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Federal Emergency Management Agency E- Grants Page 5 of 10 <br /> Would you like to add the Hazard Mitigation I No <br /> Proposal as a cost line item to the project cost? <br /> GIS Coordinates <br /> Project Location Latitude Longitude <br /> City Hall 44.0618 - 123.11919 <br /> Special Considerations <br /> 1. Does the damaged facility or item of work have insurance coverage and /or is it an insurable No <br /> risk (e.g., buildings, equipment, vehicles, etc)? <br /> 2. Is the damaged facility located within a floodplain or coastal high hazard area and /or does it No <br /> have an impact on a floodplain or wetland? <br /> 3. Is the damaged facility or item of work located within or adjacent to a Coastal Barrier No <br /> Resource System Unit or an Otherwise Protected Area? <br /> 4. Will the proposed facility repairs /reconstruction change the pre- disaster conditions (e.g., No <br /> footprint, material, location, capacity, use of function)? <br /> 5. Does the applicant have a hazard mitigation proposal or would the applicant like technical No <br /> assistance for a hazard mitigation proposal? <br /> 6. Is the damaged facility on the National Register of Historic Places or the state historic No <br /> listing? Is it older than 50 years? Are there more, similar buildings near the site? <br /> 7. Are there any pristine or undisturbed areas on, or near, the project site? Are there large No <br /> tracts of forestland? <br /> 8. Are there any hazardous materials at or adjacent to the damaged facility and /or item of No <br /> work? <br /> 9. Are there any other environmental or controversial issues associated with the damaged No <br /> facility and /or item of work? <br /> Attachments <br /> For Category C, D, E, F, and G Projects only <br /> Is effective mitigation feasible on this project? No <br /> If you answered Yes to the above question, the next question is required <br /> Will mitigation be performed on any sites in this project? No <br /> If you answered Yes to the above question, the next question is required <br /> Do you wish to attach a Hazard Mitigation Proposal? No <br /> If you answered Yes to the above question, the next two questions are required <br /> Please provide the Scope of Work <br /> for the estimate: <br /> Would you like to add the Hazard Mitigation No <br /> Proposal as a cost line item to the project cost? <br /> Comments <br /> Attachments <br /> Cost Estimate <br /> https: / /connect l .dhs.gov/ emmie /,Danalnfo= isource.fema.net,S SL +dispatchDestination.do ?... 6/9/2014 <br />