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Damage Assessment Site Survey
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RENO COUNTY
125 West First Ave.
Hutchinson, Kansas 67501
(620) 694-2915
Fax: (620) 694-2987
Owner's Name:
*
Property Address:
*
City, State, Zip
*
Mailing Address (if different from above):
Phone:
*
Alt Phone:
Type of Property
*
Single Family
Multi-Family
Business
Mobile Home
Other
Owner
*
Yes
No
Occupied
*
Yes
No
Home Owner's Insurance
*
Yes
No
Renter's Insurance
*
Yes
No
Flood Insurance
*
Yes
No
Not Insured
*
Yes
No
Degree of Damage
Select
Inaccessible
Affected
Minor
Major
Destroyed
Need Help?
Damage Guidelines PDF
Appraisal Data (1)
Land & Improvement of Real Property & Structure
Pre-disaster county appraised value
Degree of damage (percentage)
Dollar loss of property (line 1 * line2)
Est. Dollar of Insurance Recovery
Est. Dollar Loss or Uninsured Loss (Line 3 minus Line 4)
Est. Percent of Uninsured Loss
Appraisal Data (2)
Personal Property
Pre-disaster county appraised value
Degree of damage (percentage)
Dollar loss of property (line 1 * line2)
Est. Dollar of Insurance Recovery
Est. Dollar Loss or Uninsured Loss (Line 3 minus Line 4)
Est. Percent of Uninsured Loss
Appraisal Data (3)
Inventory of Machinery & Equipment
Pre-disaster county appraised value
Degree of damage (percentage)
Dollar loss of property (line 1 * line2)
Est. Dollar of Insurance Recovery
Est. Dollar Loss or Uninsured Loss (Line 3 minus Line 4)
Est. Percent of Uninsured Loss
Brief Description of the the damage to the structures due to flooding:
Will the damage to the property be repaired prior to January 1st, 2020?
*
Yes
No
Not Sure
Is the property located in a floodplain?
*
Yes
No
Not Sure
If yes or not sure, please contact Mark Vonachen, Floodplain Administrator at 620-694-2978 or at mark.vonachen@renogov.org. Repairs to a damaged structure cannot begin until a damage assessment has been completed. Reno County Resolution 2009-29 governing floodplain development and FEMA regulations require an assessment of the structure be completed and floodplain permits issued before repairs begin. Any structure damaged by more than 50% of the fair market value shall be brought into compliance with the floodplain regulations.
For questions regarding this form contact the Reno County Appraiser's Office at 620-694-2915 or the Reno County Office of Emergency Management
* indicates required fields.
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