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Home My WebLink AboutFEMA Owego Hill RdFEDERAL EMERGENCY MANAGEMENT AGENCY PROJECT WORKSHEET O'M'B' No. 30 Expires April 300,, 2001 2tH)T PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average 30 minutes. The burden estimate includes the time for reviewing Instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the forms. You are not required to respond to this collection of information unless a Valid OM13 control number is displayed in the upper right vomer of the forms. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: information Collections Management Federal Emergency Management Agency, 500 C Street, SW, Washington. DC 20472, Paperwork Reduction Project (3067-0154). NOTE: Do not send your completed form to this address. DECLARATION NO. PROJECT NO. IFIPS NO. DAA CATEGORY FEMA- 9589 -NY TOH 008 023-32160-00 7119!2005 C DAMAGED FACILITY Culverts APPLICANT Town of Harford LOCATION (COUNTY Cortland WORK COMPLETE AS OF: 7/19/2005 0% Owego Hill Road LATITUDE (W 7$.21256LONGITUDE DAMAGE DESCRIPTION AND DIMENSIONS IN 42.48125 ]u ft the declared incident period from Apra 2, 2005 to April 4, 2005 the Town of Harford and embankments throughout the town. Alun experienced severe flowing and substantial rainfall that damaged Culverts 3 3000' long stretch of 12' wide by 3" deep Seasonal road was a Site and washed out At Sft 3 a 20 15" culvert was damaged. At 5i6a 2 (N42.46358, W76.21185) long 24" pipe was damaged. SCOPE OF WORK Site 1. Install and furnish a 20'L 15" CMP culvert. Cover wfth 3" aggregate surface Course. Site 2 retop 3000' L x 12' W x 3" D seasonal road with aggregate surface course. Site 3. Install and fumish a 20' long 24" CMP culvert Cover with 3" aggregate surface course. Atiggation proposal is attached to increase culvert sizes. Does the scope of work change the Pre -disaster conditions at the site? Y Special Considerations issues included? Y Hazard Mitigation proposal included? Y Is there insurance coverage on this facility? N ITEM CODE 9002 PROJECT COST DESCRIPTION UNIT QUANTITY Work to be done G ENTER FEMA COST CODES - ENTER FEMA COST CODES ENTER FEMA COST CODES <- ENTER FEMA COST CODES <- <- <- <- ENTER FEMA COST CODES <_ ENTER FEMA COST CODES <- ENTER FEMA COST CODES <- ENTER FEMA COST CODES <- ENTER FEMA COST CODES <- e- <- ENTER FEMA COST CODES PREPARED BY: Scott Li , SE3 o PAL Huh Mu hy, FE PO /4 - FEMA Form 90-91 5EP 98 14,877.78 $ UNIT PRICE COST 1.00 $94,877.78 TOTAL COST $14,877.78 ITITLE. Town Supervi Ray Marsh REPLACES ALL PREVIOUS EDITIONS. 2. is the damaged fac Uty Iocated wRWn a floodplain or coastal high hazard area, or does R have an impact on a floodptaln or wetland? Yesi No I Unsure COMMENTS: Site not in floodplain. Map reference 360180 B 1 x 3, is the damaged fadltty or Rem of Work located Within or adjacent to a Coastal Barrier Resowce System Unit or an Otherwise prolecW Area? Yesj I No Unsure COMMENTS: [I x 4. vsaii the proposed tac9Ry repa3rsheconswrJWn etrarope urn Oce �saster wncgtean? (a.g, Moolog maNW01 , wcarwn eepe**. use ortrrncwn) Yes No Unsure j COMMENTS: Site v611 be D mitigated by Increasing culvert size. 5. Does the applicant have a hazard mitigaiion proposal or would the applicant like technical assistance for a hazard m" [on proposal? Yes ' No Unsure I COMMENTS: Mitigation proposal attached. x 5. is the damaged fadlRy on the National Register of Hlatoric Places or lho