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<br /> . SHEET .3 OF -2 SHEETS
<br /> FEDERAL EMERGENCY MANAGEMENT AGENCY DATE
<br /> PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE &'-Z&.-8~
<br /> PART I APPLICANT INFORMATION
<br />cOUNTY I NAME OF APPLICANT INAME OF LOCAL CONTACT PHONE NO.
<br />/f"cdH /-('OV# U...",,.Ly w""",s-ZP"'9"'a.s $7<?-CB.!>1
<br /> PART II - SITE INFORMATION
<br />KEY FOR DAMAGE CATEGORY (U.. approprlote letten In the "cote.ory" bloc.. below)
<br />8. DEBRIS REMOV AL d. WATER CONTROL FACILITIES g. FACILITIES UNDER CONSTAUCTlON
<br />b. PROTECTIVE MEASURES e. PUBLIC BUILDINGS h. PRIVATE NON-PROFIT
<br />c. ROADS AND BRIDGES f. PUBLIC UTILITIES I. PUBLIC RECREATION
<br />SITE CATE- LOCATION (Uu map locotion, addre... etc.)
<br />NO. GORY
<br />'1 c c:;?n {CV4..y R"",d .3~ ~ /??/k. ;;/tv/;& c/ ..5n~ 17..1--/ /..3/.
<br />DESCRIPTION OF DAMAGE
<br /> ~d#'7? 5CP?/~7 ,:/ dk~1 k7""""'~" c,.,/ ~-'7?<7ck :ri? sA,.e/ .b,-':::fe ....A,cA
<br /> /5 /~7'f?e//c7 ,,?'//8ree/M~.
<br />IMPACT: % COMPLETE COST ESTIMATE
<br />/f~ ~"Z>,;'><u/ j='7' .50 "yO t1:::l?
<br /> .-
<br />SITE CATE. LOCATION (Uae map location. odd",,,, etc.)
<br />NO. GORY
<br />/0 G Ch ~ ~a:u/ .,g.J!, ?m/~ .s~",/, ~~d>a/ -?r---ys t?-t'r hpr UeeL.
<br />DESCRIPTION OF DAMAGE /
<br /> /fdod<<n7 5C?'C/~7 ~~?Ie .; ~~q- '-/:7--"/~ 4';'/ ~/,& 4'#u~~ .<?..4 ~.ck.s
<br /> ~ s~ '?r~ h/h/"""f /s 20 kr /7 4~~ C2 /8,-r...../a1,.
<br />IMPACT: % COMPLETE COST ESTIMATE
<br /> ;fbt2/ ,re,-neT'.::ee/ ?<1?/?_ .50 ,$A:;? (?oCJ
<br />SITE CATE. LOCATION (U.. map location, tufdreu, etc.)
<br />NO. GORY a CotNi;j Xbac/ /7'fJ<<.s/ ""ff SI",Ie- ~....~ /3/ @L?j,n;h/ .,t,r"c/s.
<br />II c DESCRIPTION OF DAMAGE
<br /> A C -,to;! q,rd /r- --IS 1&:1~:z h/4S /<7/;1;:,17 A/~/ '?u/ and C<7K$"'-4 c/d1mffrY
<br /> 11/ Hed #t:1fr,rs/ a/?4'" ~2 .~ M:1,S //:'mRvn:/ tfy ~a/;?""a-~ces. tfp ,delA!!-
<br /> ;/he ~e~. 4/s0 /t1!? ee/ c ~7:1 M w("sT bp.-?L c/ Cwe (/-aL /./ds u..,..d~cu~
<br /> a,,"'/ kcU/;~ ,?u,L.
<br />IMPA~ad ",,..er cu/v..,..,-< s;4// C ~sec/. ~acl 0", h/C'.:i?" ~..~.tf. % COMPLETE COST ESTIMATE
<br /> /&>->pc~..ny ,..h.s~ /7c.w- 1Per;l. 5"0 ;it 2~ =0
<br />SITE CATE. LOCA nON (U.e mop location, oddra.. etc.)
<br />NO. GORY 0/7 UV/1/y ,*ad /.b,: <?~ creeL. <2/"",/ Z />?,;is ",esT ,,/ 7c7",,, p/, O",i Creei
<br />/Z G c7aL
<br />DESCRIPTION OF DAMAGE
<br />N<<'/6)t:!e,s /;, f~ ~U2h0r7S T%#ed acrt?.>s :!1",px"m;kf . -f't:/:) /cm/k~ ~/ r"e./
<br />,,,,,,,d..-ay. :m-e OaL creeL N?M/cp""/ '-'db h' M:r.s: 04-~ec/ O'T ~ ~he~/?/?1a>/
<br />/RCOrTb7. CCuY'1res/r.-na/es: %'-<;;CCi:J ~ 1/')<'1/WcJ,....,~"- /Vh,c~/s /7",;1 MC/H~'''' /k
<br />$/(?P()O /7 r6'/>?.?rlZ ~ ~wc/ /%ws 4>/?d ,..-e/Jr"",.e/ rp",d
<br />IMPACT: .;- % COMPLETE COST EST! MATE
<br />. /f~/ ~,PtVR/"~ C;b~ /'7""# .p-=, /00 ~/q 000
<br />NAME OF INSPECTOR rGENCY PHONE NO.
<br />~7~~ .A,/. ~H'7 ~/(h/1 /'r:!''''r~f:...../s~/? ./ ? OFFICE q~-49'381 HOME::"73_~~!,
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