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MmDMyLfl mN ce M O M O N O = N N O O = N O O ,- O m N CO M CO - M O = M N O N O O m V O m O LO M = O M O .- M .- O 0) N N O N M M M V V V CD I� ,- 0 0 ,- N o 0 N-- O V V O O N N N N O O 0 0 0 0 ,- CO 0 M CM CD M N- ,- `- T- = `- ,- . . . . . . . . N = .- N N N N V V' V' oO m M CO N N N M M V CO LD m m ,- ,- N N ,- M C N M CD m M IN o) N m CD CD LO r N M r N N V LO O M V N M O m N CO ID o M M '7 CO o O CT r m 1� M m N N I`- 0 0 CD 0 N N N M N O O O o 0 o O r CD O N O CD 0 0 0 0 0 0 0 0 0 0 0 C O O O O O O O CD O O 0 0 c D c D O O O O O O O O O O O O O O O O O O O O c D O O O O O O O O O O O O O O O O O O O O O O O O O O O J Ln L() Cn N Ln CO In CO Lf) .- ' CT V V N M I-- Cn m O) O) r CO I- V CO CO r r r W W m CD CT r I� CV V Ln O Ln c") — W W O O M CD CO M M M M = CO m m m LO CD CD O O I- N N N N O O O O O O O N N N N. O O o O 0 N N N r N N LO CO CO CO I. 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O a' m (n m N- d' CU m N- m r N m N Cn m m I- O) O e- M O m r O r M UO M O M I"- m 0 r N F" M M M V' V V' V' V Cn r r r m m m m O) C) 0 0 0 0 0 0 r r r N N N N N 0) M Z ? V V V' CF V CY V V Cr Cf V Ct V V Cf V' CF V CO (n u) (O CO CC) (O Cn (n (O Cn M In (O W (n (O W 0 U Z CITY (OF W/kTERL*O SIDEWALK REPAIR SURVEY FORM 1 ��v PROPERTY ADDRESS -- ®tee PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes No TRIM VEGETATION ❑Yes ` l No WATER VALVE Ie,, I *2 ADJUSTMENT REQD _ ❑Yes o 44-4 143 PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet El 5 Feet l 5.3 Feet ❑ Other DEPTH OF SIDEWALK lyt 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 16`i G ` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �� tD Date: 3 I PERMIT ISSUED FORMED POURED COMPLETED CITY tF WATERL•O - �➢1EWALK REPAIR SURVEY FORM :ROPERTY ADDRESS 1 1 \kJ. 4-Ta c37` - PARCEL CODE CONTROL NO. Type of Defect = CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G ❑Yes No TRIM VEGETATION ❑Yes No _ ♦' '� WATER VALVE ADJUSTMENT REQ D ❑Yes y No PARKS DEPARTMENT REVIEW REQUIRED — — — Yes ❑ No i23.5 - 31.! LOCATION OF SIDEWALK ‘IXI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet $ 5 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK it 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /55.S vsq.fit. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : 9 ' Date: d� A 1 PERMIT ISSUED FORMED POURED COMPLETED — SIDEWALK REPAIR SURVEY FORM cON, . 4 :ROPER`i y ADDRESS 1 \C:) e y • 5_0A 1 3 PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G I ❑Yes No TRIM VEGETATION ❑Yes f `No WATER VALVE ADJUSTMENT REQ'D ❑Yes INo PARKS DEPARTMENT REVIEW REQUIRED A ❑Yes KNo � t LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches X 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 2' sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes Ix No No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. —_ FIRST INSPECTION AND FORM MADE BY : 5 Date: 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - 1 ' SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ( \A d 4-1 " / 13 —34 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes XNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 0 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes to — I I PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes y No LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet °5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ► 4 inches ❑ 5 inches Cl 6 inches AREA TO BE REPAIRED 7 •O V sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: — PERMIT ISSUED FORMED POURED COMPLETED — Ail, y CITY OF WATERLOO i i zc ji SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t \he 'tis° ®-- L-- 233- PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑ Yes lNo See reverse side for Defect Codes A-F See below for Defect Code G _ TRIM VEGETATION I ❑ Yes X No t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes I No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes %<No A - - _ _ 174 - - g9 LOCATION OF SIDEWALK S Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet IX5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 7 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z s•6 .K sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : \•S Date: 3 " eet PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS -1 _ Se- , PARCEL CODE CONTROL NO. a Type of Defect d, r -�- CLEAN SIDEWALK See reverse side for Defect Codes A F ❑ Yes No — See below for Defect Code G I `�-�' TRIM VEGETATION — ® ❑Yes X No WATER VALVE — ADJUSTMENT REQ'D ❑Yes jki No PARKS DEPARTMENT *a REVIEW REQUIRED — ❑Yes No J ?;_,C.>> E- ��— LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches 015 inches ❑ 6 inches — AREA TO BE REPAIRED I$W•W f sq.ft. 4 in. 211,1) v sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [ No No. of Squares with Patches CODE G — a^ -era' r®l NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1647 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM . PROPERTY ADDRESS 0 ; PARCEL CODE CONTROL NO. f1 CLEAN SIDEWALK Type of Defect ❑ Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes lieNo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ik No _ � I PARKS DEPARTMENT REVIEW REQUIRED 121t.Yes ❑ No X4 — — vk/ , 47k LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .5.3 Feet ❑ Other DEPTH OF SIDEWALK Xr 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED SZ•2 '''sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes yNo No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 9 5 Date: 3-2- 1®t a PERMIT ISSUED FORMED POURED COMPLETED pc, 4666 .....).,,,-,,,01 , Ile ciTY •F ', \'ATERJOO Dv c_- 7 0 — SIDEWALK REPAIR SURVEY FORM coNT, PROPERTY ADDRESS 2- \i--- \z--/. 4-7 14 -;--1,--. j S' k7.-) -3 4-a, i -oo k V PARCEL CODE CONTROL NO. . --) A ''''''-' Type of Defect See reverse side for Defect Codes A-F _- CLEAN SIDEWALK See below for Defect Code G 0 Yes X No ----..„ .4_ --f, :--1. s;._ f) TRIM VEGETATION n Yes X No _ WATER VALVE i 1\ 3m 2- ADJUSTMENT REM) 0 Yes 14 No • PARKS DEPARTMENT — REVIEW REQUIRED C-- C-- • A . A A A. X Yes D No 911 C/14 VA KI i/A VA VA _ (0'i; 4'.° :5 1 5,6 .5,1.' 5,0 c- ::., J kvz,- TO 04 cy LS ors Iret rg,1 s V-1. 6,714 .... LOCATION OF SIDEWALK 1ront Yard $Side Yard 0 Other WIDTH OF SIDEWALK D 4 Feet II 5 Feet X 5.3 Feet 0 Other — DEPTH OF SIDEWALK ig 4 inches 11(5 inches 0 6 inches AREA TO BE REPAIRED 3‘2'4) sq.ft. 4 in. Co5•Z- ' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes X No No.of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : E 5 ()-• V,''' 5 Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes X No See reverse side for Defect Codes A-F See below for Defect Code G _ I TRIM VEGETATION ❑Yes JAr No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No - I PARKS DEPARTMENT . R REVIEW REQUIRED ❑ Yes tgi.No A V4 LOCATION OF SIDEWALK t Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1; .3 Feet ❑ Other DEPTH OF SIDEWALK jg 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 23.3 ` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ilo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : l� 5 Date: l -i PERMIT ISSUED FORMED POURED COMPLETED 150 eP CITY OF WATERLO• u� To 3 ` SIDEWALK REPAIR SURVEY FORM cool. Ltg PROPERTY ADDRESS PARCEL CODE CONTROL NO. Type of Defect 4-6" CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes No See below for Defect Code G ) — TRIM VEGETATION ❑Yes V..No � --► WATER VALVE ADJUSTMENT REQ1D — ❑Yes Igr No PARKS DEPARTMENT REVIEW REQUIRED c-- _ _ ❑Yes No IA- tt , LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ‘5°Z '``sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes tk No No. of Squares with Patches _ CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: t t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 12.c) N„4.1, "" V t.3 -,3A-=v o - c 4- 5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect li ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G _ TRIM VEGETATION ❑Yes KNo WATER VALVE 0—* ADJUSTMENT REQUIRED ❑Yes N'No \ � I PARKS DEPARTMENT REVIEW REQUIRED y : N`Yes ❑ No c.( s° s,o e LOCATION OF SIDEWALK $'Front Yard ❑ Side Yard LI Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g5.3 Feet ❑ Other DEPTH OF SIDEWALK rtz 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED (at)sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes tg No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 14 -7 - -1E'j PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS \3 - 2,t,w - co 7 - I(o PARCEL CODE CONTROL NO. CLEAN SIDEWALK A Type of Defect ❑Yes S No See reverse side for Defect Codes A-F _ See below for Defect Code G I TRIM VEGETATION I ❑Yes r4 No 11/4* WATER VALVE 1 JI ADJUSTMENT REQUIRED �—�—► ❑ Yes No — I PARKS DEPARTMENT REVIEW REQUIRED ° Yes ❑ No LOCATION OF SIDEWALK 1g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 733- ``f sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches — CODE G NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: N3 ®0! -I o PERMIT ISSUED FORMED POURED COMPLETED e( CITY OF � ATERJ%® Due. 3° \ ivi7 SI SEWALK REPAIR SURVEY FORM coo-. "ROPERTY ADDRESS 2 3 , d-i(1 \, / 5-tl°w� !25 p,�\3 -34--2.0 0 - y0 PARCEL CODE CONTROL NO. e Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑Yes i No - �_��— TRIM VEGETATION 'i' '� ❑Yes [ No — ~-` v ' IM i4, WATER VALVE t3 /76 ADJUSTMENT REQ'D ❑Yes INo 1. PA ICA3 PARKS DEPARTMENT REVIEW REQUIRED A ❑Yes I No - ,-" I¢ y��99 1-1 ) 108.1 — ` 13.0 \ _ 4 /.63 LOCATION OF SIDEWALK X Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet X 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ' to / f sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Uf No No.of Squares with Patches — CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. - FIRST INSPECTION AND FORM MADE BY : P--' 5 Date: 4 `2 I PERMIT ISSUED FORMED POURED COMPLETED 02) CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2-6,Z- f v PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes No WATER VALVE t�1 ADJUSTMENT REQUIRED �—Q--► ❑Yes g No — I j� I PARKS DEPARTMENT 5P0/ REVIEW REQUIRED ( ❑Yes XNo .3, A-11 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ��Other ° -- DEPTH OF SIDEWALK ❑ 4 inches (5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. 3 2-3 `` sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES LI Yes Cg No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED — - 1" CITY oF WATERLO• 10 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS S i '3 - ,34-- rgo - 603 -:ate PARCEL CODE CONTROL NO. Type of Defect A See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑Yes No — I TRIM VEGETATION ❑ Yes M No 11/4t� 4—Q—* ® WATER VALVE Ie. • ADJUSTMENT REQ'D C." ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED A ❑Yes 1 No Y_ k LOCATION OF SIDEWALK 1Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet [Other k f DEPTH OF SIDEWALK . 4 inches inches ❑ 6 inches AREA TO BE REPAIRED (415 sq.ft. 4 in. 5®. vsq,ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. -- FIRST INSPECTION AND FORM MADE BY : 11-5 S Date: 3®2 B PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 &5ij. 5 • PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes No See reverse side for Defect Codes A-F I See below for Defect Code G TRIM VEGETATION ❑ Yes f No WATER VALVE ADJUSTMENT REQUIRED 4--0—* ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes sg No 41,2 LOCATION OF SIDEWALK [S1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK g 4 inches ❑ 5 inches ❑ 6 inches — t AREA TO BE REPAIRED 4.? sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 4- Date: 3-3e-/3 PERMIT ISSUED FORMED POURED COMPLETED — , CITY COF WATERL,110 - SIDEWALK REPAIR SURVEY FORM k ROPERTY ADDRESS 3 )S- i VI t3 - 33- t7 - 0643 140.0 8°41p -7A ,---,- — \ 4" / PARCEL CODE CONTROL NO. 1I J,111,1,114 1;14 ,,, v3-75' Ty'06 39f Defect A CL EWALK — - MS' See reverse side for Defect Codes A-F ---`z, See below for Defect Code G ,‘,6; " / %Yes 0 No op ' Dim- - - EGETATION \t 0 Yes EL No , 77--... ,...) tZt? t';,“ _ WATER VALVE 4,'' ADJUSTMENT REM) w — 0 Yes a No - .%. ' • ,,-,. _ ..ii. . ,t-? PARKS DEPARTMENT _ v3 REVIEW REQUIRED 41„,1-f- , - , ' D Yes lyi No _ . ,-4/4-44,74/4-,, 1 , -, „50,,,f-- / :6:'‘ q' &t _ .--1 ,r , I jeo.'-‘ sl; ,.' _ r 54. — LOCATION OF SIDEWALK Cgl.Front Yard . 4 Side Yard M Other BAc A' WIDTH OF SIDEWALK K1 4 Feet 0 5 Feet D 5.3 Feet 1=1 Other _ DEPTH OF SIDEWALK M 4 inches D 5 inches j 6 inches , AREA TO BE REPAIRED 535P 2-sq.ft. 4 in. sq. ft. 5 in. 169°6 sq.ft. 6 in. CODE F - PATCHES LI Yes pZI No No.of Squares with Patches — CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : 1Di3 4.- 1-- Date: 3-30-ig PERMIT ISSUED FORMED POURED COMPLETED .... ¢f el ,ot. CITY OF WATERUO:0 — zz . 10' SIDEWALK REPAIR SURVEY FORM — •ROPERTY ADDRESS 331.r 1J. `/¢l 5 PARCEL CODE CONTROL NO. n. Type of Defect 6- CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G 1 ❑Yes ;Z-No — 1 TRIM VEGETATION n h ❑Yes ENo f r " 00. �efit WATER VALVE - vv.WI' 1 ADJUSTMENT REQ'D — ❑Yes 1No 1 2-1,3 ; 4; PARKS DEPARTMENT ay.2` w REVIEW REQUIRED ❑Yes I No _ /{Witi W04\ /- 6.'` \ 6". // 1 — 1(en4- CP C . — LOCATION OF SIDEWALK ❑ Front Yard , $Side Yard ❑ Other WIDTH OF SIDEWALK K,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches jg 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. I(9 a sq.ft. 6 in. 173,4, CODE F - PATCHES ❑Yes IA No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : lig 4- 1 Date: _3-3O-4 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO der® SIDEWALK REPAIR SURVEY FORM 101z9 ° _ PROPERTY ADDRESS 1311 Lf t12 5 - 33 - '177 - 0,31 :./ F.r, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes TANo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes rONo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No I I — I I PARKS DEPARTMENT REVIEW REQUIRED E4 .Yes ❑ No _ r )0/30 - f.9eoe 4o sew e.,4 # rer,9v'e g?.,rlta St") P „e 1, Co i')ele LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4$1.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED 31® 6 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes rA,No No. of Squares with Patches — CODE G NOTE :Areas marked with an"F°may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels, —" FIRST INSPECTION AND FORM MADE BY : 4. TE Date: —30 PERMIT ISSUED FORMED POURED COMPLETED LvI CITY OF WATERLOO - 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3/o5- W. no - 3. - 'If?? -Do3 , ' — PARCEL CODE CONTROL NO. ,.-\ CLEAN SIDEWALK — Type of Defect /1/,' ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION El Yes Yes No * WATER VALVE 1 ADJUSTMENT REQUIRED ❑ Yes ixi No — 1,04 PARKS DEPARTMENT REVIEW REQUIRED — � a L), I. ,L1 ❑ Yes No J v 9.d ►0/36 - 3$I sl z4etiee5 ponce a LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK g 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK %.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED VI'O sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes g No No. of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : . I>A Date: 3 43©S8 PERMIT ISSUED FORMED POURED COMPLETED — uevy CITY OF WATERLOO ,o/7 11, SIDEWALK REPAIR SURVEY FORM .� PROPERTY ADDRESS 31° w. gdz 54, . g i3 -33- Lf77 - 001 F 4-"A PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C, ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes ► No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes lI No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes l No HAS f41 9°® glop 60. 12 S " € , 00/3O - Neea swvr clef- 'e®,o4,1 '— LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other rewp1e WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK g 4 inches ❑ 5 inches 16 inches AREA TO BE REPAIRED 110.0 `sq.ft. 4 in. sq.ft. 5 in. 314,y sq. ft. 6 in. CODE F - PATCHES ❑ Yes F+ No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 0( 747 Date: 330/' PERMIT ISSUED FORMED POURED COMPLETED \O CITY OF WATERLOO SIDEWALK REPAI," SURVEY FORM - •'ROPER`I Y ADDRESS 1o3 �1,° 03-35 - 35z - oilc �� — PARCEL CODE CONTROL NO. Type of Defect • CLEAN SIDEWALK See reverse side for Defect Codes A-F El F No See below for Defect Code G j r — TRIM VEGETATION ❑Yes p No — e . _o_ 4.S WATER VALVE � � I V ADJUSTMENT REQ'D — ,C a -- ❑Yes QjNo 16. �/ 7:3) ? 4(6 1/ PARKS DEPARTMENT v4p, ,,, REVIEW REQUIRED ° °1 _ ❑Yes 1 No 17/,r/V a/ A/MX-0 - 6 . \ J K.446,11,( , LOCATION OF SIDEWALK ❑ Front Yard , `,Ll,Side Yard ❑ Other WIDTH OF SIDEWALK T ,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK /XI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2D��sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. 1 CODE F - PATCHES s.❑Yes IIN- No No.of Squares with Patches / — CODE G - (X) �, led Ate\ ac. e 6 i r / 0 e(5 4%AV 'iv,re - - 1. I NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. f — FIRST INSPECTION AND FORM MADE BY : M F Q�1 Date: °fJ1 PERMIT ISSUED FORMED POURED COMPLETED — 1 D 23 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS avoi5 , .4.5A�Pdi, cc(13 -33 -.27S - 00.5— PARCEL CODE CONTROL NO, CLEAN SIDEWALK Type of Defect ❑ Yes J No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — I I ❑ Yes gNo t WATER VALVE ADJUSTMENT REQUIRED Ye?; ❑ No — PARKS DEPARTMENT REVIEW REQUIRED o e' ❑Yes I No LOCATION OF SIDEWALK [S Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 114 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK VI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 to a sq.ft. 4 in. sq. ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes CS,No Nc. of Squares with Patches CODE G - 0.5 12,11a.t. ncc c ,14: -eJ NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1)IJ 1 Tr- Date: 3 27 /f PERMIT ISSUED FORMED POURED COMPLETED Vie — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS nV 5boro - 32- 23 - ® 7 4 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes gl No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — I ❑Yes No * WATER VALVE 1 JI ADJUSTMENT REQUIRED ❑ Yes No — At 704 PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes DUI No A1512drotAgh LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK I 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK gi 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 14. 0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes f No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 13 t Date: 1?® --/3' PERMIT ISSUED FORMED POURED COMPLETED — �� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ®20`1.V AA5bard 013 -3 - - 010 z _.. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect t"' ❑ Yes Ig No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes IL No 11/4 t WATER VALVE ADJUSTMENT REQUIRED ~ `• ❑ Yes 12- No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ►4 No LOCATION OF SIDEWALK ►+Front Yard El Side Yard ❑ Other — WIDTH OF SIDEWALK 0-4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 15 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 1 •Lt sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [ No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 13 4" Th Date: 3-�3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOORi - � ° SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l 4,56c€-c9 93 -33 - .275 - 013 ,.;' `` a PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes g No WATER VALVE t % ADJUSTMENT REQUIRED 4-0 74Yes ❑ No I �l PARKS DEPARTMENT REVIEW REQUIRED '/z" low ❑Yes A No im V. — — — u° LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK M 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK r' 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ! ,® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes l -No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : F, a- TE Date: ` /5 PERMIT ISSUED FORMED POURED COMPLETED — w CITY OF WATERLOO `o SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I l An04omr, 13 - 3 - a7 - t 1- �.. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect CI Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 ❑ Yes X.No t WATER VALVE ADJUSTMENT REQUIRED ~0 - ❑ Yes CKNo Ael\ PARKS DEPARTMENT REVIEW REQUIRED o 3 ❑ Yes X No 445 bow dt1 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK lA 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 54 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 76.E sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Dg + 7% Date: 3r - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS <,21a.t AffsioliVtA411 ct13 - - 7M - l7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — El Yes X No WATER VALVE t JI ADJUSTMENT REQUIRED 4-0 Yes ❑ No — PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes XI No CAP APIS oY' — LOCATION OF SIDEWALK N Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK X.