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Irene Preliminary Damage Assessment
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Date Reported:
Description
Street:
City:
ZIP Code:
Contact Full Name:
Contact Business Phone:
Contact Home Phone:
Contact Mobile Phone:
Contact E-Mail 2:
Status of Call:
Referred to:
Is the Structure Historic?
Internal Notes:
County:
Is the Structure Listed on the National or State Register?
Are you the Owner of the structure?
Are you a non-profit (501 c3)?
If a non-profit: What services do you provide?
For Cultural Institutions: Were your Collections Impacted?
Building Damage Type:
Building \ Site \ Business Name:
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Tropical Storm Irene
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