state historic tistlng? Is R older them 50 years? Ars there more, aimilar IMMMs near the site? Yes No Unsure COMMENTS: x �'l. Are there any pristine or undisturbed areas on, of new, the project site? Are there Iwge trade of forestland? Yes NoI Unsure COMMENTS: x ij J. Ars there any hazardous materials at or adjacent to the damaged faatity andror item of work? Yes No + Unsure ] COMMENTS: x I I J. Ana there any other environmentally or controversial issues associated wills the damaged fa Sly and/or Rem of work? Yes No Unsure I COMMENTS: Site is located in a protected stream A mernorendunt of understanding was applied for ati x the Department of Environmental Conservation on 7P26/2005. A Jurisdictional Inquiry was also sent to the Army Corps of Engineers on that date. FEMA Form 99-12o, Nov 98 FEDERAL EMERGENCY MANAGEMENT AGENCY SPECIAL CONSIDERATIONS QUESTIONS 1, APPLICANTS NAME 2. FIPS NUMBER 3. DATE Town of Harford 023-32150-( 7/19/2005 4. PROJECT NUMBER S. LOCATION FEMA TOH 008 1 Owego dill Road 9589 Form must be f tW ouj= d each project 1. Dues the damaged facSty or Rem of /some have tnswance anwor is it an Inscaabie fist/? (e.g., bWklrngs, egaipmee; vehkft eta.) Yes I No ] UnsureCOMMENTS: II x 1 I 2. is the damaged fac Uty Iocated wRWn a floodplain or coastal high hazard area, or does R have an impact on a floodptaln or wetland? Yesi No I Unsure COMMENTS: Site not in floodplain. Map reference 360180 B 1 x 3, is the damaged fadltty or Rem of Work located Within or adjacent to a Coastal Barrier Resowce System Unit or an Otherwise prolecW Area? Yesj I No Unsure COMMENTS: [I x 4. vsaii the proposed tac9Ry repa3rsheconswrJWn etrarope urn Oce �saster wncgtean? (a.g, Moolog maNW01 , wcarwn eepe**. use ortrrncwn) Yes No Unsure j COMMENTS: Site v611 be D mitigated by Increasing culvert size. 5. Does the applicant have a hazard mitigaiion proposal or would the applicant like technical assistance for a hazard m" [on proposal? Yes ' No Unsure I COMMENTS: Mitigation proposal attached. x 5. is the damaged fadlRy on the National Register of Hlatoric Places or lho state historic tistlng? Is R older them 50 years? Ars there more, aimilar IMMMs near the site? Yes No Unsure COMMENTS: x �'l. Are there any pristine or undisturbed areas on, of new, the project site? Are there Iwge trade of forestland? Yes NoI Unsure COMMENTS: x ij J. Ars there any hazardous materials at or adjacent to the damaged faatity andror item of work? Yes No + Unsure ] COMMENTS: x I I J. Ana there any other environmentally or controversial issues associated wills the damaged fa Sly and/or Rem of work? Yes No Unsure I COMMENTS: Site is located in a protected stream A mernorendunt of understanding was applied for ati x the Department of Environmental Conservation on 7P26/2005. A Jurisdictional Inquiry was also sent to the Army Corps of Engineers on that date. FEMA Form 99-12o, Nov 98 APPLICANT Town of Harford PROJECT OR SITE NO, MULM PAGE OF CALCULATIONS OF WORK TO BE DONE SCOPE OF: WORK DETAILED ON THIS ESTfMA'FE SHEET: FEMA 7589 Site 1. Inma8 and famish a 20'L 15" CMP culvert, Cover With 3" aggregate surface course. $08 2 retap 3000'1. x 12'W x 3" 0 seasonal road wkh aggregete surface course over filter fel�+ic. Ske 3. Install and fumleh a 20' long 2A" CMP Culvert. Cover wffh 3" aggregate outface outface course. Site 1 site 1 Site 2 Sita 3 Site 3 0 /414tiO/ DESCRIPTION 3352 GMP 15" (FURNISH AND INSTAL -L) 3011 AGGREGATE SURFACE COURSE ENTER FEMA r � COST CODES 3010 �GGREGATE SURFACE COURSE () I` G < C.. ENTER FEMA COST CODES () <• < < <- ENTER FEMA COST CODES 3354 CMP 24" (FURNISH AND INSTALL) 30'11 AGGREGATE SURFACE COURSE ENTER FEMA COST CODES ENTER FEMA COST CODES 0<- c_ <• <- ENTER FEMA COST CODES ENTER FEMA COST CODES 0 �c- <• c c_ ENTER FEMA COST CODES < < c c- ENTER FEMA COST CODES /0 G <- <. <- ENTER FEMA COST CODES 0 I<. 