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1?' 6 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches — CODE G - L tk.4 r va-`c, flc.er-S cat NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 4- T5 Date: 35 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS fig° Afrs ,pow „), (6913 -33 - .2V . - 003 ,. 4 (12 PARCEL CODE CONTROL NO. Type of Defect A — See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑Yes 14 No TRIM VEGETATION ❑ Yes l 'No WATER VALVE 1 ® ADJUSTMENT REQD El Yes 1No �� PARKS DEPARTMENT • REVIEW REQUIRED - - - - ❑ Yes jgNo LOCATION OF SIDEWALK 12 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK lg 4 Feet El 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /6• sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes r! No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : re Date: 42.3-/ --. PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS O A3bato u..ikt u�13 -35 - - - PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑ Yes x1 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION —" I ❑ Yes ® No i WATER VALVE ADJUSTMENT REQUIRED �—Q ❑Yes g No — i M' \ I PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes IA No "S b,iro0 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK b' 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 13.G sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes gl.No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 4' -re Date: 3- `( PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO 13 '� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .2a.l A s o rdu. k g913 -33 - .26,2 - ooy e:,° 4 0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes xi.No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes $.No WATER VALVE ADJUSTMENT REQUIRED IN.,Yes ❑ No tO PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes J&No M — 445borot.434 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK K 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED I •® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. , CODE F - PATCHES ❑ Yes X No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : -re Date: .3'a3-I $• PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO D SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5LroL 1a .?a3 -33 - Aga - 0°7 - e PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A ❑ Yes g No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes yj No 1 WATER VALVE ADJUSTMENT REQUIRED 4-0 ❑ Yes XNo — I PARKS DEPARTMENT REVIEW REQUIRED — . ❑Yes gI No 'di1 LOCATION OF SIDEWALK 1Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1414 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK *4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1(0.11 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 4' 7-g Date: PERMIT ISSUED FORMED POURED COMPLETED — 4, CITY OF WATERLOO It t D SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 2 s t3 - 3S- af - 10 5-0 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes 1M No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes Xi No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes (, 'No PARKS DEPARTMENT REVIEW REQUIRED J ❑ Yes I No s • OK LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK VI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /49. 7 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes N.No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. tt�� FIRST INSPECTION AND FORM MADE BY : C7 d- 7-6- Date: av--/8' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS cartO 4,* 4 g1i3 -33 - 1:26 0504 47;7 - PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No — See below for Defect Code G I TRIM VEGETATION 5 ❑ Yes RI No — ♦.. � -® WATER VALVE — �`+�'� I �' ADJUSTMENT REQ'D ❑Yes #KNo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No sot\tie.‘1 I CI 5 11 ra�P> LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 7. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes EX No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : + TE Date: 3 ./ ' PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO ,o 2 SIDEWALK REPAIR SURVEY FORM .•� PROPERTY ADDRESS c2 3 s -a git3 -3,3 - 977 - dc( � 5 ""l PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Al6, ❑ Yes ►i+ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 ❑ Yes gNo WATER VALVE N ��/ ADJUSTMENT REQUIRED Pri" ❑ Yes IX No -- I PARKS DEPARTMENT REVIEW REQUIRED P� � ❑ Yes f•No - - la — 4,8 I). fah 5$- LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK 14 Feet 119 5 Feet ❑ 5.3 Feet ,Other DEPTH OF SIDEWALK K,4 inches ❑ 5 inches ❑ 6 inches (70 AREA TO BE REPAIRED 6 Od sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ( No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : Die 4- 7--E Date: -,313`"i ' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 1 :4 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'O 'er s v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes [ ,No WATER VALVE / ADJUSTMENT REQUIRED 4-0—► ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No VA �•o LOCATION OF SIDEWALK ig Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet W5.3 Feet ❑ Other DEPTH OF SIDEWALK CA 4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED 31. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes INo No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: �� ` t PERMIT ISSUED FORMED POURED COMPLETED 14( oxs be co,-rpie cd CITY OF WATERLOO D''1zI��•/ Concre SIDEWALK REPAIR SURVEY FORM /7 PROPERTY ADDRESS 1 CZ— Ave- -c t - , / _ ; PARCEL CODE CONTROL NO. ,' 1 CLEAN SIDEWALK _ Typezof Defect ❑ Yes No See reverse side for Defect Codes A-F 7 See below for Defect Code G TRIM VEGETATION — ❑ Yes X.No — WATER VALVE ADJUSTMENT REQUIRED ❑Yes No — I I PARKS DEPARTMENT REVIEW REQUIRED evwaie PDA Ica in Yes ❑ No 1 / .e - - — (---c) / . ..... / LOCATION OF SIDEWALK .Front Yard ❑ Side Yard ❑ Other b WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IX 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches 0,6 inches — AREA TO BE REPAIRED 5 S. 1 q s .ft. 4 in. sq. ft. 5 in. ss sq.ft. 6 in. CODE F - PATCHES ❑ Yes i'No No.of Squares with Patches CODE G - NOTE Areas marked with an"F"may be repaired by patching.All other areas shall be paired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : F-'5 12)(' IS\--'4"a Date: .3"2,3` (g a PERMIT ISSUED FORMED POURED COMPLETED � k ;' T7) e c'Q l 1e mot, .� vicre CITY ••F WATE!:L®® >B l SIDEWALK REPAIR SURVEY FORM L •ROPERTY ADDRESS 1 �- , a ,r - 3 tic-;2 C o �c2 PARCEL CODE CONTROL NO/ Type of Defect il / CLEAN SIDEWALK See reverse side for Defect Codes A F f ❑yes No See below for Defect Code G — i1 TRIM VEGETATION ❑Yes ffyNo — " - . ► Al WATER VALVE i4,\ ADJUSTMENT REQ'D — ,, 1 CI Yes yNo f') i n �.. , PARKS DEPARTMENT y 1�L � REVIEW REQUIRED _ Yes ❑ No — 1 — LOCATION OF SIDEWALK `, J Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ,' ❑ 4 Feet ❑ 5 Feet Vt 5.3 Feet ❑ Other DEPTH OF SIDEWALK tgt 4 inches ❑ 5 inches `� ❑ 6 inches a AREA TO BE REPAIRED 19 .S '. sq.fit. 4 in. sq.ft. 5in. sq.ft. 6 in. CODE F - PATCHES ❑Yes X No No.of Squares wig Patches — P CODE G - NOTE :Arefas marked with an"F"may be repaired by patching.All other areas shall repaired by — renstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : 7"5 \3cY Date: \ �3®t PER IT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO Cc Oe SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z-\ ,Lr c� -3 - - o\ j PARCEL CODE CONTROL NO. / �S 1 CLEAN SIDEWALK /1—. Type-of Defect ❑Yes ' No See reverse side for Defect Codes A F See below\for Defect Code G TRIM VEGETATION `� I ❑Yes . g No ... WATER VALVE ADJUSTMENT REQUIRED ❑Yes 1 No PARKS DEPARTMENT REVIEW REQUIRED �e..�!ti?CCU •�1�V1 P ' 1- ✓1 ❑Yes No — — — — — — — y VA- VA LOCATION OF SIDEWALK irFrontYard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g 5.3 Feet':, ❑ Other DEPTH OF SIDEWALK'' .4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REP,4iRED 59.43 sq.ft. 4 in. sq. ft. 5 in. a sq.f. 6 in. CODE F - PATCHES ❑Yes IA No No. of Squares with Patches CODE G -/ NOTE Ars marked with an"F"may be repaired by patching.All other areas shall be repeired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � Date: 4 ` 2 PERMIT ISSUED FORMED POURED COMPLETED -fp b col Acre CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2- I 6v / - 1- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C / El Yes ' gNo See reverse side for Defect Codes A-F • / See below foi-Defect Code G TRIM VEGETATION 0 Yes No WATER VALVE / ADJUSTMENT REQUIRED CI Yes No PARKS DEPARTMENT REVIEW REQUIRED (12)e MO lie PO vV1 10* Ca 0'1 El Yes No LOCATION OF SIDEWALK E.Front Yard 0 Side Yard CI Other WIDTH OF SIDEWALK 0 4 Feet 0 5 Feet xs:3 Feet CI Other DEPTH OF SIDEWALK 4 inch CI 5 inches \ C:1 6 inches 2.3 si AREA TO BE REPAIRED 2 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes M No No. of Squares with Patches CODE G - / • NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. tt-7 FIRST INSPECTION AND FORM MADE BY : Date: 4 -2-- -te ii PERMIT ISSUED FORMED POURED COMPLETED 54, is CITY OF WATERLOO 571 j , SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS Zl PARCEL CODE CONTROL NO. CLEAN SIDEWALK —. Type of Defect ❑Yes 'No See reverse side for Defect Codes A F • I See below for Defect Code G TRIM VEGETATION I ❑Yes INo WATER VALVE ADJUSTMENT REQUIRED ~4:11-11,- I Yes 1I No PARKS DEPARTM' NT REVIEW REQUIRED ,D.( XYes ❑ No A K4, S.o LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet jg 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK St 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED •0 "sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ►+!No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : DI>5 Date: 3- " PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO c'yk. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z.,F=- r 7 PARCEL CODE CONTROL NO. (Lb CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION i ❑Yes yi No WATER VALVE ADJUSTMENT REQUIRED 411—Q� CI Yes `No — PARKS DEPARTMENT REVIEW REQUIRED ❑Yes yfiNo 4 aLA- - LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet IX45.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches EY5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. 2'•.3 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes rf No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Nib 5 Date: 4-2 ®( PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ZZ- , PARCEL CODE CONTROL NO. C 4 CLEAN SIDEWALK Type of Defect 8 ❑Yes 'N.No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes No \At/I WATER VALVE ADJUSTMENT REQUIRED 44—Q--► ❑Yes No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet Xj 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ) 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED (pa.0 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED • CITY OF WATERLOO fl SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑Yes tI,No WATER VALVE ADJUSTMENT REQUIRED ❑Yes liNo i PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes to , ) LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet $ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches — I AREA TO BE REPAIRED 01.CQ, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 14No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F" may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S \)> Date: 4 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 5 - SIDEWALK REPAIR SURVEY FORM 72/) PROPERTY ADDRESS li 3 ,g- a-- `i 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes cX,No See reverse side for Defect Codes A F • See below for Defect Code G TRIM VEGETATION ❑Yes No 11/4 t WATER VALVE ADJUSTMENT REQUIRED ~Q� ❑Yes No PARKS AT REVIEWDEP REQUIRED Yes ❑ No — — A (//11 — 4.z 4.1 C ) tA LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet X 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IKT 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1It.5 / sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ryt No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Rs 7 Date: 3 3 16 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ir \ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2A- k '� PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect A t ci, ❑Yes ' cSNo See reverse side for Defect Codes A F — See below for Defect Code G I TRIM VEGETATION I ❑Yes No , WATER VALVE 7: ir ADJUSTMENT REQUIRED 44-0-40. ❑Yes No — PARKS DEPARTMENT _ REVIEW REQUIRED 16,3 Yes ❑ No — — — - — ® ( — LOCATION OF SIDEWALK %Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1X4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 1 Zc„ sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES. ❑Yes No No. of Squares with Patches- CODE G - — NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ? Date: 2- PERMIT ISSUED FORMED POURED COMPLETED _ ®CITY OF ATER �.® SIDEWALK REPAY'. SURVEY FORM PROPERTY ADDRESS cO -3 m g /3913 -3 iz.,7 - oox -7 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes jNo - TRIM VEGETATION ❑ Yes 1 No -0 ATER VALVE 1 v'+ `. a ADJUSTMENT REQ'D Yes y❑[ No PARKS DEPARTMENT REVIEW REQUIRED — — ❑ Yes CNo 0-4 J LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK c91,4 Feet ❑ 5 Feet ❑ 5.3 Feet KOther S.,A- DEPTH OF SIDEWALK ►A 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4`7 7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - I F 1s-6kc LAJ Abzus umE r- 67 :i-r fve �� `610 iCATIOAI 1(2(-Aex--iA,E).1— Pt= PANE)— MA' ' 01,260 "t� NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : t Date: fil�� I cii3 vecylb PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 k I - - - ca3 I 6 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 54 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes IANo WATER VALVE ADJUSTMENT REQUIRED �—Q ❑YesPARKS ( No 1 1 I REVIEW REQUIRED NT — 4,‘ I o� ❑Yes No S60\ 11B7) - - - - - - 0 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X 5.3 Feet ® Other - DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 'e l{ • sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes tN No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. /J FIRST INSPECTION AND FORM MADE BY : y/� 7 Date: 1" 'i PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM (ei17/19 PROPERTY ADDRESS "i0 it/° i3 -3 - 31 - ;,r) PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes X No 1 JI WATER VALVE ADJUSTMENT REQUIRED I( �T ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED I � ❑ Yes ,) No 44 '11-11 t71 •3 I LOCATION OF SIDEWALK 4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK A 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 711SC 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED `" I 7c sq ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes A No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : it/tA Date: *ZOE PERMIT ISSUED FORMED POURED COMPLETED pS>17:0,\\01 CITY OF WATERLOO6 SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS NA _ 7/3 -3 - 151 - 77;� PARCEL CODE CONTROL NO. - Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F — ❑Yes 0. No See below for Defect Code G TRIM VEGETATION _ ❑Yes 14 No t / WATER VALVE — � "'� Ie l\ I ADJUSTMENT REM ❑Yes NNo PARKS DEPARTMENT REVIEW REQUIRED _ ❑Yes T No —„ o 50 — . --) 'ro t$ LOCATION OF SIDEWALK 1g,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ] 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK pg,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ` / sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes jZt No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : MB 2,610Date: — PERMIT ISSUED — FORMED POURED COMPLETED — CITY OF WATERLOO �- SIDEWALK REPAIR SURVEY FORM ''/B7l)e( PROPERTY ADDRESS %t'` t" �'�►® — 13 - - )35 3 ;i ___ 7 PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes ,�No _ I See below for Defect Code G TRIM VEGETATION ❑ Yes giNo AL ADJUSTWATERMV ENTVE REQUIRED ❑Yes ®,No I I PARKS DEPARTMENT 5.° REVIEW REQUIRED ,, Yes Yes ❑ No o LOCATION OF SIDEWALK ,M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet I Other ,-2a DEPTH OF SIDEWALK Z 4 inches ❑ 5 inches ❑ 6 inches - — AREA TO BE REPAIRED GF, �,5 s f 4 in q sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes X.No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 03/A PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO (0:\\�,\� SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /0)1, ; ) e PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect g ❑Yes `l No — See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G I ❑Yes r No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes x.No — I 1 PARKS DEPARTMENT — �r a �J REVIEW REQUIRED a``C ,�` )4 Yes ❑ No 53 X, / Aril _ LOCATION OF SIDEWALK 3A Front Yard ❑ Side Yard ❑ Other , - . WI DTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ,,Other ®� DEPTH OF SIDEWALK )4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes U No No.of Squares with Patches CODE G - DA-e°1‘4)& CCA ° -- NOTE :Areas marked with si"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of fullp �� FIRST INSPECTION AND FORM MADE BYAAP Date: g , -- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO //7) SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 11 1-11 13 -35 - I3 - V PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑ Yes ,No TRIM VEGETATION t -V4 Yes El No if 04 • WATER VALVE irs ADJUSTMENT REQD 1 ❑Yes $No �1b,/ PARKS DEPARTMENT 6,C}` REVIEW REQUIRED ,.Q Yes ❑ No I ) C� a • LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet ❑ 5.3 Feet Other ,} 1 DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ` Z7 0 sq.ft. 4 in. sq.ft. 5 in. sq.ft 6 in. _ CODE F - PATCHES E Yes ' �,No No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED V\ CITY OF WATERLOO (9 xl SIDEWALK REPAIR SURVEY FORM [4;'0,11.9trle_ PROPERTY ADDRESS f MI3 - - I 7 - 47 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes ,No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes g No WATER VALVE ADJUSTMENT REQUIRED 0.Yes KNo — I PARKS DEPARTMENT REVIEW REQUIRED 0,11 ❑Yes )I No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED - 2 Osq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes i No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /f Date: e PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO I�I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS IV PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes N.No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes ,C No WATER VALVE ADJUSTMENT REQUIRED G `. . gYes ❑ No PARKS DEPARTMENT REVIEW REQUIRED o ❑ Yes No II.I lei(I LOCATION OF SIDEWALK j Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK f 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 14 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED ''� 16•q sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES El Yes No No. of Squares with Patches _ CODE G - (x ) " . to e r" v9' e 43&1111€4464-1-dogs v of Meet ®vet$ 'rept- reoki:Tezcomide9 NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /14 Date: d PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO c/7//,,ThSIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `11 1 \ e- gi I - /77 - oi/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION — 1 ❑Yes eikNo WATER VALVE tit ADJUSTMENT REQUIRED �— ❑ Yes 1No — 1 PARKS DEPARTMENT REVIEW REQUIRED >` El Yes No 13,1 l °wee LOCATION OF SIDEWALK Wront Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 4 inches LI 5 inches ❑ 6 inches AREA TO BE REPAIRED d sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G 5 tir e-e--' ) CSC) deet t/I r`' e S r5 ®3— `C-p1 the- .! NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Pam- n7 ' i Date: PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOR V PROPERTY ADDRESS /LUU ( ®ems 1 -35-0 - l PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes KNo See below for Defect Code G TRIM VEGETATION ❑ Yes No 1 JI WATER VALVE F0 ADJUSTMENT REQUIRED J `. . I ❑ Yes ;o a PARKS DEPARTMENT �6(") REVIEW REQUIRED 1464 ActAf - El Yes No 5.0t r LOCATION OF SIDEWALK ®Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED dV sq.ft. 4 in. sq.q ft. 5 in. sq.ft. Bin. CODE F - PATCHES ❑Yes ,INo No.of Squares with Patches CODE G U �� �4® - "5 NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : etii Date: 03 1 PERMIT ISSUED FORMED POURED COMPLETED Ci OF WA`TERL • `�' SURVEY FORM _ �.