Winter Storm Ice Damage Evaluation Sheet

Inspector Name Date Location/Address

Property Type Residential Commercial Industrial Other

Item/Area	Damage Description	Severity	Action Needed
Roof		Minor Moderate Severe
Gutters		Minor Moderate Severe
Windows/Doors		Minor Moderate Severe
Foundation		Minor Moderate Severe
Exterior Walls		Minor Moderate Severe
Trees/Landscape		Minor Moderate Severe
Other		Minor Moderate Severe

Additional Notes