4 G 4 ENTER FEMA COST CODES 0 �4 <_ G G ENNTER FEMA COST CODES <_ ENTER FEMA COST CODES USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HERE USER MAY INPUT — t]A < O Qv 20 1 20.0 LF ! $ 12 ! 5 0.25 I 3000 12 0.25 20 12 0.6 CY ! $ 666.7 TON $ 20.0 LF �$ ().61 Cy $ GRAND TOTAL: 44.00($ 88()_00 28.00 1 $ 15.56 19.00 $ 12,566.67 65.00 $ 1,300.00 28.00 $ }I 15.56 k $ 14,877.78 APPLICANT Town Of Hadord SCOPE OF WORK DETAILED ON THIS ESTIMATE SHEET: PROJECT OR SITE NO, Mim Hazard Mitigation Calculation Worksheet Sita I. Upgrade from a 20 long 18" CMP culvert to a 20' ImV 24" polyethoene pipe, Site 3. Upgrade fmm a MY long 24" CMP culvert to a 20' long 30" polys tone pope. FEMA R a a J� 20 20.0LF $ 55.00 Y 1 20 zool LF la 60,orji PAGE OF 1589 9,200.00 2,300.00 GpJ1 MCRIPTION site 1 3343 POLYETHLENE PIPE 24" FURNISH AND INSTALL O f<- <- <_ c- ENTER FEMA COST CODES 0�- < < <- ENTER FEMA COST CODES 0 <- <- c• <- ENTER FEMA COST CODES Site 3 3344 POLYETF{LENE PIPE 30" FURNISH AND INSTALL 0 < 4 G c_ ENTER FEMA COST CODES 0 4 4 G c ENTER FEMA COST CODES 0 c- <_ <_ c. ENTER FEMA COST CODES ENTER FEMA COST CODES 0 G G ENTER FEMA COST CODES 0 IG G < < c- ENTER FEMA COST CODES ENTER FEMA COST CODES 0 <- G <. <- ENTER FEMA COST CODES 0 G <. < <- ENTER FEMA COST CODES 0 <_ G < <- ENTER FEMA COST CODES 0 < G < - ENTER FEMA COST CODES 0 <- <- c- G ENTER FEMA COST CODES 0' <- < ENTER FEMA COST CODES USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HERE { USER MAY INPUT OWN t)ATA HERE I USER MAY INPUT OWN DATA HERE FEMA R a a J� 20 20.0LF $ 55.00 Y 1 20 zool LF la 60,orji PAGE OF 1589 9,200.00 2,300.00 Federal Emergency Management Agency HAZARD MITIGATION PROPOSAL (HMP) 1589 APPLICANT PROJECT NUMBER CATEGORY DATE Town of Harford TOH 008 C 7/19/2005 SCOPE OF MITIGATION WORK:11 Site 1. Upgrade from a 20' long 15" CMP culvert to a 20' long 24" polyethlene pipe. Site 3. Upgrade from a 20' long 24" CMP culvert to a 20' long 30" polyethlene pipe. FEMA COST CODE 3352 3343 3354 3344 ESTIMATE OF WORK MATERIAL AND/OR DESCRIPTION CMP 15" (FURNISH AND INSTALL) POLYETHLENE PIPE 24" FURNISH AND INSTALL CMP 24" (FURNISH AND INSTALL) POLYETHLENE PIPE 30" FURNISH AND INSTALL <- <- <- <- ENTER FEMA COST CODES <- <- c_ a- ENTER FEMA COST CODES s- <- - <- ENTER FEMA COST CODES <- <- <. <- ENTER FEMA COST CODES <. <- <_ <- ENTER FEMA COST CODES <- <- <- ENTER FEMA COST CODES <- <- e a ENTER FEMA COST CODES <- <- <- <- ENTER FEMA COST CODES <- <- <- <_ ENTER FEMA COST CODES QUANTITY UNITS UNIT PRICE 20 LF $ 44 $ 20 LF $ 55 $ -20 LF $ 65 $ 20 LF $ 60.$ NET TOTAL COST - ON ADDITION TO PROJECT WORKSHEET TOTAL) PREPARED BY: TITLE: Town Supervisor Ray Marsh COST (880) 1,100 (1.300) 1,200 120 j TOWN OF HARFORD HIGHWAY DEPARTMENT 4ri(' r " - 271 Route 38 Harford Mills, N.Y. 13835 '��' 607-844-9178 Road Name: Equipment Hours: Total,// ' 71 Uclls 60 3 /% l// 4 S Gp ' Quantity Item/Material PrirelUnit ;�✓ fir--' Total o0 ;o _ ,� SO } r„ , Man Hour = $per Baur Number of Hourso h jJ TOTAL ESTIMATE® COST FOR REPAIRS i .I