�\�`� SIDEWALK REPAIR \ 1 PROPERTY ADDRESS , - OPI i 3 - 5- 1 77- 01(,- r PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect ® r ❑Yes Lg No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION i ❑Yes XiNo WATER VALVE ADJUSTMENT REQUIRED ❑Yes ii4 No — I PARKS DEPARTMENT 0 ''----- ------- ----1/" 16-- REVIEW REQUIRED ❑Yes No )7/1 t/I / ' \ ' LOCATION OF SIDEWALK ,Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,X14 inches ❑ 5 inches ❑ 6 inches _ J s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED ` q — CODE F - PATCHES Ef No No.of Squares with Patches I CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. ;, �1� FIRST INSPECTION AND FORM MADE BY AA a 19A) Date: _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 6:2 j 7/ PROPERTY ADDRESS l 1112.0 Bet tit; L - - 1i7- 0l"7 `` 97 PARCEL CODE CONTROL NO. '- Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes g No See below for Defect Code G TRIM VEGETATION Li Yes jR1No 1 �I T VAL ADJUSTMENT VE REQUIRED �F El Yes L No PARKS DEPARTMENT (.119 REVIEW REQUIRED ❑ Yes No 14.11 B-1 it/v(421P-t---- LOCATION OF SIDEWALK *i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK N'4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ig 4 inches ❑ 5 inches f ❑ 6 inches AREA TO BE REPAIRED V l s sq.ft. 4 in sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes A No No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ��!! FIRST INSPECTION AND FORM MADE BY : fy4 2 BA) 03/ 1 Date: PERMIT ISSUED FORMED POURED COMPLETED (12 ri 1\i CITY' OF WATERLOO SIDEWALK REPAIR SURVEYS — PROPERTY ADDRESS 'i® 3 - !77 ,,f CIF PARCEL CODE CONTROL NO. �, _. k - CLEAN SIDEWALK Type of Defect `". See reverse side for Defect Codes A _ F ❑Yes No See below for Defect Code G I TRIM VEGETATION _ ❑Yes No I_ VALVE fQ� WATER-. ADJUSTMENT REQ'D ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No ._._-.---- f\jO. 5L� — — 1 ) °p-T LOCATION OF SIDEWALK K Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK lyl 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )4 4 inches ❑ 5 inches - ❑ 6 inches - AREA TO BE REPAIRED y,f , i 2 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑ Yes tg No No.of Squares with Patches CODE G - DAer:oret-0 pi,A,J citrikice.W4 Cake- repkaatat- ifig/tel ( ) NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �� f� r FIRST INSPECTION AND FORM MADE BY BM Date: — PERMIT ISSUED — FORMED POURED COMPLETED gc4— S CITY OF WATERLOO 4%17111 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 691-t- 3 - 3 - 171 - PARCEL CODE CONTROL NO. - \) Type of Defect ` CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I [ `Yes No TRIM VEGETATION _ At ❑ Yes X No ~4Dt -': — WATER VALVE 1e 1\ ADJUSTMENT REQ°D ❑Yes xNo I IL—k PARKS DEPARTMENT �! — — REVIEW REQUIRED ❑ Yes A No VA I \ LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK A 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK A 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED' _ lb i n sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes n No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Ail, kg7f0 Date: 3/i/V44G7 WI ote3/408 PERMIT ISSUED FORMED POURED COMPLETED Ci OF WATERLOO (\‘/A\ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I 5/ii oct - 1 3 -3- 17 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes yi,No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes g.No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 14 No — if 1\4 (l r I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes )No - - - - Lip` - - — VAF),4\ 5iC d LOCATION OF SIDEWALK ( Front Yard El Side Yard El Other WIDTH OF SIDEWALK i 4 Feet ❑ 5 Feet El 5.3 Feet El Other DEPTH OF SIDEWALK )K 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED V /61 d sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. 1 Kid FIRST INSPECTION AND FORM MADE BY : f Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 4- 6 SIDEWALK REPAIR SURVEY FORM 6l 17f 1 6 — PROPERTY ADDRESS 17i(€ dry ce--- 13 -35-3 - 017 f. /45. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect i4Al ❑ Yes yi No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes Tal Ne------ \> e- - �t W ER VALVE ;'. - 1 ENT REQUIRED 41-0 yl No I 1 ' •RKS DEPART a - \� -t(YDWk A ! RE' " 'WIRED N 10°44-) 5 2S ? ❑Yes .No VA LOCATION OF SIDEWALK 14 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK g 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '� 17a Z- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes AND No.of Squares with Patches - CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : h Date: 074g _y PERMIT ISSUED FORMED POURED COMPLETED } '` CI OF WATERLOO ``�1� SIDEWALK REPAIR SURVEY Y FORM PROPERTY ADDRESS 01 84/1-1 M1 - 3-3 - 09 ,; 101a — PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F — See below for Defect Code G 1 ❑Yes $.No TRIM VEGETATION ❑Yes WATER VALVE I ADJUSTMENT REQ'D Yes ❑ No 1\14 ‘, DG via ILcCtj, Imo' P S DEPART ENT RED ❑Yes No � j 1,riel r LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED V Z0. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes )No No.of Squares with Patches CODE G - _ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. A� FIRST INSPECTION AND FORM MADE BY : Date: 03/Zehe s ® — PERMIT ISSUED FORMED POURED COMPLETED _ 64-S CITY OF WATERLOO 7 l SIDEWALK REPAIR SURVEY FORM F,),L__ L PROPERTY ADDRESS IW -- ' ' ;\r- 4.4.44.-- — 903 - 35- 331 - GO3 /07 PARCEL CODE CONTROL NO. of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes e No See below for Defect Code G I TRIM VEGETATION ❑Yes V ►. 41--0- ATER VALVE 1 if • I ADJUSTMENT REQD Yes ❑ No � Ii ', 1 e- _ ,,,,OU,J`. ,( re ' "ASKS DE=_PART T ® \ � 'a R v' IRED �=I ❑Yes [ No .— l'IdONI3° ,5 J 34/-,k,,,A.,,,,,,- D-t- • LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,,4 inches/ ❑ 5 inches ❑ 6 inches 'AREA TO BE REPAIRED •'in sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑ Yes A No No.of Squares with Patches CODE G - V W.-- 4.096,44 +ma fy Bt`° p� d f®oaa\" NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ilitg 2 NJ Date: 704 t b PERMIT ISSUED FORMED POURED COMPLETED 5e% CITY OF WATERLOO — \ \\ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS IctO tic&koto i3 - 5 - 3J - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of DefectA ❑Yes X,No — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes $No WATER VALVE ADJUSTMENT REQUIRED ❑Yes X No PARKS DEPARTMENT .5 `®� ? q® REVIEW REQUIRED a�4 1� �� a ❑Yes ,No rig, '1® 5' : a (�") U-killOCe LOCATION OF SIDEWALK XFront Yard ❑ Side Yard , I❑ Other WIDTH OF SIDEWALK A 4 Feet 05 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK y'4 inches X5 inches ❑ 6 inches AREA TO BE REPAIRED 51.I sq.ft. 4 in. dJ 1 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches — CODE G - /Z5,v y 5wettf-e, 4 5 5Af d C`tT Z' NOTE:Areas marked with an'TF"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : -11 Date: q 1140 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 10 34 14-i\vikoCe.--' f J _ 9/3-35- -1 - ,f° '�' i i o PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect / ❑ Yes J No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION Ji `` I ❑Yes Et No VJI V 1( 2C' m 1 kW4) �, WATER VALVE e 1 K. Au(.ti�v e ` ADJUSTMENT REQUIRED _ �0-. e� u � 1 '� plow° {c `re�� ✓ ❑Yes e No Serv,'ce PARKS DEPARTMENT REVIEW REQUIRED �� ❑Yes No 52` ff LOCATION OF SIDEWALK l Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK J 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED `' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ,No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 15 i i - cit -3 - 31 - I I t _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect i . 1 D Yes 0 No See reverse side for Defect Codes A-F _ See below for Defect Code G I TRIM VEGETATION I ❑Yes No ATER VALVE ADJUSTMENT REQUI ED 1 Yes Ll No _ I 1 KS DEP MENT , — REVIE REQUIRED E` 'D ❑Yes ( No ;1 - \ , , , _ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK i v 4 inches 5 inches ❑ 6 inches — AREA TO BE REPAIRED `�f `:p',)sq.ft. 4 in.` - sq.ft. 5 in. sq.ft. 6 in. k CODE F - PATCHES MIYes b No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : - Date: 0 /(!ge3 r r., gAi 6,7/6'l iaR, — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM 4 PROPERTY ADDRESS !sue PARCEL CODE CONTROL NO. `Y , CLEAN SIDEWALK Type of Defect ❑Yes EI,No See reverse side for Defect Codes A F See below for Defect Code G ) TRIM VEGETATION I ❑Yes 0No �t WATER VALVE ADJUSTMENT REQUIRED ❑Yes :` No PARKS DEPARTMENT REVIEW REQUIRED . / L Yes ❑ No .) 1,!% �I f 0,0 LOCATION OF SIDEWALK I EFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK EJ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 32 4 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches _ CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : MI5 64,1Date: :=- • ' - If"1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 0 SIDEWALK REPAIR SURVEY FORM — ' (Akli PROPERTY ADDRESS ' - r PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes g No — See reverse side for Defect Codes A-F I See below for Defect Code G I TRIM VEGETATION I I ❑Yes ,qNo — WATER VALVE ADJUSTMENT REQUIRED . . - —10- ❑Yes )No I PARKS DEPARTMENT 2 I REVIEW REQUIRED E'`, ❑Yes gNo — II \ _ FFi, gg 4' LOCATION OF SIDEWALK 14 Front Yard ❑ Side Yard , ❑ Other — a ® WIDTH OF SIDEWALK ix 4 Feet ❑ 5 Feet ❑ 5.3 Feet El Other DEPTH OF SIDEWALK r 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED' C sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes A No No.of Squares with Patches CODE G - '� A�. J =°'L- \? - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. n 04 P / • FIRST INSPECTION AND FORM MADE BY : t11* Date: 74W — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM c,//1/1;\ PROPERTY ADDRESS 1 ,5 e,, 1 1 -3- tat - 01t to PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect o ❑Yes CIllo See reverse side for Defect Codes A-F ' See below for Defect Code G j TRIM VEGETATION j 1 ❑Yes INo WATER VALVE ADJUSTMENT ' QUIRED Q j ❑Yes :��:No <%./°/*I' j j 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes AND LOCATION OF SIDEWALK $Front Yard ❑Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet X 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 11 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 6 Date: 3% ,' — PERMIT ISSUED FORMED POURED COMPLETED ffr-i + + CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1O e . I - S- l - 1 7 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes IN No See reverse side for Defect Codes A-F See below for Defect Code G 1 TRIM VEGETATION — ❑ No WATERYes VALVE ADJUSTMENT REQUIRED ♦'Q,. ❑ Yes AgNo — PARKS DEPARTMENT REVIEW REQUIRED — 1 1 J ❑Yes 1 No - - 1 - - a� . a 0, I - LOCATION OF SIDEWALK pa Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet L5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1-13• 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes KNo No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I ILI aeALAA Ri - 35-lo5 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes A No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes yr,No WATER VALVE if ADJUSTMENT REQUIRED ❑ Yes gNo I I 17• PARKS DEPARTMENT p JIREVIW/ QUIRED 54 Yes ❑ No 50‘5099 qq r 5,0 - gait to " -6 IA. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK l4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 75.5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches . _ CODE G - �5.7Ve ' e (mot A r�5� �` (4�t�,�l.A1° ? mA ® I NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. -- FIRST INSPECTION AND FORM MADE BY : RA) Date ° � PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM \\,5 )"\1\0\t` PROPERTY ADDRESS 1/ PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect ❑Yes fiAo See reverse side for Defect Codes A-F — J See below for Defect Code G J TRIM VEGETATION I 1 ❑Yes gNo WATER VALVE ADJUSTMENT REQUIRED 4-0—* ❑Yes M No 1 e 1 PARKS DEPARTMENT — P REVIEW REQUIRED a ° ❑Yes )No ( 4/ • LOCATION OF SIDEWALK r Front Yard ❑Side Yard , ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )0 4 inches ❑5 inches ❑ 6 inches — AREA TO BE REPAIRED e•0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes INo No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f Date: 6 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ,,,,5_ SIDEWALK REPAIR SURVEY FORM ` PROPERTY ADDRESS 1 r1 BrA-AA (r? I 'q I lcl — t 5 - - MI - O ) PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect ❑Yes No — See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION WATER VALVE ie/-.),2- 1/1 epj.U.S. NT REQUIRED I I \`\.PARKS DEPARTMENT ,.�,. r REVIE]N._REQUIRED-y__.- LIS r 1,'� ❑ Yes w ,si No — OA LOCATION OF SIDEWALK Xs Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet $5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK A4 inches ❑ 5 inches. ❑ 6 inches AREA TO BE REPAIRED 4 ` /,O sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes 0,No No. of Squares with Patches CODE G - 1 V% i itirr r reilft48, cif L 6;,-,,# aditi 1/4`1 — NOTE :Areas marked with an"F"may be repaired by patching.All other"areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : ( X-C Date: 0 3 - PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLS- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 - s -3 - / 2-a t PARCEL CODE CONTROL NO. - Type of Defect _ See reverse side for Defect Codes A-F CL SIDEWALK See below for Defect Code G ❑Yes jg No TRIM VEGETATION ❑Yes I No \At1.1 Ie --► " WATER VALVE j► �`� � ADJUSTMENT REQD 111, Yes pg.No '- PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes No o 51A) 2 • — LI ; ' 'l, LOCATION OF SIDEWALK Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet ❑ 5.3 Feet ) Other 5 DEPTH OF SIDEWALK C ,4 inches , ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '` 2 ?O sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes gl No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : M Bit-W Date: 0ig6'.�6 PERMIT ISSUED — FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 4141) 14k PROPERTY ADDRESS 13- - I - ° -` PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G 1 TRIM VEGETATION 1 ❑Yes ,I31.No WATER VALVE ADJUSTMENT' •UIRED 4-0—* ❑Yes j No PARKS DEPARTMENT REVIEW REQUIRED 3 ❑Yes E-No . ' - - - - LOCATION OF SIDEWALK $Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ,4 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ` I ZS sq.ft. 4 in. sq.*. 54n., sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"Fe may be repaired by patching.All other"areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: OW PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY f -, - i '6 - f/, 7 el, , — PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A ❑Yes gNo See reverse side for Defect Codes A-F See below for Defect Code G j TRIM VEGETATION j 1 ❑Yes d)No WATER VALVE ADJUSTMENT REQUIRED ~0—*- ❑Yes l.No 1 PARKS DEPARTMENT 10.0 Q REVII A REQUIRED C� Yes ❑No I ,Etzria, a C LOCATION OF SIDEWALK 1 Front Yard ❑Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet At 5 Feet ❑5.3 Feet El Other DEPTH OF SIDEWALK 0,4 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED `" ° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in CODE F - PATCHES ❑Yes INo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. friPs FIRST INSPECTION AND FORM MADE BY : Date: Di/ g v PERMIT ISSUED - FORMED POURED COMPLETED CITY OF WATERLOO .- Mt let SIDEWALK REPAIR SURVEY FORM col -ROPERTY ADDRESS / gi"`i",1"... - A - ���� f 7 Alp( CONTROL NO, PARCEL CODE Type of Defect A tf 0 \f� :a- - CLEAN SIDEWALK — See reverse side for Defect Codes A F ❑Yes No See below for Defect Code G ...,4 i TRIM VEGETATION — ❑Yes $No -W !— ti --► WATER VALVE i l\ i 1 ADJUSTMENT REQ'D i ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED — a(yg • — — — — ❑Yes No ri �E Cir ertjA Ave. LOCATION OF SIDEWALK ❑ Front Yard , Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet a 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK )4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ` '- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Li No No.of Squares with Patches — CODE G - /..(_ P ear'it tz,`i I F I:AL F L- Ai ,_ i-=.t_.�/J T- r .f.,_:r tZ i ii1,1t,.,A(:-LP.J 1- '11ji_' ._.. NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. (� Q /, FIRST INSPECTION AND FORM MADE BY : Al, !' Date: PERMIT ISSUED FORMED POURED COMPLETED ://),>""" CITY �F WATERL.O \Lk1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS — PARCEL CODE CNTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes No 4 - - I6 TRIM VEGETATION A � ❑Yes ( No WATER VALVE F ADJUSTMENT REQ'D ❑Yes IXNo PAAR • ,6 REVIEWRKSDEP REQUIREDTMENT — — El Yes No J LOCATION OF SIDEWALK xi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet , ]5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 7 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F - PATCHES ❑Yes C�4.No No.of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Mtg& Date: �€ r/t � � R PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ‘1 SIDEWALK REPAIR SURVEY FORM ROPERTY ADDRESS & - /3- . /03 - 01,5 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F 0 Yes jg No ._ See below for Defect Code G I TRIM VEGETATION ❑Yes Ai No if N --► WATER VALVE ADJUSTIVIENT REQ'D Yes ) No ®, ti ( Irg �' PARKS DEPARTMENT REVIEW REQUIRED ..: ❑Yes E No ----N.-- No J i LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet .5 53 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED )614' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches f, CODE G - � (x ) �'�� 55a�e. j p _ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : , 1 ifv5retijout Date: q -11 V PERMIT ISSUED ' FORMED POURED COMPLETED CITY OF WATERLOO \\6\ SIDEWALK REPAIR SURVEY FORM - I PROPERTY ADDRESS z ° Fes /3 - - 107 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes JANo See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑Yes ,t No — 1`t JI WATER VALVE • if-0—* ADJUSTMENT REQUIRED ❑Yes SNo 1 PARKS DEPARTMENT 5.\ �I RE REQUIRED a1\ ,Yes ❑No `f — o . LOCATION OF SIDEWALK C;Front Yard ❑ Side Yard , ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet yt5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 50.5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No,of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 0 .11 �`� — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5k A _ I -5 -/0 - i PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect (3 ❑Yes IsNo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION l ❑Yes VINo WATER VALVE ADJUSTMENT REQUIRED ❑Yes 0 No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes %No ,1k ye, LOCATION OF SIDEWALK � Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet j£5.3 Feet ❑ Other DEPTH OF SIDEWALK `lr 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2-7, sq.ft. 4 in sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes SIX No No.of Squares with Patches CODE G - i clowtmes NOTE:Areas marked with an"F"may be repaired by patching.All other.areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : 10-5 Date: -I -1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - /7".. )''' ‘a‘\t‘c‘ PROPERTY ADDRE�s I' 9 - °� .1 - 35 / - 012, )3 4. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes jgNo See reverse side for Defect Codes A-F — j See below for Defect Code G I TRIM VEGETATION I ❑Yes XNo — WATER VALVE — • ADJUSTMENT REQUIRED .4-1(1)--0. ❑Yes X No i I PARKS DEPARTMENT j1 r REVIEW REQUIRED Yes ❑No _ — ftt I KVA LOCATION OF SIDEWALK Front Yard ❑ Side Yard , ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ,° ,sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : A, N\JDate: O-A — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO T SIDE,WALK REPAIR SURVEY FORM ,OM PROPERTY ADDRESS � k'1 9/ - 1O7 - COL/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes p°No See reverse side for Defect Codes A-F See below for Defect Code G 1 TRIM VEGETATION 1 1 ❑Yes )i No WATER VALVE ADJUSTMENT REQUIRED t— —► ❑Yes p.No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No ° — — — — — LOCATION OF SIDEWALK X Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet A,5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED , sq..ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 11 No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. int) ,��// /112 • FIRST INSPECTION AND FORM MADE BY : Date: G>`'I/ PERMIT ISSUED -� FORMED POURED COMPLETED CITY OF WATERLOO `�`e SIDEWALK REPAIR SURVEY FORM — , PROPERTY ADDRESS 1 eA-jk . -35- - afx9 \ PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑Yes No See reverse side for Defect Codes A-F — J See below for Defect Code G TRIM VEGETATION J J ❑Yes 1`t 'KAT-ER-VALVE �\ a T !!E — 4 No _ C1/4 0f LOCATION OF SIDEWALK XFront Yard El Side Yard ❑ Other — WIDTH OF SIDEWALK El 4 Feet A 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK , ,4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES El Yes X No No.of Squares with Patches CODE G - I l)a .11�- cf ,c `� Cl — — NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : 1 Date: 010214S PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM &Mir? prs�r � PROPERTY ADDRESS . " . ,3 - - 10 - 10 13. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ANo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION 1 i ❑Yes kr,No "' • WATER VALVE [' JI ADJUSTMENT REQUIRED f--Q—► ❑Yes IKNo 1 PARKS DEPARTMENT so Yes REV -We,REQUIRED❑No 4 \ r i;e2) F-y2A-Att LOCATION OF SIDEWALK Front Yard ❑ Side Yard . ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,5.3 Feet ❑ Other DEPTH OF SIDEWALK A 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 15,. 5 ‘sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes X No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : A ;``' Date: kde PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO . \ \� SIDEWALK REPAIR SURVEY FORM PROPER ADDRESS c-9 4 -5- !o7 - I 39 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F — I See below for Defect Code G TRIM VEGETATION I I ❑Yes $No _ t JI WATER VALVE ADJUSTMENT REQUIRED I Yes 1 No ®`M '' I PARKS DEPARTMENT (60\ . 7- \. 4� � REV EQUIRED 5,®! _ VY � vJAtYes ❑No — !'Y��"�1GLB - - •nos sf2' FcP11'i. �+' iwiwe ire LOCATION OF SIDEWALK E Front Yard ❑ Side Yard , ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet Er Feet ❑ 5.3 Feet I] Other DEPTH OF SIDEWALK A 4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED /ZS.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES 0 Yes ,JXI No No.of Squares with Patches CODE G - - _ NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : I Date: /�'' i ,i�/� — [/ r' PERMIT ISSUED FORMED POURED COMPLETED _ _i__________.3d-'6 CITY SF WATE LSO (pti���1al — SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 2 7 6 KTc/4 _ ' r �1 5 -35-i. 5 - Oig 4t) E5±�l - PARCEL CODE - CONTROL NO. .. "'-'" ‘Ni: -.. .----o• - ' '-' 0 Type of Defect a� - - CLEAN SIDEWALK See reverse side for Defect Codes A-F gyp c ❑Yes 1 No See below for Defect Code G - --"-I.-- -� N TRIM VEGETATION (N) 1.6 K ❑ Yes g,No :_`� �.— P- ; --► rjik WATER VALVE i i' I --4ADJUSTMENT REQ'D — ,, El Yes fNo 3 °2C PARKS DEPARTMENT -- s� ��3 REVIEW REQUIRED 5° 5::1419' _ —1 _ X Yes ❑ No — fi1 i/\XI . 1100 1 — 6/TCa ,4I/E- k nA '''',, lek ..... LOCATION OF SIDEWALK IN Front Yard X Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet X] 5 Feet EX1 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED Ze'Z,®sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. iri- I CODE F - PATCHES ❑Yes ElNo No.of Squares with Patches _ CODE G - GO 'es sir Atz. A a Ae bur-ro Caw: Pl Ac nn ‘sr FANE/—, c>..S r e F, (tZ -r 0 o. 1 -_,—TF) a A'c- ) a1 KEL.,5 NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : l egti Date: 24 Wi — PERMIT ISSUED FORMED POURED COMPLETED CITY OF W:ATERL.O �� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS , ;O 1` ; -, PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A^F CLEAN SIDEWALK See below for Defect Code G I ❑Yes i No TRIM VEGETATION tTzt ❑ Yes No — $\ cA WATER VALVE ADJUSTMENT REQD ❑Yes eIRJ No .0 PARKS DEPARTMENT REVIEW REQUIRED ❑ No — ' 4 • ITC:47)'.6Q-- LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet r 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ) 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /56.5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES CI Yes 1,g No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"F"maybe repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : itifh Date: - biff PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 67friltat PROPERTY ADDRESS2rL PARCEL CODE CONTROL NO. • A CLEAN SIDEWALK Type of Defect ❑Yes j No See reverse side for Defect Codes A-F -- 1 See below for Defect Code G 1 TRIA ETATION. C ' { 1 Yes ❑No v WATER VALVE ADJUSTMENT REQUIRED ❑Yes •►,'No 1 ` 1 PARKS DEPARTMENT -y- 6 REQUIRED Yes ❑No L � LOCATION OF SIDEWALK J.Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet pi,,5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK XI,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED', Wa° 5 sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes itNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. �f FIRST INSPECTION AND FORM MADE BY : i Date: PERMIT ISSUED -` FORMED POURED COMPLETED CITY OF WA—ERLOO — ���� SIDEWALK REPAI F; SURVEY FOR,. � PROPERTY ADDRESS S r0 F z rc — &c7/5 -35- 1O6 - 003 )41+ PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect A REQUIRED See reverse side for Defect Codes A-F I ❑ Yes I No See below for Defect Code G — TRIM VEGETATION REQUIRED ❑ Yes No — `t WATER VALVE 4— -0. ADJUSTMENT REQ'D — Cj Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No Si V/it 5.0 LOCATION OF SIDEWALK Eg Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet M Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- Z5. S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes ;I No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : K,15 Date: 04'- 0-6 3 ' 05- FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ce/11)19 PROPERTY ADDRESS 1 gel\rc-11 i - - i I45 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Li No See reverse side for Defect Codes A F See below for Defect Code G j TRIM VEGETATION I I ❑Yes „Er No WATER VALVE ADJUSTMENT REQUIRED ��� ❑Yes I No 0 I I covitfA ' I �y ; I PARKS DEPARTMENT 3 REVIEW REQUIRED ❑Yes No WA &AL LOCATION OF SIDEWALK Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ti 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK kl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.tl ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes fX No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. AA®® ,� FIRST INSPECTION AND FORM MADE BY : DEAF f Date: r ®/ PERMIT ISSUED -� FORMED POURED COMPLETED C1 SF W: TERLS® — E-- �\O\ SIDEWALK REPAIR SURVEY FORM aa\�1 PROPERTY ADDRESS 14, \ — 015 — — ( — ) — PARCEL CODE CONTROL NO. Type of Defect 1 See reverse side for Defect Codes A-F \ CLEAN SIDEWALK See below for Defect Code G ? ❑Yes 0 No — i \ TRIM VEGETATION ❑Yes $No ~ `Fi 4 TER VALVE / 4'7 ' DJUSTME Q' NT.RED [ Yes`°ti ' ❑ No 1 1 �� , FA ERTM �i / REVI N W REQUIPARED ENT • ❑ Yes >K1 No 0 .5 : j 91 i BoviiciR.AAJ Ak1A, LOCATION OF SIDEWALK EA Front Yard • ❑ Side Yard ❑ Other - WIDTH OF SIDEWALK $i 4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK $4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED `'`f AL sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - IX) a L ' `\e_ Gt -"�� .. �'P..)- - l � i '�C� is NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. jo — FIRST INSPECTION AND FORM MADE BY : . , Date: 0M° t v PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ( /z7119 PROPERTY ADDRESS aeuf 1 - 030 1S PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4 ❑ Yes )i No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION -' I I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes [L No I I PARKS DEPARTMENT 7 ' (Li ) I® 0 REVIEW REQUIRED ( ❑ Yes lI No `\\ N - VA �H 563 \, )5 b I. lay LOCATION OF SIDEWALK gFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ' 4 inches C 5 inches ❑ 6 inches . . AREA TO BE REPAIRED ` 100•0 sq.ft. 4 in. •C2 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ,No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : / N ) Date: 0 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /0 LI &ram 1 o 6 - 0 y 5 - - PARCEL CODE CONTROL NO. 10) Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I ❑ Yes rX No TRIM VEGETATION ❑ Yes g No — N WATER VALVE �' ADJUSTMENT REQ'D — ❑ Yes $.No PARKS DEPARTMENT — REVIEW REQUIRED — — jr Yes ❑ No _ ,fw Y a LOCATION OF SIDEWALK ❑ Front Yard ► Side Yard ❑ Other WIDTH OF SIDEWALK yl 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK SI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I -1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IA.No No.of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : � d- YIE Date: 3'zf/$ PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO 4/z6/C5 -� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / k! r ,- - -�1( - z- tt PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes )No See reverse side for Defect Codes A-F See below for Defect Code G 1 TRIM VEGETATION 1 1 ❑Yes f tNo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes M No 1 l\ , 1 °Z PARKS DEPARTMENT 17.0 1 REVIEW REQUIRED ❑ Yes X No I//4 LOCATION OF SIDEWALK ]Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches 1 ,5 inches ❑ 6 inches AREA TO BE REPAIRED /6 ° sq.ft. 4 in. 21 sq.ft. 5 in, sq.ft. 6 in. l to, CODE F - PATCHES ❑ Yes /,,Pg No No. of Squares with Patches —� CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ; ) , Date: ailn PERMIT ISSUED FORMED POURED COMPLETED .,stis/te, Cm, OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5 3 g� - - I -€PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect r.4 ❑Yes $No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — I ❑Yes No WATER VALVE T ADJUSTMENT REQUIRED 4-0—* ❑ Yes gt No \ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ,0 No LOCATION OF SIDEWALK pi:Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK t4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ,m No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : Date: 01We PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 4,/z6,/r9 -� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - ` IL(lf 13 - 5- ffl - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes gNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes AN() WATER VALVE -- ` ADJUSTMENT REQUIRED ❑ Yes No I 1 PARKS DEPARTMENT REVIEW REQUIRED �\ ❑Yes <M No ' V LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 44 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4/6® sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes A No No. of Squares with Patches -� CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ) Date: 3I&M f d PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 ' I? 1n 1 - - i. - Old 1( ) PARCEL CODE CONTROL NO. CLEAN SIDEWALK _ Type of Defect ❑Yes C No e See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — ❑Yes (Et No WATER VALVE ADJUSTMENT REQUIRED �4 ❑YesnNo — , PARKS DEPARTMENT REVIEW REQUIRED 1 � ❑Yes tINo i /A - LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK fg 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK h 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes rK No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : Ii i Date: �/ PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO (p�/Z6/1 9. SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS -1`1 a z Z.4 Emzetki Est a PARCEL CODE CONTROL NO. 1 4. K v Type of Defect - `s' i \" See reverse side for Defect Codes A-F CLEAN SIDEWALK ' ; ` See below for Defect Code G e ❑ Yes ( No r. �� I�_ n { li ‘ Z. — TRIM VEGETATION 4 fV —1 .a ;I �T, g� Yes p No IA ❑ -- i ' I ,1 WATER VALVE '5' ,� ADJUSTMENT REQ'D I Yes ❑ No i r . 1 re:if �� ," �� PARKS DEPARTMENT ,`' p �� 4, REVIEW REQUIRED Ems_ _ • � S tt9' � El Yes pLi�� No ii- ' \ --) P ''� tGds t� �1 "io' 1 ) --. , 1 1 1 LOCATION OF SIDEWALK (J Front Yard . 0 Side Yard 0,Other Y _ WIDTH OF SIDEWALK ❑4 Feet El 5 Feet ❑ 5.3 Feet 0 Other ._,, DEPTH OF SIDEWALK 1 4 inches ❑ 5 inches ID 6 inches — AREA TO BE REPAIRED Sc (-=sq.ft. 4 in. sq.f#. 5 in, sq.ft. 6 in. ° 5°I,C A CODE F - PATCHES ❑Yes 0 No No.of Squares with Patches CODE G 1 6f�)eY�-em ��d -o® �\i:=� �: «v�'a� our- `aY'��1 Ems€ sa _ _ `f �. .1. 3E:‘x�- , L-i s rfi .' 3: ?,� ,1,L.i At . s� NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : il;g- 'NI Date: 4- �1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM >O$®a PROPERTY ADDRESS I v - 0/7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect G. ❑Yes $No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — 1 ❑Yes to WATER VALVE JI ADJUSTMENT REQUIRED �— --► ❑Yes J No — 1 PARKS DEPARTMENT copit..eurr Nor svEDREVIEW REQUIRED 2 ❑Yes No La] 1//) ,A,Z.:7/6.7/11M t G'A i LOCATION OF SIDEWALK ) ' Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK jg 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK S 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 96;0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in - CODE F - PATCHES ❑ Yes LhNo No,of Squares with Patches p (LI) 0Oif CODE G - SA c �� -�s,� � V � ;?Pr: �vs I/ i 1. '�v2&S' arty t,� G� � NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : �► '' Date: _ frig._ PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO 5/2//1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS o K.? - 4' 35 t 5 -3A-- 2-Z 1 - 05,E , -- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑ Yes CNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes g No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No I I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes t-Vz.) 3 ? LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes C 'No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3"°3 i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS o PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes XNo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes I No '11/4t WATER VALVE ADJUSTMENT REQUIRED ❑Yes No • PARKS DEPARTMENT — REVIEW REQUIRED Yes ❑ No A VA c LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK I ®4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 25.g sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes V No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : (TS°'? Date: 4 sL - l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO IF t SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS CAM -g Ave-, ✓ - Or=12-C, - OO 1 PARCEL CODE CONTROL NO. Type of Defect ¢ CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes Na See below for Defect Code G TRIM VEGETATION ❑Yes No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED 5%1' ❑Yes No — — A4. 4.1 5 0 LOCATION OF SIDEWALK i0Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Ol 5.3 Feet ❑ Other DEPTH OF SIDEWALK IA 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED `t g sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes INo No.of Squares with Patches — CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : `13 Date: 4 ' 2- PERMIT ISSUED FORMED POURED COMPLETED p„,4_,-- CITY OF WATERLOO — 'V SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �.64 e a gb'' > - -Z - 3 ' \-7 _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes ` lo See reverse side for Defect Codes A F _ See below for Defect Code G TRIM VEGETATION ❑Yes . iX.KNo WATER VALVE \ 1 JI ADJUSTMENT REQUIRED .4.-0—► ❑Yes No — PARKS DEPARTMENT REVIEW REQUIRED — - _ ❑Yes J No A \ L.s� _ LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 26.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes llo No. of Squares with Patches- CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : L t3\11)"5 Date: 4 eZ. - I PERMIT ISSUED FORMED POURED COMPLETED GITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 5(4/1 PROPERTY ADDRESS l c 4" t -3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' 15kNo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION — I I ❑Yes WNo WATER VALVE N ADJUSTMENT REQUIRED El Yes AINo I I PARKS DEPARTMENT _ REVIEW REQUIRED 'a',/ E'Yes ❑ No A Sst LOCATION OF SIDEWALK A,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK IN 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Al•D ✓sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches- - CODE G NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: 4 - 18' PERMIT ISSUED FORMED POURED COMPLETED 404 CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS S2- R - V e c_55to - - Zoe _( QL r7 — PARCEL CODE CONTROL NO, CLEAN SIDEWALK — Type of Defect ❑Yes X No See reverse side for Defect Codes A-F See below-for Defect Code G TRIM VEGETATION — ❑Yes No WATER VALVE ADJUSTMENT REQUIRED 411-0-10- ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED — LI,l Yes ❑ No A 4.o - Ca LOCATION OF SIDEWALK ;8 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet yt 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2(.2 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches- — CODE G - NOTE:Areas marked with an"F'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Sib 5 Date: 4-2-_ l� PERMIT ISSUED FORMED POURED COMPLETED -- CITY OFWATERLOO R"ks6 -- SIDEWALK REPAIR SURVEY FORM Do�� "g co QS "ROPERTV ADDRESS G ,� ✓ S,((,I PARCEL CODE CONTROL NO. 5� 1/i9 Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes 0.No TRIM VEGETATION t ❑Yes X No --► j WATER VALVE j uD ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED � /' ❑ Yes No it f' i1 8,31 �.Z LOCATION OF SIDEWALK .Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 5.3 Feet ❑ Other -` DEPTH OF SIDEWALK T4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED y3D sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. MEM CODE F - PATCHES ❑Yes KNo No.of Squares with Patches -- CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 3flJ Date: 4 'Z PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO "06 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7/ ( nybeil Vc1,13 - 0I - Doti }F PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect G ❑Yes 16 No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes ,lNo WATER VALVE 1`At J/ ADJUSTMENT REQUIRED � --► ❑Yes jg No _ PARKS DEPARTMENT REVIEW REQUIRED — • ❑Yes Or No 411 9e6 ' LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ? •® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes KNo No.of Squares with Patches — CODE G - NOTE :Areas marked with an'eF" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: gat"IX PERMIT ISSUED FORMED POURED COMPLETED — 13 �a CITY OF WATERLOO 5I 19 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 735" na..trbc// — F913 -3'1- aoi - 001 lot F, v3 PARCEL CODE CONTROL NO. Type of Defect A See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes No TRIM VEGETATION _ \t, "3 ❑Yes I�No • .411-0-- lieWATER VALVE I m ADJUSTMENT REQ'D ❑Yes (No f J1 1S.6 ;(� PARKS DEPARTMENT /3(�' ��� REVIEW REQUIRED ❑ Yes 10 No • rw,./4/7•A7,1 • / 5.„ n 1 ) DI c),„,,, ,..*Ak 0 S (.3%.re.f (a el pi.vi Avc. insin(Cce di" 0e.,J co".crci-e, — LOCATION OF SIDEWALK 54 Front Yard . ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet M 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK CA-4 inches NI 5 inches ❑ 6 inches AREA TO BE REPAIRED 34.O sq ft. 4 in. to S•.O sq.ft. 5 in. sq.ft. 6 in. C 3 CODE F - PATCHES ❑Yes VI.No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D B J. .-/L Date: yo2-/g PERMIT ISSUED FORMED POURED COMPLETED 'SA'''. f,- CITY OF WATERLOO — t SIDEWALK REPAIR SURVEY FORM 41/ PROPERTY ADDRESS ,2 Da- D 51/.? - - 1 - ®J i•� 1 ` — PARCEL CODE CONTROL NO. Ai 4...,, Type of Defect - ,,^ CLEAN SIDEWALK See reverse side for Defect Codes A-F, El fires No See below for Defect Code G I _ I TRIM VEGETATION ❑Yes fei No t — WATER VALVE ©\ . i,.L , ADJUSTMENT REQD I ❑Yes X No 1 PARKS DEPARTMENT — a ,o REVIEW REQUIRED 5.0' �At_._ ❑Yes No - 1E z H - opf.,J I - LOCATION OF SIDEWALK E Front Yard X Side Yard ❑ Other WIDTH OF SIDEWALK 14 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK NI 4 inches + 5 inches ❑ 6 inches I <>' — AREA TO BE REPAIRED /aaa° sq.ft. 4 in, Li I•a sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes pl_No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : x -1-5- Date: 3-- —is PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO s72 747 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 02,233 Cak5 pelt I3 -33- di/ - 047 ' l 06 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK -- ❑ Yes Xi No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes jNo WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes JZ No _ I PARKS DEPARTMENT ( ) ( ." j REVIEW REQUIRED b 1r® .? ❑ Yes jJ No — — dig 5.1` y.o` —�.0' WA WI ri I Ft B 1 t Ca5/c� LOCATION OF SIDEWALK IX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK o 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ( 4 inches ® 5 inches ❑ 6 inches AREA TO BE REPAIRED ° . sq.ft. 4 in. y 8. 