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Individual Assistance Preliminary Damage Assessment Form Instructions Event: DEFINMONS Event Title.E ."Groundhogs Day Tomado.""Severe Weather 2009 1,STRUCTURE TYPES The most common structure types recorded during a Joint PDA are: As of: Single Family-A residential structure designed to host net more than one family, Date of Damage Assessment.E.g."612f08,""i lr27110" sharing no watts or structural elements with another dwelling. County Team Member: Multi-Farrilly-A residential structure designed to host more than one family,potentially sharing Names of IDA Team Members.E-g-"Carol Burnett-Property Appraiser" walls or structural elements with another dwelling(multiple doors). Page: Mobile Home-A residential structure with no permanent foundation and that may he readied Sheet number for the current date.E ,`Page;19`"Page;5" for mobile transport: County: Business-A structure whose sole use is that of a commercial,industrial or County in which PDA is being conducted, professional enterprise. Number: 2.OWNERSHIP Assistance estimates often depend on whether a resident owns the structure in Address number and unitialpt-E-g-"1209,"16W A' which they reside and have no other residenceto return to,forthis reason it is important to assess Streak; property ownership- Street name.E,g,'Gatewood Ave,""Crimson Lane" Owner(0):A residential structure whose legal posessor is also the permanent resident, L,9NQ R Rot-der(R):A residential structure in which the legal posessor allows a tenant to use the Grid Zone(for Florida,either 16 or 17 R)&100.00Ci-nn Square Identification(two letters:i, structure as their permanent residence. E,g,`16 R GU""'17 R MM' Secondary(2nd):A residential structure occupied part-time by a person In addition to his or USNG 1st: her primary residence(ex.Beach-front homes,vacation properties) East-West Grid Coordinates Nst set of numbers on GPS unit).Extend to 4 digits,Eg,"6591,"`5409" 3,ASSISTANCE In order to justily additional assistance requests,it is important to ascertain whether USNG 2nd: survivor has other assistance sources to help them recover,such as insurance or financial resources, North-South Grid Coordinates(2nd set of numbers on GPS unit),Extend to 4 digits,E.g.`6481,""7902" Insured(INS):A resident who is insured for the type of event which caused damage, Low-income(LO):A resident who has limited resources to assist in their recovery. Structure Type: Ovmership: Assistance: 4.DAMAGE LEVEL SF:Single Family home O.Owner INS:Insured Destroyed-Structure is a total loss.Not economically feasible to rebuild.Permanently MR Multl-Family R:Renter LO:Low-income uninhabitable. MH.Mobile Home 2nd:Secondary Major-Building has sustained structural or significant damage and is currently uninhabitable- BIZ:Business Extensive repairs are necessary therefore the structure cannot be made habitable in a short period of time(less than a month), Inaccessibiw Minor-Structure is damaged and uninhabitable.Minor repairs an-necessaryto make the Home is inaccessible to Damage Assessment team OR resident. structure habitable—but they can be completed in a short period of time(less than a month). Water Depth: The dwelling has some damage,but can be used without significant repair. For flooding,approximate water depth in inches. In living areas only,does not include basements Affected-Structure has received minimal damage and Is habitable without repairs. or crawl spaces,