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<br /> , . SHEET 1 OF -2 SHEETS <br /> FEDERAL EMERGENCY MANAGEMENT AGENCY DATE <br /> PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE ~-e<;. -8-s/ <br /> PART I - APPLICANT INFORMATION <br />COUNTY 1 NAME OF APPLICANT I NAME OF L.OCAL CONTACT PHONE NO. <br />.-ft;",,/r' "f>Ovff LoUd/V/ cz,,,b~,,,c/c, cA-",,~<s Po""q.M.s 1379-015.?! <br /> PART 11- SITE INFORMATIOl? <br />KEY FOR DAMAGE CATEGORY (U.e aPPl'OprlGt. lett.... 'n the "category" bloclr. below) <br />.. DEBRIS REMOVAL d. WATER CONTROL FACILITIeS 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- LOCATION (U.e map location, addre.., etc.) <br />NO. GORY <br />/ C (/" C#VAry-A".,..'/ /Z9/ 22 ",jes ~ t?/ <<s. 4" <br />DESCRIPTION OF DAMAGE <br />/W'edH_ :s<<~ny. ",,/, ~~"",~,f",~/ h-?7"'o/-i- d> .>.k:/ ~-~ ~///ch /5- .::0~r/7 <br />a.."q'" .3b ~ ""'''~. .:5/)""", ,,>?;'- W5//"'c/ <br />IMPACT: " COMPLETE COST ESTIMATE <br /> .if'~""",_/~~, 50 ~~t'Oo <br />SITE CATE- LOCATION (U.. mcrp locGtIon. add,..., etc.) <br />NO. GORY <br />Z C c:::h G~MT), tf"t>>c/ ..33A", 4' h7/k J~ t?/ ?/S,..yGJ <br />DESCRIPTION OF DAMAGE <br /> bn,...sn.e SClV''j? "'/ A/tf!r>r /'>'7 A/Q/'&' Q"d <7"<<r~r Jb s/ee/ b'-'ze ,.".~/dJ /$ 9GJ /'~ <br />,2 q"c1 /t,; ~ ,..../04. 4ko ",b;vT ZOo ~/ </,rd"'/ .-"'""",,:/ J,.",s J,.a4 Y "'''''0 ~'''''-::7.300 <br /> C'e/ ",,,s/ ,,/, bN<:ye &",/ ~~y ....."''''~;Y. <br />IMPACT: " COMPLETE COST ESTIMATE <br />C/e?=c/;6 ~<:... r~p~q07/-"" 7"""" C:5 $. <br /> ~O= <br />SITE CATE- LOCATION (U.. mcr,p location. odd,... ete.) <br />NO. GORY <br />3 C Ch C~ ~<2d' /"f2'.F;jusr eos,.",/, 5T'~ h/j.l...."Y /3/ <br />DESCRIPTION OF DAMAGE <br /> /-I'edw- SC""""''Y "'~ ~"'cks """"/4/7"'a//.> d? .s/~/ bN7e ....-.4,ch /$ 7~/,~ <br /> /'7 -uq' /b /'eer '-','*'. s:.k "''''/ y/s/)""e/ <br />IMPACT: % COMPLETE COST ESTIMATE <br /> /?Cad' .-"'e/77m;"ec/~~"7. 0 'lis;ooo <br />SITE CATE- LOCATION (Un map location, addre... ete.) <br />NO. GORY Ch C<'Wry ~ad /8~c/<<.s/ e~",/ C""v"'j/ Rba4' /8 <br />4- c <br />DESCRIPTION OF DAMAGE <br /> /'Iedbr",? sed "'/ ~pcks ""-/ /",,,//.s /'6 sk/ 6N~e ?/~'C~ /$ 55.r:;"'T <br /> /7 a.# /C; ,w/~ .S//e.. /7<1'/ P/"s/~e. - <br />IMPACT: " COMPLETE COST ESTIMATE <br />/fO<?d ~q/,~ re~- 50 ~C?0tX> <br /> ;/ <br />NAME OF INSPECTOR AGENCY PHONE NO. <br />c/"'n<?~har,> ,.u; ~ .FHA/A / ro/.....-""n6 ..o".;,.As";'" OFFICE231/-'7938 I HOME~:,_-::~~ <br /> ;rJ/;-/'" ~,J~ ,/"'.....,?___~"_~ /J,cr'~ 4'/'J' 7/,'__J '" C'2 ~/I_I_~_ ,-. <br />