0 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 3J}3 7t Date: /r PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — cAfk SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0/.2Lid o73 tayer q( - 2 O - oo7 I fly — PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ►+ No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION — ❑Yes AT No WATER VALVE t�I ADJUSTMENT REQUIRED ❑Yes XI No — \" I�1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes g No LOCATION OF SIDEWALK L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [k4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ®' 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : Tr. Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO T ...... SIDEWALK REPAIR SURVEY FORM ®u LtS c_o PI' 9 8 R5 PROPERTY ADDRESS 9 c) -°'' A t ✓ 0 ,--5 ,34 -22-, -0c, I z c-) 54-fS PARCEL CODE CONTROL NO. -' -i- S.) 512 M — c. Type of Defect ..... See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G I ❑Yes X No TRIM VEGETATION 0 ❑Yes J 'No — ....-0-4,.. 134 3 ri? 3 WATER VALVE i ' . ADJUSTMENT REQ'D CI Yes R No ell PARKS DEPARTMENT ® REVIEW REQUIRED — — — ❑Yes 1No Azt,„ LOCATION OF SIDEWALK ikl Front Yard • ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ► 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I72.0 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes X No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Z ' Date: 3-5'2.—` PERMIT ISSUED FORMED POURED COMPLETED ak CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS j cam\- ‘-'5 -36 -Z03 - 0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 I ❑Yes No WATER VALVE i JI ADJUSTMENT REQUIRED —► ❑Yes A,No — PARKS DEPARTMENT REVIEW REQUIRED at?` ❑Yes No A VA L� t51& LOCATION OF SIDEWALK Ng Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ( 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 •2 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes l No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1-2 Date: •2 - t PERMIT ISSUED FORMED POURED COMPLETED CITY OF W; TTERL•O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i 3 0 cU d tA c- -, t,3 -3 Z0. a c�1 PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G 0 Yes XI No TRIM VEGETATION \'� ❑Yes No AZO—* I(� WATER VALVE 8. ADJUSTMENT REQ'D ❑yes XI No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK rpC4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 •? sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 7-5 Date: 2 - PERMIT ISSUED FORMED POURED COMPLETED ,"/ CITY OF WATERLOO ' SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS ,2 A I.,,b>'g. C,r ( 3 -3 - o -o O �.` PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect 4 ❑Yes X No See reverse side for Defect Codes A F — See below for Defect Code G I TRIM VEGETATION I I ❑Yes g No WATER VALVE ADJUSTMENT REQUIRED �Q-•► ❑Yes ANo — /04 _ PARKS DEPARTMENT REVIEW REQUIRED 7- �, il� ❑Yes No % %' -7.3° 6.1 — — WIMIIIIMEBOININIM 5 0 o� 60114,11)/4 t r. LOCATION OF SIDEWALK TAFrontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ,5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches 1%5 inches ❑ 6 inches / e .f AREA TO BE REPAIRED 77 0 sq.ft. 4 in. 146' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G - _ NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM � , PROPERTY ADDRESS Z--5 Cow--o I c-R , 13 -3 - v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Xi No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 'F No t J/ WATER VALVE .4—Q-+ ADJUSTMENT REQUIRED ❑Yes IX No PARKS DEPARTMENT REVIEW REQUIRED tXYes ❑ No A 172 c..c.)Lovutri� LOCATION OF SIDEWALK in Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 115.3 Feet ❑ Other DEPTH OF SIDEWALK I4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED (PI•7 'sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No. of Squares with Patches CODE NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ( Date: 4 ® PERMIT ISSUED FORMED POURED COMPLETED CITY Of WITER2.0 i \ SIDEWALK REPAI SURVEY FORM v ROPERTY ADDRESS za A- Co k. L/ ✓ . PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK • See reverse side for Defect Codes A-F Yes o See below for Defect Code G I TRIM VEGETATION ;� ❑Yes lNo t �— ; <<. WATER VALVE / \ ADJUSTMENT REQ'D +r I ❑Yes No ` . i I PARKS DEPARTMENT — I REVIEW REQUIRED • - - - - ❑Yes No LOCATION OF SIDEWALK ra Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet K5.3 Feet ❑ Other DEPTH OF SIDEWALK XI 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 2Z•0 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes pi No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : tSb Date: 4-S PERMIT ISSUED FORMED POURED COMPLETED CFrY OF WATERLOO SIDEWALK REPAIR SURVEY FOR" r 6kg. PROPERTY ADDRESS C-C - g- PARCEL CODE CONTROL NO. -' CLEAN SIDEWALK Type of Defect See reverse side for Defect Codes A-F El Yes jg No See below for Defect Code G TRIM VEGETATION 1 ❑Yes No 1` 1 JI WATER VALVE ♦. , ,,_,_ ADJUSTMENT REQUIRED ❑Yes g No 1 I PARKS DEPARTMENT REVIEW REQUIRED 2 ❑Yes ]No LOCATION OF SIDEWALK X Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet IX 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 2.1 sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes -- [ No No. of Squares with Patches - CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 �} S Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A F _ See below for Defect Code G 1 TRIM VEGETATION j l ❑Yes No t WATER VALVE ADJUSTMENT REQUIRED ❑Yes pcNo \. j 1 PARKS DEPARTMENT REVIEW REQUIRED qr3 Yes ANo A A VA VIA ,5 9.3 _ LOCATION OF SIDEWALK jg Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK 0K 4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED 13- isq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES LI Yes No No.of Squares with Patches CODE G - _ NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : ` B Date: 4-s P -- PERMIT ISSUED FORMED POURED COMPLETED CITY' OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t l - t - , -51; PARCEL CODE CONTROL NO. ,/: ` CLEAN SIDEWALK Type of Defect ❑ Yes XNo See reverse side for Defect Codes A-F J See below for Defect Code G J TRIM VEGETATION J ) ❑Yes Ig No WATER VALVE ADJUSTMENT REQUIRED 4-0 El Yes iNo J % \ J J 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes XNo C.- 1A LOCATION OF SIDEWALK Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4.3 1sq,ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes yl No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED I OF l CITY' OF WATERLOO SIDEWALK REPAIR SURVEY FORM 61' ) ‘ PROPERTY ADDRESS S\&- C 1r \: b V 5\3 -3L.— ®1 - -7 / —i3 PARCEL CODE CONTROL NO. / y .. ACLEAN SIDEWALK '"^ Type of Defect ❑ Yes IX No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I I Yes ❑ No WATER VALVE f`-- ' k ADJUSTMENT REQUIRED a �°g' N ❑Yes No I PARKS DEPARTMENT °it t REVIEW REQUIRED IAa0 , v P 4'c % ,`- r'� a®t s� 4, ,Z Yes _ ' (J��/� ' .`' rr- f1 '3f,. ..sir. � VGA 0 V / 3 d✓V�i.s�✓�.a IA. �lryYm 4 Ys LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ig.5.3 Feet ❑ Other — DEPTH OF SIDEWALK ig 4 inches ❑ 5 inches ❑ 6 inches I AREA TO BE REPAIRED i .8 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ 2 CODE F - PATCHES 0 Yes 14No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : ?-3 .t�D C7 Date: PERMIT ISSUED FORMED POURED COMPLETED c CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS \ a rat, 5011 b\LI? -3 -ZU`1 - col v Z _ PARCEL CODE CONTROL NO. i "7, CLEAN SIDEWALK Type of Defect _ ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes `No I I 5.c6 PARKS DEPARTMENT REVIEW REQUIRED 3 Yes ❑ No At + r gq� 4.0 ) 1 1.3 r , �, 6 \ . A;TAA LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard IA Other B' L WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 4,.5.3 Feet D Other — DEPTH OF SIDEWALK PIK4 inches ❑ 5 inches ❑ 6 inches 0'1 AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: 4' 2 • l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS g1 i3 -33 - HO - ®a Z1 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes g No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes 1No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I No LOCATION OF SIDEWALK °i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK C44 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK V 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I Li •Li sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �i5 ♦ Yt Date: 3-ZHS PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM +0 /z-5,, PROPERTY ADDRESS 1602 De\otne. PARCEL CODE CONTROL NO. Type of Defect l 6CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes 'No See below for Defect Code G TRIM VEGETATION I ❑ Yes 11. No -' WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes X No — I I I PARKS DEPARTMENT REVIEW REQUIRED X Yes ❑ No 414 De164.11 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK l 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5a.0 sq.ft. 4 in sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : 1 �Z1 /Date: PERMIT ISSUED FORMED POURED COMPLETED 14 CITY SF WATERLOO \v SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .270'1 DDP//%e 'fi3 - 7?- 9a. - ow _ _, 2il. PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A F ❑YesI No See below for Defect Code G TRIM VEGETATION 0 it ---v-C.- %) ❑Yes r. No — WATER VALVE ~©\ o � ADJUSTMENT REQ'D I (4 ❑Yes $No i',' PARKS DEPARTMENT REVIEW REQUIRED y,S7 ❑Yes No - 7 J 1J _ be.v. _ LOCATION OF SIDEWALK X Front Yard . ❑ Side Yard ❑ Other WIDTH OF SIDEWALK %4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches g 5 inches/ ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. i 9° a sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 1$ No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D 3 i- T e Date: 3 a/- PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d765 e,k0,A, �9 I3 - 3 3- y45" - O jf ZL,17 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ' O. No See reverse side for Defect Codes A F S See below for Defect Code G I TRIM VEGETATION -- ❑Yes EN() 1 WATER VALVE ADJUSTMENT REQUIRED =uQ� ❑Yes 54 No _' \ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No �l d . . LOCATION OF SIDEWALK 11 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK [cP4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 0.0 v sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes i! No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R +. srg Date: 3-.20-/$ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO zc"\\ SIDEWALK REPAIR SURVEY FORM — id PROPERTY ADDRESS 816; — P i i 3 - S 5- I Z4f, - CO.S V.% Z! PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A ❑Yes :"Ej No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes :1K1.No 't WATER VALVE — ADJUSTMENT REQUIRED `` ❑Yes ` �No a � li 1 I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes i FNo Ikk/ b 1 .ram / - l_ i LOCATION OF SIDEWALK 8 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet tf'5.3 Feet ❑ Other DEPTH OF SIDEWALK N,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2-5.5 }''sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes l No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels.• t FIRST INSPECTION AND FORM MADE BY : I SS - ftS Date: ti l� f r — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO b/26/ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS <32a i _ e,1t 1 , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect . ❑Yes NNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION l ❑Yes X No At if WATER VALVE ADJUSTMENT REQUIRED 4-0 ❑Yes XNo �j\ 1 PARKS DEPARTMENT REVIEW REQUIRED %Yes ❑No 731 _)?*n e LOCATION OF SIDEWALK k Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK NIr 4 inches f +5 inches ❑ 6 inches AREA TO BE REPAIRED 711,7 sq.ft. 4 in. 2-3-1 vsq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes XNo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : fI 1 c ') Date: LlAO) PERMIT ISSUED FORMED POURED COMPLETED CITY Cr WATE L.O \16 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `'' • 3Ci6 41Z(0 oO 7 v ` PARCEL CODE CONTROL NO. Type of Defect % i — See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes L7 No __---- I TRIM VEGETATION ❑ Ji..No — N WATER Yes VALVE �, i, ADJUSTMENT REQ1D- — J ❑Yes No No C--) PARKS DEPARTMENT — REVIEW REQUIRED xrYes ❑ No t,J0 ci • v - 111 _.; - LOCATION OF SIDEWALK Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet aj 5,3 Feet ❑ Other — DEPTH OF SIDEWALK I14 inches , ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F PATCHES ❑Yes ! 'No No.of Squares with Patches CODE G NOTE:Areas marked with an".F"maybe repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : <) Date: AL/ / PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM /zoll1 PROPERTY ADDRESS (t -r €\1()(1 V('r PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A ❑Yes f:No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes Er No '' WATER VALVE ADJUSTMENT REQUIRED �J W ❑Yes ;® No — � i PARKS DEPARTMENT I 1 REVIEW REQUIRED �` ' ❑Yes iNo ,zrM v v /. LOCATION OF SIDEWALK N Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 1.5 Feet ❑5.3 Feet ❑ Other -' DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 29.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Jv No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : 1115 S Date: (VW iO /8 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO bm< SIDEWALK REPAIR. SURVEY FORM - PROPERTY ADDRESS 1c)c f a.< < PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect rk ❑Yes b'No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes No — WATER VALVE — 1 ADJUSTMENT REQUIRED �--a ❑Yes FfNo I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ;1 ;No — . t i %f LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard , ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet £1'5.S Feet ❑ Other DEPTH OF SIDEWALK • t.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5° 1 x sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes clErNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : C RS Date: #018 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM Izobak PROPERTY ADDRESS airs s - SS- lS I - , PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑ Yes NiNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑Yes )4INo 1 if WATER VALVE ADJUSTMENT REQUIRED I I ❑ Yesw No l I PARKS DEPARTMENT r REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK 1 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 1, _5 Feet ❑ 5.3 Feet ❑ Other -- DEPTH OF SIDEWALK V4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 29.0 vsq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : t. Date: 4/1t 4 3 PERMIT ISSUED FORMED POURED COMPLETED 2\ CITY OF WATERLOO — vole SIDEWALK REPAIR SURVEY FORM OP PROPERTY ADDRESS Ci Pi E°I. - 35" - 13i - oo6 `f_, - PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A ❑Yes ,IX'No — See reverse side for Defect Codes A-F See below for Defect Code G j TRIM VEGETATION — j ❑Yes No WATER VALVE — t JI ADJUSTMENT REQUIRED ;-0— ❑Yes F+ No 1 PARKS DEPARTMENT REVIEW REQUIRED 3' ❑Yes X.No — 1 6.93 — — — _ (774 ..._ / \ LOCATION OF SIDEWALK R Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet k 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 31. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes X No No. of Squares with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : 11'[16 .g Date: 611/10i 0 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF W:TE L.O SIDEWALK REPAIR SURVEY FORM ___S:t_ ____— PROPERTY ADDRESS .7 L. e./A 1e r Bev' ' 3'5 p 13 o 007 ,, PARCEL,CODE CONTROL NO. Type of Defect A `" See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes 41No TRIM VEGETATION if ❑Yes EA No J Ie0. ? WATER VALVE 1 ; ,-j ADJUSTMENT REQD ❑Yes g No II 1 ° f Sd�'' j PARKS DEPARTMENT . 5.8 -5-3 REVIEW REQUIRED ❑Yes tv"No IP LOCATION OF SIDEWALK LE4 Front Yard , 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet El 5 Feet ❑ 5.3 Feet 0 Other DEPTH OF SIDEWALK IQ'4 inches , p 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 ;J '"sq.ft 4 in, sq.ft. 5 in, s .ft. 6 in. q CODE F - PATCHES ❑Yes CAI`No No.of Squares with Patches -- CODE G - NOTE:Areas marked with an"F"maybe repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. Y FIRST INSPECTION AND FORM MADE BY :• 11/1. it � l d.. Date: lc— PERMIT ISSUED FORMED POURED COMPLETED P or CI r Y OF WATERLOO SIDEWALK REPAIR SURVEY FORM /\ PROPERTY ADDRESS /607 j o i t/ -4753 PARCEL CODE CONTROL NO. — CLEAN SIDEWALK Type of Defect , (' ❑Yes J,No — See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION _ I ❑Yes N o -\4\ - ATER VALVE Zee � r — t AD( ENTREQU ,)IRE -k,---0-0- iLi'� (-4' ' Yes ❑No 0 A 15,c) r- Ili ‘irl' _ \ ' tri: ,,,C (51' 1 PARKS DEP• :lr.• ENT lEW REQJ1PED` 6c6c) \II', ° ' Yes A No IA WNW \e'. '''' 1 \ ,/ , ' if _ . . _ ,v _ paver LOCATION OF SIDEWALK ;NI Front Yard ❑ Side Yard , ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet A 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK jg1 4 inches 711.5 inches ❑ 6 inches AREA TO BE REPAIRED . J'5 'sq.ft. 4 in. 5 ' sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - p.9 - o (l 619 470 NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : MA 9/E0 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS /Oa— �' — 13- 5 - I39 q PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G J TRIM VEGETATION 1 ❑Yes A,No 1` 1 JI WATER VALVE f-0 ADJUSTMENT REQUIRED ❑ Yes KNo J . 1 � -- PARKS DEPARTMENT bj�5 1 O I c5LINO QUIRED �® y Yes Sh LOCATION OF SIDEWALK ®i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet $ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ),4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED "< -' �sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes A,No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : A, I Date: M40 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM (, PROPERTY ADDRESS y -3 - NI\ PARCEL CODE eCONTROL NO. C EAN SIDEWALK ofDefect ❑Yes No _ Se everse side for Defect Codes A F See low for Defect Code.G I TRIM VEGETATION ".1.--)C,-,Y\C \') / I ❑Yes g No -- WATER VALVE t if , ADJUSTMENT REQUIRED ---;,,--43)— kepi ❑Yes 4 No I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑1ll0 _ ale . \rdil _ — 2® — — ,, W N A _ *-e" 4 \ 1 LOCATION OF SIDEWALK 0- ont Yard ❑ Side Y d . ❑ Other — WIDTH OF SIDEWALK a 4 Feet g 5 Feet ❑ 5. Feet ❑ Other DEPTH OF SIDEWALK ig 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAI" D `"d` .(-)\'sq.ft. 4 in. sq.ft. 5 in sq.ft. 6 in. _ CODE F - PATCH S ❑ Yes N.No No.of Squares with `etches CODE G - NOTE:Ar--s marked with an"F"may be repaired by patching.All other-areas sha be repaired by re Instruction of full sidewalk panels. FIRST 14 SPECTION AND FORM MADE BY : MAW Date: PERM! ! ISSUED FORM D POURED COMPLETED CITY OF WAATERL•O SIDEWALK REPAIR SURVEY FORT /zr j •'ROPERTY ADDRESS IO7 - weu P r� 11 — 1 - 5- I3 - ev& / 7 it PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK - See below for Defect Code G l ❑Yes )No — \r Imo\ TRIM VEGETATION ❑Yes egi No _T.71 ,.. 40-0..... WATER VALVE 1 \ ADJUSTMENT REQD 1 ❑Yes No i1 PARKS DEPARTMENT R REQUIRED — — — — Yes No — 5 j W . LA, LOCATION OF SIDEWALK Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet FL5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 14 inches . ❑5 inches ❑ 6 inches AREA TO BE REPAIRED 27.0 `sq.ft, 4 in. sq.ft. 5 in, sq.ft. 6 in, — CODE F - PATCHES ❑Yes r No No.of Squares with Patches CODE G - NOTE =Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : AA,6 ! Date: VA PERMIT ISSUED — FORMED POURED COMPLETED CITY OF W:\TEr?=•O ,x/WHL-, ,% SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - _ & —3 133s 07 , PARCEL CODE CONTROL NO. - A Type of Defect CLEAN SIDEWALK - - See reverse side for Defect Codes A-F See below for Defect Code G ( ❑Yes No ( I I TRIM VEGETATION '�� c El Yes 0No — WATER VALVE Ie 4,\ l ADJUSTMENT REQ'D❑Yes J No — . PARKS DEPARTMENT 6 .p," , REQUIRED — �,1 ,(Yes ❑ No j, f ' & �`' — • c.;; e:i Os 'cif' _./ Dvoies— — LOCATION OF SIDEWALK Front Yard , ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 71,5 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK 17;4 inches . ❑5 inches ❑ 6 inches AREA TO BE REPAIRED 10 I_C sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes ,CNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : P % a Date: 4- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ®$ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l Devo15/ e. 511.3 -33- Lio?4 - oso �� 4- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes A No PARKS DEPARTMENT REVIEW REQUIRED -- ,> ° Yes CI No LDGV °re- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK CAl 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED aQ.° sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in, CODE F - PATCHES ❑ Yes g No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 3 4- T5 Date: -o22—ft -- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Ljf on.SA t sciI3 - y - 03( r PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect G ❑Yes KNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — El Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes g No _ I I I PARKS DEPARTMENT REVIEW REQUIRED — ,7 ' ❑ Yes 1No 101. evoPsl;re LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK f .4 inches :5 inches ❑ 6 inches AREA TO BE REPAIRED 19.a sq.ft. 4 in, tI4* sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : cVD 1r P Date: rc!' PERMIT ISSUED FORMED POURED COMPLETED — 1 % CITY OF WATERLOO 3 ® 1p SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Dedvon5 .;te Q 1.3 - - 11,26 ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION •— I I ❑ Yes pj.No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes l No I . PARKS DEPARTMENT REVIEW REQUIRED -- a ❑ Yes S1 No r LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 ,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 a•®' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes yj No No. of Squares with Patches —' CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : DB Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM ID' J PROPERTY ADDRESS lisp; PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes X No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION —' ❑ Yes XNo WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No — I I PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes Xi No — Dto 5 ,ivy LOCATION OF SIDEWALK 'g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IX 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK !4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ao.® sq.ft. 4 in. _ sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ig No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : 4- -re Date: ® PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO o SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS LIM Dtvonshire, 13 -33- y77 - 007 ‘/ 21-3 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes :4 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes X No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes 14 No I PARKS DEPARTMENT REVIEW REQUIRED b ❑ Yes X No 1 aK LOCATION OF SIDEWALK EX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IX 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ea°•0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes X No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. - FIRST INSPECTION AND FORM MADE BY : 74 Date: 24`/g PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - Z :\ SIDEWALK REPAIR SURVEY FORM \v, - PROPERTY ADDRESS 1495 Dega1454ire 113 -33 - 427 - Oo 0, v. � PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect c ❑Yes IX No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I El Yes X No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes PI No I � PARKS DEPARTMENT REVIEW REQUIRED• — , 5,4 Yes No Ov- bk LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IA 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /a'°-° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I .No No.of Squares with Patches '- CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 13 J- Date: 3`2Z `/® PERMIT ISSUED FORMED POURED COMPLETED —' 1 g CITY OF WATERLOO (D SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'I ( o 4 ;re 4i3q/3 - OO Z ,r PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes l No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes N'No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes g No _ I PARKS DEPARTMENT REVIEW REQUIRED ok ❑Yes No wd De,vo4 5 LOCATION OF SIDEWALK CIA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK cx 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1Aj,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I ._ � sq.ft. 4 in. sq,ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes I No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � 4 Tf Date: 3 2Z-IT PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (® uonckar PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect El Yes fX1 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION '— I I ❑Yes IX No WATER VALVE ADJUSTMENT REQUIRED n] ❑Yes N No _ I I I PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes 'gj No ev s,hir LOCATION OF SIDEWALK N.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet El 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED '6'0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : VB T Date: "® PERMIT ISSUED FORMED POURED COMPLETED — 3 `$ CITY OF WATERLOO I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS '03 Q u on O r e, f3 - - 42-7 - 00 � Z 7 �)+ I .r PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes [X No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes ix No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes fNo r, I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes yI No :t)edvo4 Ate, LOCATION OF SIDEWALK XFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ($4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches IX5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 9I• sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes (ANo No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �1 FIRST INSPECTION AND FORM MADE BY : D V Date: 3 -" PERMIT ISSUED FORMED POURED COMPLETED .�� `� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS LIG pet/wkly.. '81/3 - 3 - liA _ 0Li® - PARCEL CODE CONTROL NO. Type of Defect A „6,1 `� CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes [7 No — See below for Defect Code G ;-: TRIM VEGETATION ' ❑ Yes in No 0 If .. _ t ::-4—► �` \ cl' -4 WATER VALVE — if 1\ ADJUSTMENT REQD Ill Yes XNo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes J INo _ Teener _ LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK (x 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches X 5 inches ❑ 6 inches — AREA TO BE REPAIRED C a°0 sq.ft. 4 in. _ sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes S.No No.of Squares with Patches CODE G - _ NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : L4 rE Date: /8' PERMIT ISSUED FORMED POURED COMPLETED 3A CITY OF WATERLOO IC' SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS tt 51 it PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes E No WATER VALVE N AD STMENT REQUIRED Yes :'❑ No I It;` ', PARKS DEPARTMENT REVIEW REQUIRED .., (0- 5` 1„r) (New) 9.4c Yes X No e - /.M i// ! e,van5 A;0e. LOCATION OF SIDEWALK gI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK g 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK g,4 inches , 5 inches ❑ 6 inches AREA TO BE REPAIRED ® .,F 3 .-- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : bt3 TeDate: 31-id PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS evd45h/ie, 1 ?/j -Y3- V - oi 5 - - PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ; ❑Yes tg No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED �—Q—► ❑ Yes si No 101 I I PARKS DEPARTMENT REVIEW REQUIRED — g ❑Yes Ica No 1.4' bevoil5 00 LOCATION OF SIDEWALK l*Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IX 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK V 4 inches jg 5 inches ❑ 6 inches AREA TO BE REPAIRED L 7• sq.ft. 4 in. 012.0 sq.ft. 5 in. sq.ft. 6 in. ° CODE F - PATCHES ❑Yes g No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 13 4- Date: 3-zI/e PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 555- Detion5 ir 1 r3 -J3- 106 - Ors" / PARCEL CODE CONTROL NO. Type of Defect A G See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes No V � TRIM VEGETATION 1 ❑ Yes ACT No W VL AD ATERJUSTMENTAVE REQ'D 6.4 El Yes g No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No W,1 'atidn5h,rc. LOCATION OF SIDEWALK XI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK [g 4 inches X 5 inches ❑ 6 inches AREA TO BE REPAIRED °°1 sq.ft. 4 in. 3 , sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes V,No No.of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3 1"/$ PERMIT ISSUED FORMED POURED COMPLETED k CITY OF WAT ERL�•• -- � \\°\ SIDEWALK REPAIR SURVEY FORM "ROPERTY ADDRESS it L Io ` PARCEL CODECONTROL v V 9ONTROL NO. 1 - a, W20- a� \ — Type of Defect A (S�CLEAN SIDEWALK See reverse side for Defect Codes A-F 1: gib' �e ❑Yes � No See below for Defect Code G �-- I,1� e0,7) S,) — ' 'TRIM VEGETATION ❑Yes 1 .No — a / 5.� -411--a� WATER VALVE i [ \ i ADJUSTMENT REQ D A ❑Yes p No PARKS DEPARTMENT �r � REVIEW REQUIRED VI ^ j 1°3� ❑Yes p No — 66--vo Age- LOCATION OF SIDEWALK Lgi Front Yard , g Side Yard ❑ Other WIDTH OF SIDEWALK fkl 4 Feet ❑ 5 Feet igj 5.3 Feet ❑ Other — DEPTH OF SIDEWALK R14 inches 'gi 5 inches ❑ 6 inches AREA TO BE REPAIRED `4' 2I1°& sq.ft. 4 in. 31 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES CI Yes XNo No.of Squares with Patches — CODE G - O U 5 c (z) 14°1 4"rJ 44 L5 ;✓, �/001 'to <AUe (?j4N1.1:4;r4Gi ca� / S'.7' 1K AA S NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. Ag FIRST INSPECTION AND FORM MADE BY : RI c Date: O.�3/ 5/`b PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO f i�II SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 110 PARCEL CODE CONTROL NO. ACLEAN SIDEWALK Type of Defect ❑ Yes -No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes „,E-etNo ... t WATER VALVE F©� ADJUSTMENT REQUIRED ❑ Yes gNo PARKS DEPARTMENT -� REVIEW REQUIRED ❑Yes `a No E LOCATION OF SIDEWALK r'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Af 5.3 Feet ❑ Other DEPTH OF SIDEWALK rg 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED / ,5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. r FIRST INSPECTION AND FORM MADE BY : 1 Date: 77 PERMIT ISSUED FORMED POURED COMPLETED li,1 ‘1‘ C TY OF WATERLI S J 0 SERE ALK REPAI . SURVEY FORM •ROPER Y ADDRESS I - 41,4 a v 5 5 C5-3 ar-. - 2-_ V- Z 5 7 — PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes 1No See below for Defect Code G 1 — TRIM VEGETATION 2 ❑Yes 1 No _ 0—* WATER VALVE S ADJUSTMENT REQ'D — � � d. ❑Yes V No (c") 4 11 f 7' 1 PARKS DEPARTMENT — REVIEW REQUIRED A“, , _ fr. isr — _ Yes ❑ No 14 V4 / 111:1, 5,e /.5 LOCATION OF SIDEWALK Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK Nyr4 inches ' 5 inches ❑ 6 inches AREA TO BE REPAIRED 9'I.1, sq.ft. 4 in. -g�Q sq,ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S 5 ) Date: 4 e - le PERMIT ISSUED FORMED POURED COMPLETED _ (kr,k 1 Ocd-c, Coo C...- CITY OF WATERLOO 7, \ SIDEWALK REPAIR SURVEY FORM — GROPER T Y ADDRESS a 3O Ea i r(4) G F9/7 -33 - P o - ad if ' Z5 \ PARCEL CODE CONTROL NO. Type of Defect A r 6 I4> • See reverse side for Defect Codes A-F ® a CLEAN SIDEWALK L,See below for Defect Code G ❑Yes g No TRIM VEGETATION \ JI ❑Yes $1 No .44-0.....0. WATER VALVE I ADJUSTMENT REQ'D WI , I ❑ Yes ANo ,1 4 t{ 0/ v S �: PARKS DEPARTMENT 16.7 ` % kt, REVIEW REQUIRED ❑ Yes INo // q -- LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other / WIDTH OF SIDEWALK i,4 Feet ❑ 5 Feet ❑ 5.3 Feet Cl Other DEPTH OF SIDEWALK, 4 inches 5 inches El 6 inches �� AREA TO BE REPAIRED P �• LI y y �t sq.ft. 4 in. , �tII•gsq.ft. Sin. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 1 No No. of Squares with Patches CODE G - i \r. NOTE :Areas marked with an "F"may �be repaired b y patching.All other areas stilt be repaired by reconstruction of full sidewalk panels. — FIRSTJNSPECTION AND FORM MADE BY : DI 4- TE Date:. 3" 22 /g — PERMIT ISSUED FORMED POURED COMPLETED CI OF WATERLOO - SIDEWALK REPAIR SURVEY FORM / PROPERTY ADDRESS c1311 Fa.irw07 / g 7 a -35 - 070 - a/ q ./ Zloo / PARCEL CODE CONTROL NO. / JLEAN SIDEWALK — Type of Defect 6 ❑Yes y No / See reverse side for Defect Codes A-F -- See below for Defect Code G TRIM VEGETATION I ❑ Yes ) No — WATER VALVE a ADJUSTMENT REQUIRED ❑Yes X„,No — `\ I PARKS DEPARTMENT — REVIEW REQUIRED ISV(1)4\ Lk� 3G�(, ❑Yes No — — — — '�y Abcef Lk) 6,� ` rawet ,,. — LOCATION OF SIDEWALK I;g,Front Yard ❑ ide Yard ❑ Other — WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ' ❑ 5.3 Feet ElOther DEPTH OF SIDEWALK ❑ 4 inches X 5 inches, ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. 31.O sq.A. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. _ , FIRST INSPECTION AND FORM MADE BY : r� !Sate-• ®i PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 5/A9f>, PROPERTY ADDRESS .4 ® -2333 filtirw,ty g?/3 -33-ago - o4/ Z(P► PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑ Yes X No See reverse side for Defect Codes A-F See below for Defect Code G — I TRIM VEGETATION ❑ Yes lXNo WATER VALVE N ADJUSTMENT REQUIRED ❑Yes ( No - I PARKS DEPARTMENT b�> REVIEW REQUIRED ❑ Yes XNo _ �• y.®` Y LOCATION OF SIDEWALK X Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK l 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED ,55 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes fX No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : 1) + Date: -® PERMIT ISSUED FORMED POURED COMPLETED CI OF WATERLOO x SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Y-- - ol 3 ( �_r''4)o/ 391.E -33- °No - U®® z .- — PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect A C ❑Yes g No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION — I ❑Yes No WATER VALVE t it ADJUSTMENT REQUIRED —0—► ❑Yes X No _ PARKS DEPARTMENT 3 REVIEW REQUIRED — 59.") ❑ Yes MNo cam) 'VI` - - - - — / \ / Il, ° \ . _ LOCATION OF SIDEWALK l Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches [ '5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. °' 0 sq.ft. 5 in. sq.ft. 6 in. 1 CODE F - PATCHES ❑Yes ►4 No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : a 4. 1-E Date: 3-,22 f g PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO ASP} SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS LC> t ,,-__ - b ‘„3 - 3 - \ v Z.& PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes No See below for Defect Code G TRIM VEGETATION ❑Yes N No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No - I PARKS DEPARTMENT REVIEW REQUIRED ,t1 ❑Yes No A VA 4,E g.cy -` LOCATION OF SIDEWALK 1g Front Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches A 5 inches ❑ 6 inches -- AREA TO BE REPAIRED 20,S sq.ft. 4 in. Z s •0 sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 'b` '> 4-2 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS to -k 9 - - CL1 b PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes lyNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes 11No WATER VALVE ADJUSTMENT REQUIRED ❑Yes VNo 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes isNo 141 '7{ 149 I LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 15 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK y 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 "" sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: "2 ` 1 PERMIT ISSUED FORMED POURED COMPLETED — _ CITY OF WATERLOOliZ71rci SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS I 7-- re,. A -� � r PARCEL CODE t CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No ` I See below for Defect Code G T GETATION A,Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT l REVIEW REQUIRED e �� CI Yes 1% N 1� o \k/WI') g' LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED r- r;) sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES CI Yes No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: it'd PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO(�\i-\\\ SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS PARCEL CODE CONTROL NO. CL -1 EWALK + Type of Defect Yes ,' ❑ No See reverse side for Defect Codes A F — See below for Defect Code G TRIM VEGETATION \ ❑Yes ❑ No WATER VALVE t ADJUSTMENT REQUIRED — 411-41)--10- 0 Yes ❑ No 104 k,,, -c--),-:s, _ ''PARKS DEPARTMENT REVIEW REQUIRED i' o waR, ❑Yes ❑ No — ) i / \ _ rd7C -JC — LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK 114 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches CI 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 ' = 0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - 4.10944,S4t fc9Cer C' NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. ie FIRST INSPECTION AND FORM MADE BY : AAbg6K\ Date: 03 — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORMCz7I PROPERTY ADDRESS I I - - ! - OIL -z-7 PARCEL CODE CONTROL NO_ Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes (No I See below for Defect Code G TRIM VEGETATION I ❑Yes ja No WATER VALVE -4\ ADJUSTMENT REQUIRED � � ❑Yes g No �� I PARKS DEPARTMENT rZ Li-6' REVI 1,REQUIRED ®�\ ® Yes El yg® (Cce-g-' (11 -31 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes AND No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WITERL•O - / \� SIDEWALK REPAIR SURVEY FORM - �V Litz re PROPER ADDRESS 5+ f).0 .35 434 e . .- , 7 PARCEL CODE CONTROL NO. Type of Defect a C CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G 1 LA \ TRIM VEGETATION ® al, ❑Yes No — 10, ,i 4_41),;.. ‘ 4-3 WATER VALVE ADJUSTM alp — �1�- I ❑Yes No J� PARKS DEPARTMENT _ (�,C ��a REQUIRED — — 10 , ® Yes \ ❑ No _ b c � 1,. — A tV — LOCATION OF SIDEWALK .Front Yard . ❑ Side Yard 0 Other — WIDTH OF SIDEWALK ❑4 Feet '5 Feet ❑ 5.3 Feet l Other 511 DEPTH OF SIDEWALK x,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 7 ° L:aq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes 4 No No.of Squares with Patches — CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. l� FIRST INSPECTION AND FORM MADE BY : Date: — PERMIT ISSUED FORMED POURED COMPLETED — 4-3 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM +� ���i� PROPERTY ADDRESS a5-3® !Orig. $9/3 -33- Vol - OO2 m e o PARCEL CODE CONTROL NO. 0769 Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes XNo WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes XNo KS PARKS AREIEWDEP REQUIRED NT y,® ❑ Yes X No G look LOCATION OF SIDEWALK IS Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK IA 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 12 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 16.0 vr. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f3 re Date: 3 PERMIT ISSUED FORMED POURED COMPLETED loi l 'S CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9"3( C(0 ri,A, 46gt3 - - ilai - a 3/ 4 Ze( PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑Yes X No * WATER VALVE 1 JI ADJUSTMENT REQUIRED -:—.Q... ❑Yes No I PARKS DEPARTMENT — REVIEW REQUIRED LA,o ❑Yes No oK A I \ - LOCATION OF SIDEWALK V Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK g 4 Feet El 5 Feet • ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 1 •® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes g No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1)3 4- 71 Date: r P PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �5;37 C0vr 65Q®3 -33- 4j3 - 06 ,1 PARCEL CODE CONTROL NO. Type of Defect CP CLEAN SIDEWALK ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G — I TRIM VEGETATION ❑ Yes J No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes E'_4. No I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No /O•3' 3.9® 111.1 G , LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK eg 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 'i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes l:No No. of Squares with Patches CODE G - llu. na RGie •: ree NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Pa* �,5 Date: 3?"-/ff PERMIT ISSUED FORMED POURED COMPLETED '5147 CITY OF WATERLOO �� I � SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS as/0 (or i, -®33 - yof - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes g No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes g No WATER VALVE I ADJUSTMENT REQUIRED ❑Yes No I PARKS DEPARTMENT REVIEW REQUIRED Lt1 X Yes ❑ No f A (or,i-ct, — LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK L4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED l b4 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes p No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. `� . d®�� FIRST INSPECTION AND FORM MADE BY : '9 5 4- Date: 3 PERMIT ISSUED FORMED POURED COMPLETED � I3 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 10/a'ii PROPERTY ADDRESS 07P16 ; t, PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK ❑ Yes S.Iqo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes ► No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes ►' No I I PARKS DEPARTMENT 1,7 REVIEW REQUIRED ❑Yes N.No 3.1 LOCATION OF SIDEWALK ►. Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches [�5 inches ❑ 6 inches —' AREA TO BE REPAIRED sq.ft. 4 in. I LI• g q sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Df. I- T£ Date: 34471Vg PERMIT ISSUED FORMED POURED COMPLETED `2 CITY OF WATERLOO °\ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,9`�4 G for INA, 6113 -33 -9'0I - Z-0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes X No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ;1' ❑Yes IX No LOCATION OF SIDEWALK 154 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK CX4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED I(•11 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes lA No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : PO TE Date: ig PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO is 21 145 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2$S-.S" (' ariA gq,3 - - (103 - 02 V. - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes XI No See reverse side for Defect Codes A-F See below for Defect Code G _ TRIM VEGETATION ❑ Yes X No WATER VALVE ADJUSTMENT REQUIRED El Yes gNo _ I I PARKS DEPARTMENT `Ja® REVIEW REQUIRED 41.� s � ❑Yes No Glorinek LOCATION OF SIDEWALK X Front Yard ❑ Side Yard LI Other WIDTH OF SIDEWALK iX 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK L 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED °• 0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1)6 °4- TC Date: T124/-18 PERMIT ISSUED FORMED POURED COMPLETED is V'��° CITY OF WATERLOO !O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS g3C®I G/®r;c 9�3 - ?1- g03 - O ILS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes X No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes t-_1 No WATER VALVE ADJUSTMENT REQUIRED j1] ❑Yes X No — PARKS DEPARTMENT REVIEW REQUIRED 11,5 ❑Yes X No //•a' r4/07,1 Gto ' LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK iyi 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. , • 6 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1) fi' TA' Date: 710Z0 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO 16 SIDEWALK REPAIR SURVEY FORMotz"l PROPERTY ADDRESS 026 os Wor �913 - 3.3- 903 - O2 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes v.4 No See reverse side for Defect Codes A-F See below for Defect Code G _ TRIM VEGETATION ❑Yes 1K No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No I I I PARKS DEPARTMENT REVIEW REQUIRED 51 ❑Yes ► No G/ott,a LOCATION OF SIDEWALK EX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK I '4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED 0•® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes g No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D5 f TS Date: Y'2 /g PERMIT ISSUED FORMED POURED COMPLETED ,�16 CITY OF WATERLOO ID SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 622 l oc PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes tg No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes g No WATER VALVE ADJ SQUIRED 'Yes No I �' �e. ;�PA KS DEPARTMENT '-REVIEW REQUIRED k;�. ❑Yes X No W 24. — ri®l, 3.gt ri3plac @ d G tot LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK CX 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 1 S. a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ,1 No No.of Squares with Patches CODE G - _ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : sl�i3 4 Date: 3 245�f� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 12.:it' PROPERTY ADDRESS .Z 6 6(0,i 8 113 -33- 9903 - PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes g No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes I.No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes IgNo PARKS DEPARTMENT REVIEW REQUIRED 1 6 ft LIZ) ❑Yes No ® I /'/"/,4/4 Y7/i - - - OK e t Woe LOCATION OF SIDEWALK (x Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK g,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1g.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED a• sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ),No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � �` Date: 3-26° PERMIT ISSUED FORMED POURED COMPLETED � CITY OF WATERLOO 'O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a )(a ; i3 -3 - yo2 - OC ;`- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes IX No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes g No WATER VALVE ADJUSTMENT REQUIRED ]V Yes c )LNo n., PARKS DEPARTMENT , REVIEW REQUIRED rt,%n h ❑ Yes X No 3.81 ._ or fa. LOCATION OF SIDEWALK TA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK f4 Feet ❑ 5 Feet ❑ 5.3 Feet LI Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 5.•a 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes LI No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 4 T Date: 3' °f0 PERMIT ISSUED FORMED POURED COMPLETED 64-8 CITY OF WATERLOO ,®iz.�/h& SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Xo LiI G t ( R13 -33 - 4103 - Dig ,„ PARCEL CODE CONTROL NO. Type of Defect l )0 See reverse side for Defect Codes A-F m(5 -* CLEAN SIDEWALK See below for Defect Code G ❑ Yes tk No TRIM VEGETATION ❑ Yes tij.No N WATER VALVE ADJUSTMENT REQ'D ❑ Yes % No i®°� 1.0.9 PARKS DEPARTMENT g' REVIEW REQUIRED • — — — ❑ Yes VNo � 5„ G crick_ LOCATION OF SIDEWALK Front Yard j1 Side Yard ❑ Other — WIDTH OF SIDEWALK 14,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 6•® s .ft. 4 in. 79. q sq,ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : a d E Date: 3 ® a I -16 PERMIT ISSUED FORMED POURED COMPLETED o� CITY OF WATERLOO ,J � SIDEWALK REPAIR SURVEY FORM — 191 PROPERTY ADDRESS 6 r - /A GK y c _ . . - � - 1 ' CONTROL GODS NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A F ❑Yes V3 Na See below for Defect Code G l TRIM VEGETATION ❑Yes Tg No \tit 4-0—* WATER VALVE - ADJUSTMENT REQD❑Yes L No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 7q.No 6,,v..Acvo, LOCATION OF SIDEWALK ❑ Front Yard XSide Yard ❑ Other _ WIDTH OF SIDEWALK jx 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED °°` 10.O sq.it. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes yt No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ci21\) Date: / / — PERMIT ISSUED FORMED POURED COMPLETED b - CITY OF WATERLOO , ' - SIDEWALK REPAIR SURVEY FORM la 112"1 tak PROPERTY ADDRESS 1 ai S-- 1 - - f l l - Zc5 ,, - PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK El Yes g No See reverse side for Defect Codes A-F See below for Defect Code G — TRIM VEGETATION J ❑Yes K I No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED 6%, ❑ Yes 12KNo 1 LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK j 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches A 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 3Z 0 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ` No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : Date: O d — PERMIT ISSUED FORMED POURED COMPLETED CI OF WATERLOO,7__0: \`� SIDEWALK REPAIR SURVEY FORM \11 0 PROPERTY ADDRESS ) '' 13 — 5— ( — 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A p ❑Yes f'No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes eig No "t1 ' WATER VALVE JI ADJUSTMENT __QUIRED 9 -•-,Q--► ❑Yes i I I PARKS DEPARTMENT . 1 04 l Z REVIEW REQUIRED �a S.� C2 4' ❑Yes ,No 7 \ 0 YnY LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK A4 Feet ❑ 5 Feet ❑ 5.3 Feet Cl Other DEPTH OF SIDEWALK A 4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED 5. sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES Li Yes S No No.of Squares with Patches CODE G - NOTE :Areas marked with an"P'may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. p, FIRST INSPECTION AND FORM MADE BY : MRS '" Date: 1 0 U PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO t l� SIDEWALK REPAIR SURVEY FORM J ,z J 19 � PROPERTY ADDRESS I W o, rvI,e_— - 35- Hi - PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect 11 ❑Yes M No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes l No • WATER VALVE ADJUSTMENT REQUIRED N ❑Yes g No I I PARKS DEPARTMENT RE A . QUIRED itj\ EYes ❑ No _14 e°' hiatuif LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1 -4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 16_® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ] No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F°may be repaired by patching.All otherareas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY ; BDate: 0 //�"�s'/0/A v G PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - r O SIDEWALK REPAIR SURVEY FORM L9VA PROPERTY ADDRESS 1 Z-I Weteklitort .--- 0113 1 - Oz & z9e -- PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes p No WATER VALVE ADJUSTMENT REQUIRED ❑Yes JET No — � PARKS DEPARTMENT REVIE REQUIRED — ,C) eglYes ❑ No • Aumfre-- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK yi 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3.6 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes A No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : jf '\ Date: PERMIT ISSUED FORMED POURED COMPLETED — • CITY Y OF WATERLOG. _._Sz__-S SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d(20 ti_ ro (p/R/1 l - - Id1 - c .-- . PARCEL CODE t S�m CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes x No — See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes No- it if WATER VALVEtrill,"3 -411-0-÷ , ADJU MENT REQUIRED i I Yes El I I '- PARKS DEPAR MENT / 3,a] A REQUIRED -= / \, d fi . U No / _ 3,(ok ti,:if)\111 , I/A 1 kr.r":„. -;_,,-- N.JcIct, / \ LOCATION OF SIDEWALK N Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED °111 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes It No No.of Squares with Patches cAr CODE G - Il \kl uei ,,lit, 6L, 14 isr 64--, '1,iJ 10e, 04ArbaCe-Pt 11)flfia f-i,VIej 4-0 C0101 y —` NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : 445 . Date: l / PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM V ky PROPERTY ADDRESS 1-55 fi.4,Aarwe.„ M;( - - /07 - o2 o 1 — PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect . • C ❑Yes IX No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes is No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes $ No — I PARKS DEPARTMENT REV1E. REQUIRED 6a5�t 0. s (59 — e.� a Yes ❑ No i 1161.e- ) _ 4 1 &.cot — LOCATION OF SIDEWALK ,t Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Z.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches A 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. 17 Z sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ,LJ No No.of Squares with Patches — CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. (� FIRST INSPECTION AND FORM MADE BY : im 6 " Date: /116 PERMIT ISSUED FORMED POURED COMPLETED — CITY' OF WATERLOO �- SIDEWALK REPAIR SURVEY FORM Ca//ZM PROPERTY ADDRESS / Y) (3 —, — lei — O (( 3C)Z PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes N No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION - I 1 ❑ Yes -No �t WATER VALVE ADJUSTMENT REQUIRED I � ❑ Yes No I PARKS DEPARTMENT j R EQUIRED _ ®® m pi Yes ❑ No 1 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK , 7 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK j 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED q sq.ft. 4 in. sq.ft.. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ),No No.of Squares with Patches CODE G -OC)-g ltode4: ? 1 0 �f �i G�e6 j fir' C% d-- = ,cdtpA , Hem clolr, ( i9' .IR/IiLv hnr,_ G'�A �"p 4/ NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. I� , FIRST INSPECTION AND FORM MADE BY : g Date: /LI///I P PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM (0`��` . f ram` PROPERTY ADDRESS i Mi5 -35 PARCEL CODE CONTROL NO.• - - CLEAN SIDEWALK Type of Defect ❑Yes „El No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — 1 ❑Yes ,LNo WATER VALVE t JI ADJUSTMENT REQUIRED ♦..Q--► ❑Yes ) No — I / 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes la No e\ _ — i/lei - e LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK r4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes ,® No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : FADate: lif t-J_U% PERMIT ISSUED FORMED POURED COMPLETED — Cr Y OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS , 4) /0 /9 Lo PLA c / PARCEL CODE CONTROL NO. Type of Defect A ° CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes rE1 No See below for Defect Code G TRIM VEGETATION 1 ❑Yes 0No 1`t JI WATER VALVE 4— ADJUSTMENT ADJUSTMENT itO UIRED ❑Yes gNo ' PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 3 ,6 0. .Ao — LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ) 4 inches ❑ 5 inches ❑ 6 inches • AREA TO BE REPAIRED 3I• a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes No No. of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other"areas shall be repaired by reconstruction of full sidewalk panels.• A p p FIRST INSPECTION AND FORM MADE BY : $Vt t1� JV Date: ®4 Z-Via_ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — QD:„../ \ SIDEWALK REPAIR SURVEY FORM A L 1 PROPERTY ADDRESS �, � 5� s' LP\ ( —35 - 1/E1 —010 .3(0 _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of DefectA ❑Yes No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION — 0 -Fit WATER VALVE f F — t AD _ ► ENT UIRED `...0.� ) Yes . ❑ o — I I ARKS D ARTMENT EV EQUIRED ❑Yes No — 7,9:_ ' — — — — /XIX), — i , ,\:. „0,:4 R„,Alibdive---- LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK , 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK yl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes A No No.of Squares with Patches Leo,-"'t:-t.t.- 1:144?-r-tijoe_ cti 1 A.....e-4-', CODE G - (X) t 1 c !Omar' e t- N_ ,0 'xMl _ NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. — • FIRST INSPECTION AND FORM MADE BY : ; 4) Date: /g PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO 64- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS LJ 1 t ' _ �'( /�/l `� — ' 1 - l/l - !l 31z PARCEL CODE CONTROL NO. Type of Defect ,6i CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes 'Vi No See below for Defect Code G TRIM VEGETATION._.__. ❑Yes _._._ No m _? — t y it WATER VALVE 5 W54.1.4' I Z ADJ MENT REQUIRED ��� Yes ❑ No 1 l 000(e, I PARKS DEPARTMENT e' av- \, REVIEW REQUIRED_..- ❑Yes --JENo — al \ iii6 i ve4/1 8..tl �,V,X / \ _ 1-1444Pate---- LOCATION OF SIDEWALK Xi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK j4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK )4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED qg<�I sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑Yes 1,Igi No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : N8 -R)NjDate: 03/g/ G PERMIT ISSUED FORMED POURED COMPLETED 4P CITY OF WATERLOO Xti ,6\ SIDEWALK REPAIR SURVEY PROPERTY ADDRESS 2,7 C ,16 - - HHi - 0 pz, 314 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect C ❑Yes h No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION _ I I ❑Yes A No WATER VALVE — S/ ADJUSTMENT REQUIRED .4.-0.♦ ❑Yes )No _ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 1 9'(2\ — — — — _ LW _ - LOCATION OF SIDEWALK , Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK JX,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ,C4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED r6`0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes b^No No.of Squares with Patches CODE G - NOTE :Areas marked with an°F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. A A �� / — FIRST INSPECTION AND FORM MADE BY : � Date: ie PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 105 t- PARCEL CODE CONTROL NO. + Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes 7/No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes No I PARREV RIEWKS REQUIRED Z. a A L14I pa Yes No 1,41 V/r<v) �,� 4s/Ast 1. 3 o LOCATION OF SIDEWALK tYC Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ig 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Tel sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 72, CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S d t Date: PERMIT ISSUED FORMED POURED COMPLETED CITY SF W TERLSO \ SI SEWALK REPA1, . SURVEY FORM RAPER i Y ADDRESS 11' ' -'5 - .ate v' • - '3 - A 01,3 V ttp PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes No See below for Defect Code G — TRIM VEGETATION ❑Yes No Q - WATER VALVE ® ADJUSTMENT REQ D — ❑Yes rg No PARKS DEPARTMENT — REVIEW REQUIRED . _ — — ❑Yes r No VA LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 0 o 1sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 14 No No.of Squares with Patches — CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : (Z5 b11°5 Date: 4 " ( PERMIT ISSUED FORMED POURED COMPLETED — CDi 4 -1 ool. e / ---- CITY OF WATERLOO i t, ' SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS %?I3 - 33- 107 - 005- / 3)7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ®Yes IX1 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes X No WATER VALVE N ADJUSTMENT REQUIRED Yes ❑ No PARKS DEPARTMENT'' REVIEW REQUIRED IV 1,3k ❑Yes No aI LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet \❑ 5.3 Feet ❑ Other DEP TH OF SIDEWALK.{ 4 inches ❑ 5 inches ❑ 6 inches / AREA TO BE REPAIRED I b. sq.ft. 4 in sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R 14 re Date: tlaki, PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO 101 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 73 Jana 66113 -:33 - 407 - 061 :). - - PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect 'P L ❑Yes jg No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION El Yes Yes No WATER VALVE ADJUSTMENT REQUIRED (�] %Yes ❑ No — I PARKS DEPARTMENT REVIEW REQUIRED — M/BQp ❑Yes lNo if"Lam.7, 2i'•°' "'.V. AZ' r4/47/14's I(7A/014 VIT//d>' \‘. /,)/7 .- w - 3U i7-e LOCATION OF SIDEWALK tx Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ca 4 inches ] 5 inches ❑ 6 inches AREA TO BE REPAIRED ((3- sq.ft. 4 in. Li a• 0 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : DF • 4- TE Date: 3 IV!e PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO S }� SIDEWALK REPAIR SURVEY FORM 'o' > /, PROPERTY ADDRESS 7,2 ct `,TrA It 39.(3 -33 - 4o - 003 / 3t ts4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect • f G ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes gNo _ WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes Jg) No _ I . 1 PARKS DEPARTMENT REVIEW REQUIRED �.