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Cir DETAILED DAMAGE INSPECTION REPORT <br />U.S. Department <br />of Transportation <br />Federal Highway <br />Administration <br />(Title 23, Federal -aid Highways) <br />report INUIIIIJOI <br />vFE-o3° <br />Sheet <br />Location (Name of Road and Milepost) <br />(ca tk - -r 115k e�+ . <br />Description of Damage <br />C lvtr-F wabhout p <br />( of <br />FHWA Disaster Number <br />FL- du—Oy <br />Inspection Date <br />ld'2t.o-0Li <br />Federal -aid Route Number <br />State County <br />F i rr Ty-,cL an p,;tsc►- <br />Cost Estimate <br />Emergency Repair <br />Description of Work to Date <br />(Equipment, Labor, and Materials) <br />Unit <br />Unit Price <br />Quantity <br />Cost <br />Completed <br />Zorxelf Lin f 1 r -r f fel' r5 <br />Remaining <br />Method <br />❑ Local Forces <br />. E State Forces <br />Contract <br />Subtotal <br />PE/CE <br />Emergency Repair Total <br />5'Do.— <br />Permanent Restoration <br />Method <br />Ej Local Forces t3 State Forces <br />Contract <br />Subtotal <br />PE/CE <br />Right -of -Way <br />Perm. Repair Totals <br />Environ tal Assessment Recommendation <br />.V Categorical Exclusion <br />Q EA/EIS <br />Recommendation <br />Eligible ❑ Ineligible <br />Estimated Total <br />Concurrence <br />[Dies <br />Q No <br />State Engineer <br />",,c00.`" <br />Date <br />JO- ZCo --OL/ <br />Date <br />Concurrence <br />[✓'Yes ❑ No <br />Form FHWA•1547 (Rev. 4-98) <br />gency presehtative <br />Ek—c)--r; <br />Date <br />.,. <br />