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U.S. bepa <br />nt <br />of Transportation <br />Federal Highway <br />Administration <br />Location (Name of Road and Milepost) <br />4 S -1-v eel- (I►+" Cott + +o 11+1' AUei ►ue <br />DETAILED DAMAGE INSPECTION REPORT <br />(Title 23, Federal -aid Highways) <br />Description of Damage <br />Q,C0j3idt waSN e t 0.1L -Le. <br />Description of Work to Date <br />(Equipment, Labor, and Materials) <br />Cost Estimate <br />Unit <br />Method <br />0 Local Forces Q State Forces [Contract <br />Method <br />0 Local Forces <br />Environm <br />mow. Assessment Recommendation ❑ EA/EIS <br />Exclusion <br />cp State Forces <br />Recommendation <br />Concurrence <br />Concurrence <br />Eligible Q Ineligible <br />Yes 0 No <br />0 No <br />fes <br />Forrn FHWA-1547 (Rev. 4-98) <br />earn e <br />Unit Price <br />0 Contract <br />Quantity <br />J1? - Otto <br />Sheet <br />I of <br />FHWA Disaster Number <br />F L - DIA —O -1. <br />Inspection Date <br />tO -2(3-OLE <br />Federal -aid Route Number <br />State County <br />FL g�-1lcatn�er <br />Completed <br />Cost <br />Remaining <br />g1cpo. <br />Subtotal <br />PE/CE <br />Emergency Repair Total It$, OCO . °' <br />Subtotal <br />PE/CE <br />Right -of -Way <br />Perm. Repair Totals <br />$000. <br />, <br />Estimated Total $ <br />FHWA. Engine <br />State Engineer <br />ency <br />presenta <br />Date <br />10-2(e -OU <br />Date <br />0 -16-0/ <br />Date <br />G�`Z�D-p <br />