <br />r/t:td,~ 5<P",e "'''BaS <?'7/ /e/7I S"''?7e r,pqd ""<? ea.s:/ beue hqre-epf46/e, La/"}~'V""'e'-- ~as <br />.:ftZO e H'tY.{ W.rehca/e ...-"'ad .-7;i~e~' a...../ M/rref 0.., 4.-es/' <7/C*' ""/' ?reeL, U"""0Y' 51?es ~ok <br />_"'~e ,ti/a/e "'-X/ ?~ave/ ~",/ -'?~c/ 4r C,_/y .$k~,,,*. <br />IMPACT: % COMPLETE COST ESTIMATE <br />-1"=:/ .>i-~Qn7 C~/7'?H'~ b#r:,-,~ 5G) $?I~61t70 <br />SITE CATE- LOCATION (UM mop location. add,..... ete.) <br />NO. GORY ?J.-? U,$/Y ~a"/ :3'tJasr etzor "'/ uumy ~o~ ,35. <br />/5 C. <br />DESCRIPTION OF DAMAGE <br />5/ee/ bnl~ 3V'~d-~ Q"7c1 /~ 4/ ,,-,/a6 H4S ft~Z h-elo.J~ dHr:, ne c;__:/-.. <br />,/t/s/ ~ec6'/::/;4~ rn:'" 5mk Zh~..5 ~Cd4/ ~~/.. ,?c-.4~ A> ck cnaje- '/ <br />rr.6C&-r7e<'7/ ""A/ph /.-?c~r~s. e/hr0C'///-r fie""' c",/?C..-e~ b~Y C;A/...-~?":) <br />IMPACT.;/, Ie. e/ n' f " COMPLETE COST ESTIMATE <br />Me> C <7=. h/$ /$ & A? 4"uess n; a '<?~r/J . $X., <<,oo~ .5c=e- <br /> 0 des;c..-~h07, <br />SITE CATE- LOCATION (v" map location. oddre... etc.) <br />NO. GORY c//? Cb~Ml'.Road 6'~ 9 /?l/;6~ 6'.e$~41/ CC<<7/-~ <br />/(P C. <br />DESCRIPTION OF DAMAGE <br />~ .Jr7~C. 2(//&/ j;{., ~ /~ /.xr .w/c.e fYd..S ~.dt/f h/~ &~r, C:;um1r ks <br />Jtld rece/ve4 ~e=a ~::t: Funh rT,?,,? .s~k. h'7h~~s ~ d? .6-/te- <br />rr/4an>8.-?/- /../;fc/7 //7~ 6'5 ~C'//e'-/77ep/ (~ c'MC'7:!~,6cy c<<ker; .) <br />IMPACT: " COMPLETE COST ESTIMATE, <br />~Q/ ~.>d 0 ~~~ See <br /> . ~,-,~h~ <br />NAME OF INSPECTOR AGENCY PHONE NO. <br />JMa,."oha., ,11,/, >>U7 ~h')7A ("<7#,.,..,,10 .?//v/s..-h". OFFICE Z3f4/ff38 I HOME =~:~~:~ <br /> / <br />-r>f_ / 0 1--. ~^,,-^^j. ~,_..I//P{_.r //.".-,1 =1 .'-,.! -/ - <br />