� ; 3,7 y.! _'- ❑Yes 1,No rzr o mke LOCATION OF SIDEWALK E- Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK L4 inches i71 5 inches ❑ 6 inches / / AREA TO BE REPAIRED 7�o sq.ft. 4 in. 3 t• sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Lg No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — • FIRST INSPECTION AND FORM MADE BY : + 1-6 Date: 3 2ffIS PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 735- Y014e glIJ - 'f07 - 002 1.7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A-; Q r ❑Yes : No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes '0 No WATER VALVE ADJUSTMENT REQUIRED No = �h Yes , ❑ = Icz, P-ARKS'DEPARTMENT REVIEW REQUIRED — ❑Yes X No f- c - f7/0;fx,c,r,w)wfvo, .4( z� , N.) LOCATION OF SIDEWALK Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK IX 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Via.4 inches X 5 inches ❑ 6 inches AREA TO BE REPAIRED !0 a sq.ft. 4 in. •a sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I1 No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1)(3 d' Date: 3 1-a PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM a ? lP PROPERTY ADDRESS 7Y/ ;;76 6i13 - 37- 4107 - dig s' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes y No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes X No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No _ I I PARKS DEPARTMENT REVIEW REQUIRED 21/5) ❑ Yes jg No LOCATION OF SIDEWALK LX Front Yard El Side Yard El Other WIDTH OF SIDEWALK $4 Feet ❑ 5 Feet El 5.3 Feet El Other DEPTH OF SIDEWALK ig 4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 16 0• ® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes i No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. -' FIRST INSPECTION AND FORM MADE BY : 6 + re Date: ?Z//8° PERMIT ISSUED FORMED POURED COMPLETED w ' CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS bO3 Sat 013 - 33- 31.7 - 010 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — 1 ❑Yes No WATER VALVE 1 JI ADJUSTMENT REQUIRED --Q--► ❑Yes Ii No — PARKS DEPARTMENT REVIEW REQUIREDsedt — ❑Yes X No LOCATION OF SIDEWALK y Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK V] 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK TA 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED f 0 •®sq.ft. 4 in. It,• sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching,All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : � 4- Tt Date: 3421/8 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO ; _ z�l SIDEWALK REPAIR SURVEY FORM l PROPERTY ADDRESS &7q gl13 -3X -oo7 :s 3Z14- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G TRIM VEGETATION I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes X No PARKS DEPARTMENT REVIEW REQUIRED 5 vJJ"� ❑Yes 1 No LI Si -Sage. LOCATION OF SIDEWALK i,I.Front Yard ❑ Side Yard ❑Other WIDTH OF SIDEWALK Ij 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IX 4 inches ❑ 5 inches ❑ 6 inches _.. AREA TO BE REPAIRED t 10.8 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes g No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : k °1i T Date: J f 18 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 4 SIDEWALK REPAIR SURVEY FORM v- - PROPERTY ADDRESS 5 1 6 5113 -33' -� 7 - co 37t.,, PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect C ❑Yes ` No See reverse side for Defect Codes A-F ] See below for Defect Code G I TRIM VEGETATION I I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes 53'No — I I I PARKS DEPARTMENT REVIEW REQUIRED -7 ❑Yes 'No _ �•36 �'0_ — — \ it* LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ri 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK gt 4 inches 5 inches ❑ 6 inches — ✓ ,i AREA TO BE REPAIRED 30-ill sq.ft. 4 in. 3a•O sq.ft. 5 in. sq.fit. 6 in. CODE F - PATCHES ❑Yes g No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 4- TT Date: 3-'z1-fg PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO r SIDEWALK REPAIR SURVEY FORM zG`/l _ PROPERTY ADDRESS 4317 Ase £�f po -35 ' 327 ' ®lz V 317 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes X No See reverse side for Defect Codes A-F I See below for Defect Code G TRIM VEGETATION I I ❑ Yes No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes %No _ I PARKS DEPARTMENT REVIEW REQUIRED ,p;,1 f ;, ❑ Yes No 3•7 LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK M,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK i 14 inches ❑ 5 inches ❑ 6 inches ,/ _ AREA TO BE REPAIRED 3 a•0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES I Yes ❑ No No.of Squares with Patches r CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : De 7'5 Date: 3-441P®g PERMIT ISSUED FORMED POURED COMPLETED N.Cy CITY OF WATERLOO — to e IL SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5612 Zovu (3113 -33- - 00 7 / 3zO - i PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A, ( ❑Yes • INo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes J1No WATER VALVE ADJUSTMENT REQUIRED �--Q—► ❑Yes 1gi No — PARKS DEPARTMENT — REVIEW REQUIRED ta,L4 ❑Yes l No a e. LOCATION OF SIDEWALK 154 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK K 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches El 5 inches ❑ 6 inches ;i AREA TO BE REPAIRED tl .1 sq.ft. 4 in. 10,2 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 54.No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3 �i e g PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO r SIDEWALK REPAIR SURVEY FORM 10/z 16 PROPERTY ADDRESS 523 YAK n 13 -33 -337 - O V PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes Xi No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes Ig No WATER VALVE ADJUSTMENT REQUIRED ❑Yes gNo I PARKS DEPARTMENT REVIEW REQUIRED . ` `� ❑Yes No "PI 3.7' F -. 4, LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED l 0• sq.ft. 4 in, d 7. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Yes ❑ No No.of Squares with Patches / CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ®j TT Date: ®' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO to SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 5016 7.81e gil3 - 37 -327 - OO ,' 3 0 f , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect It ❑Yes jkl No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION l ❑Yes No WATER VALVE ADJUSTMENT REQUIRED — �] ❑Yes XNo PARKS DEPARTMENT REVIEW REQUIRED "( ❑Yes QNo Woe` (4 LOCATION OF SIDEWALK l.Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK Lg 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Lig 4 inches ❑ 5 inches ❑ 6 inches r' AREA TO BE REPAIRED I to.1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes [ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D,(3 Date: 34/Vg PERMIT ISSUED FORMED POURED COMPLETED i)I `v CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ko PROPERTY ADDRESS I IOC V�PA 1 3 — 33- 9.17 — of `' 6 4 PARCEL CODE _ CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' [ No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes 4No WATER VALVE ADJUSTMENT REQUIRED \ I ❑Yes VI No PARKS DEPARTMENT n REVIEW REQUIRED 0 Yes No Ktriti- LOCATION OF SIDEWALK W.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK F. 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches ❑ 5 inches rxt 6 inches AREA TO BE REPAIRED 51. . s sq.ft. 4 in. sq.ft. 5 in. gel-8 sq. ft. 6 in. — CODE F - PATCHES ❑Yes IX No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : T3 4 Date: 3-38-t5 PERMIT ISSUED FORMED POURED COMPLETED n ,: CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /Ili /6A4 C . _ �93 - - 477 - 09 1 / FPS PARCEL CODE CONTROL NO.CLEAN SIDEWALK Type of Defect 6 ❑Yes 1.No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes IA No — WATER VALVE ADJUSTMENT REQUIRED N ❑Yes k No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No 113 6 LOCATION OF SIDEWALK TA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK $ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK fl 4 inches ❑ 5 inches Ig 6 inches — AREA TO BE REPAIRED 677•a sq.ft. 4 in. sq.ft. 5 in. 7g.® sq.ft. 6 in. CODE F - PATCHES ❑ Yes r No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 1'¢' FIRST INSPECTION AND FORM MADE BY : �- Date: 13-3®'/0' PERMIT ISSUED FORMED POURED COMPLETED S i- ''_'• CITY •F WATER tO - SIDEWALK REPAIR SURVEY FORM 6://3)11 PROPERTY ADDRESS kiillbq 1 _ i/ -35- / 5- v( - PARCEL CODE CONTROL NO. — Type of Defect See reverse side for Defect Codes A-F 9 , CLEAN SIDEWALK See below for Defect Code G ❑Yes ��`No TRIM VEGETATION 1\t, ,'I ❑Yes �� WATER VALVE 1 r1kt.' — _ ,_0_0. t ,A© TMENT REQ'D Yes ❑ No r (59 0 1,, .. 1 'PARKS DEPARTMENT Lit T -' REVIEW REQUIRED - - - - El Yes No \ • • \ A LOCATION OF SIDEWALK S,,Front Yard , Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ig5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK $4 inches X 5 inches ❑ 6 inches AREA TO BE REPAIRED a( s' 23 CI s° sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes A No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : (46g643 Date: rrnifieb PERMIT ISSUED FORMED POURED COMPLETED l ,' CITY OF WATERLOO \�ci SIDEWALK REPAIR SURVEY FORM — ky A\ PROPERTY ADDRESS I 1 K01611 _ ol 1 -35 - 105 - lc: PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK Type of Defect A ❑Yes X No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes g No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 1$No I I PARKS DEPARTMENT _ REVIEW REQUIRED ❑Yes pCNo 11 ,5 _ 103 — — - -i OM VA 14 s6 &E) _3.Li / \ _ 1S64 LOCATION OF SIDEWALK 4 Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ✓ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK m 4 inches ❑ 5 inches El6 inches AREA TO BE REPAIRED 81 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES —❑ Yes � No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ' _ Date: 01,Rife ..... PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO 4-13 SIDEWALK REPA IR SURVEY FORM PROPERTY ADDRESS 3 20 (m 6/J 3) PARCEL CODE CONTROL NO. Type of Defect ACLEAN SIDEWALK ❑ Yes ENo See reverse side for Defect Codes A-F -- I See below for Defect Code G TRIM VEGETATION ❑ Yes tNo WATER VALVE ADJUSTMENT REQUIRED ❑Yes lNo PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No 3.5 A (4.H� L LOCATION OF SIDEWALK [RFront Yard ❑ Side Yard ❑Other . WIDTH OF SIDEWALK tA 4 Feet ❑ 5 Feet q 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 0 5.4 sq.ft. 4 in, sq,ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IN No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels, FIRST INSPECTION AND FORM MADE BY : R-5 N-'" W.7 Date: 3 PERMIT ISSUED FORMED POURED COMPLETED 1-0 CiTY SF WATERLIO• Dui 4- E. cl.),<\/i SIDEWALK REPAIR SURVEY FORM Rs — (g, i ROPERTY ADDRESS cili5 e , 1 • _ I5 - 35- 10.E - 00 v PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G i ❑Yes Co i TRIM VEGETATION ❑Yes A No tIf 4., WATER VALVE — JO. ® ADJUSTMENT REQ'D ❑Yes , No — PARKS DEPARTMENT 1 REVIEW REQUIRED 43 El Yes No py.A - . C8Aif,o, te--- k j LOCATION OF SIDEWALK 5 Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet gf.5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK 1,i4..4 inches ❑5 inches ❑ 6 inches — AREA TO BE REPAIRED :/ Z sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes )4 No No.of Squares with Patches CODE G — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : m , / Date: r" ' �4 — a PERMIT ISSUED — FORMED POURED COMPLETED -4)-L-- CITY OF WATERL** — SIDEWALK REPAIR SURVEY FIIRM • r•ROPERTY ADDRESS /001 - _ Bc1/3 -i0i( - CO 1 PARCEL CODE CONTROL NO. 1 Type of Defect A)G ) CLEAIDEWALK _ See reverse side for Defect Codes A-F See below for Defect Code G 0 Yes ,4No - ''-' l --•-•'- TRIM VEGETATION 0 Yes ) No \t, 1k! ._.% ,...% .44( .. hi -* <04.7 AC .., 0 '''''‘ ri --., - WATER VALVE i 1 \ _ - N ADJUSTMENT REQ'D t• - 'S.1 7--- ' ., 0 Yes A No • PARKS DEPARTMENT • REVIEW REQUIRED 6vitedis 117:er,7.1:). • TAYes El No • ,-----;,-- (--') •=-„,(-- ri,1///////47/1 I X I,R i 0\'' • - . ',v) i 1 c-- ) 1 1 • 1.atc- 1 j _ Fored- ..... LOCATION OF SIDEWALK g Front Yard . IKSide Yard 0 Other • WIDTH OF SIDEWALK A4 Feet f4 5 Feet 0 5.3 Feet 0 Other _ DEPTH OF SIDEWALK A 4 inches . 0 5 inches 0 6 inches AREA TO BE REPAIRED ZOL3 sq.ft. 4 in. sq.ft. Sin. sq.ft. Sin. .... CODE F - PATCHES 0 Yes ) ,No No.of Squares with Patches ___ CODE C OCOoti1 VIA:A4- M- atekteti-J. 5,AA-gee_- f 5coff) S-.fereve - obr` repkee-e) Priek-4- 11 twickga ''' 16; LF ile .-4Viha!Zi'--- tieco 0, 6,1K i .. NO IE:Areas marked With an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ..... FIRST INSPECTION AND FORM MADE BY : ge--i4stecteut • Date: 9-11/-45 _ • PERMIT ISSUED - FORMED POURED COMPLETED ``1 \� CITY OF WATERLOOco\ \5' SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I®C K L - - PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect 4+6- ❑Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes 11,No — WATER VALVE ADJUSTMENT REQUIRED — (V ❑Yes lg No (4) PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ly No — e // �*'j- jet — t A _1 1L 1 / LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Is 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 56,D I sq.ft. 4 in. Z0,61 1 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I 'No No.of Squares with Patches CODE G - NOTE :Areas marked with an'IF" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : -6D� Date: 3 -2 3- I PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /017 e;14 I( Ave_ 01 1 PARCEL CODE CONTROL NO. • Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes r No See below for Defect Code G TRIM VEGETATION j ❑Yes I .No \At If WATER VALVE �Q--► ADJUSTMENT REQUIRED ElYes l No j I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 1/07/ j`41 q.itAt LOCATION OF SIDEWALK Front Yard ❑Side Yard , ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK /'- 4 inches ❑ 5 inches ❑6 inches AREA TO BE REPAIRED r5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in, CODE F - PATCHES ❑Yes X No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : e°'d��SfZ. 4 ''9 1 Date: CP N✓l • —' PERMIT ISSUED FORMED POURED COMPLETED .///kCITY.OF WATERLOO ( 0\\‘) SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS )0a.a_ — S30 -3U-- z 3 s -c7 3 SC.p, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes LNo I � — PARKS DEPARTMENT 4 b REVIEW REQUIRED ❑Yes No _ VA 11A \ 0 e,-cu LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK 714 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches yf5 inches ❑ 6 inches AREA TO BE REPAIRED I L.0 sq.ft. 4 in. IC0.t7 sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 2-5® [ FIRST INSPECTION AND FORM MADE BY 5 Date: �`� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO g:1-212) SIDEWALK REPAIR SURVEY FORM 6/ i 3l Ick PROPERTY ADDRESS t 1 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes fNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes No WATER VALVE — N ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ,® ID Yes ? No VA A A \ LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. let. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Ilk No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: --3-2-�® PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO (s)V1\\9\ `'� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ha. d z ( _ ` tl -3 — z5 - oz9 � ,,,c PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Cs ❑Yes t l No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes X No WATER VALVE t If ADJUSTMENT REQUIRED 4— ❑Yes ,TA No PARKS DEPARTMENT REVIEW REQUIRED V� 1 10 ❑Yes No Se9t i \ _ Ks‘;-,miAti _ LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other _, WIDTH OF SIDEWALK CA Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK P 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 15.6 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes r'VJ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. i in D b t 0FIRST INSPECTION AND FORM MADE BY : M Date: — PERMIT ISSUED FORMED POURED COMPLETED CITY SF W;1TERL.• SIDEWALK REPAIR SURVEY FORM __ PROPERTY,ADDRESS nil- . : i i 113/ y PARCEL CODE CONTROL NO. Type of Defect C--)C, See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ai D Yes No TRIM VEGETATION -41\ \ E D Yes No , -4— E 4, _ j `:� WATER VALVE • ADJUSTMENT REQ'D 0 IJj D Yes 7g No c ; ,..-" 4 PARKS DEPARTMENT REVIEW REQUIRED - - � — — D Yes No .) LIA LOCATION OF SIDEWALK $Front Yard , D Side Yard 0 Other WIDTH OF SIDEWALK :4 Feet ❑5 Feet D 5.3 Feet 0 Other DEPTH OF SIDEWALK (V 4 inches D 5 inches El 6 inches AREA TO BE REPAIRED 1)2.0 sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES D Yes IA No No.of Squares with Patches Qp CODE G 0,) LAA am, 'oiC044,14045 o NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. p� FIRST INSPECTION AND FORM MADE BY : 'LI/ . . Date: a PERMIT ISSUED FORMED POURED COMPLETED CITY OF WA ERI 0 9 SIDEWALK REPAIR SURVEY FORM rm ROPERTY ADDRESS 9 O O. 1/4,4 1 A ►3 A III - 020 3102- PARCEL.CODE CONTROL NO. - Type of Defect A,5 CLEAN SIDEWALK c A ,i h✓ ; See reverse side for Defect Codes A-F ❑Yes ;No — fi 01 6 r,t See below for Defect Code G i `I'0 I TRIM VEGETATION ❑Yes= flo — lf � —r-s- �. ' WATER VALVE 3 /(`�L— i� O.i� AD.] ENT REQ D I Yes ❑ No �<-.. PARKS DEPARTMENT REVIEW REQUIRED ❑Yes grNo — J — LOCATION OF SIDEWALK ❑ Front Yard . A Side Yard ❑ Other WIDTH OF SIDEWALK J4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ja 4 inches , ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED ie. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes A,No No.of Squares with Patches CODE G - — NOTE:Areas marked with an'TF"may be repaired by patching..All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : itiO 460 Date: 03 ,46 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERL •,• — SIDEWALK REPAIR SURVEY FORM 1S4-15 9 -ROPERTY ADDRESS }2.o7 ;v4�1 i • (W/3) I` 09, 1 -3 - 151 - 00i 31.,ag PARCEL CODE CONTROL NO, Type of Defect A, C — / CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑Yes I No d TRIM VEGETATION \t, �� r�► 0 'M— a ❑Yes No f— —.► �� WATER VALVE . i ,\ 16,01 , ADJUSTMENT REQ'D A � 1 r ❑Yes No — PARKS DEPARTMENT REVIEW REQUIRED �1�� — — — ❑Yes No 00 i( — LOCATION OF SIDEWALK B Front Yard . ❑Side Yard ❑ Other WIDTH OF SIDEWALK 0 4 Feet ❑5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK ;I K4 inches . ❑5 inches ❑ 6 inches — AREA TO BE REPAIRED ,'gin° sq.fit, 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes ❑ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: C53la Ii - 8 y PERMIT ISSUED FORMED POURED COMPLETED /, CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM — (0` PROPERTY ADDRESS 1 Apt PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes yt No WATER VALVE f o i€ A _ ENT REQUIRED46 rt v,_ --0 ' ( L1No Pr elt f n,, Of 04 -\ . — 01,1044641641e I I PARKS DEPARTMENT �„ REVlEWREQUIRED iJ� El No 1-1P1 I xr Vhi t m LOCATION OF SIDEWALK jx.1 Front Yard El Side Yard El Other WIDTH OF SIDEWALK t,4 Feet El 5 Feet ❑ 5.3 Feet ❑ Other T DEPTH OF SIDEWALK xi 4 inches El5 inches ❑ 6 inches AREA TO BE REPAIRED 32 2-sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes pi No No. of Squares with Patches f CODE G - 6C) T� 6a1� oo'Ce�` �� � �� ! � c�p —� ie' 7 NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : lk Date: 0,- " PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 13I ° (/ ( s ! �/ 0 -94- i - oo5 3/07 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes IKNo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes is No WATER VALVE 1 , ADJUSTMENT REQUIRED ~ ❑ Yes rIg.No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ,X.No VNA ) g l LOCATION OF SIDEWALK ki Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK )I 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK SI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [ ,No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 1� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM()Y \ PROPERTY ADDRESS J . :v tallI -. - ( -0o7 570 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ,No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes 'No if WATER VALVE ADJUSTMENT REQUIRED IeQ I ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes eikNo Li LOCATION OF SIDEWALK II Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK /3c4 Feet ❑ 5 Feet LI 5.3 Feet ❑ Other DEPTH OF SIDEWALK yt 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 3Z•1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : mem Date: / / F — PERMIT ISSUED FORMED POURED COMPLETED CITY •F W`TERL** SIDEWALK REPAIR SURVEY FORM ��� — "ROPERTY ADDRESS 1'/O Ko L • 4 IQ( PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G 01 1 I `` ❑Yes l No TRIM VEGETATION ❑Yes piNo 10 if -40" —► ! WATER VALVE 't ADJUSTMENT REQ'D 1 ❑Yes J No PARKS DEPARTMENT REVIEW REQUIRED — — ❑Yes ,iNo No N . roll J LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet a 5 Feet ❑5.3 Feet lg Other 5°I I DEPTH OF SIDEWALK ❑4 inches if>5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 inK 5•5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Yes ❑ No No,of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : AS Date: / //;g PERMIT ISSUED FORMED POURED COMPLETED b ,o CITY 0 WATE!:�! • ° ek SIDEWALK REPAIR SURVEY FORM /7;,\\"\\N I — kJ/ .,ROPER ROPERTY ADDRESS / 0 d + G( PARCEL CODE CONTROL NO. - Type of DefectA , r CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ( ❑Yes A No — TRIM VEGETATION Iiff ❑Yes IgNo -- *- N F, WATER VALVE _ j 1 Al7,lUSTMENT REQyD ❑Yes 7 No $ 8 Z Ve L� n PARKS DEPARTMENT ° 1\ �� REVIEW REQUIRED — — '� ❑Yes IX No — 144 WI - • j - LOCATION OF SIDEWALK ,(Z Front Yard . ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 0,5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK A4 inches , ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED ILIZ.sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in, CODE F - PATCHES gYes ❑ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. laki FIRST INSPECTION AND FORM MADE BY : j 1` Date: 6 / 0 PERMIT ISSUED FORMED POURED COMPLETED — u. CITY OF WATERLOO f✓ SIDEWALK REPAIR SURVEY FORM (c)// — PROPERTY ADDRESS I l� _<av4 t Mi3 -3i1-1R -co3 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G I TRIM VEGETATION ❑Yes [:No \1`t JI WATER VALVE ADJUSTMENT REQUIRED a ❑Yes No � I I PARKS DEPARTMENT 10.e REVIEW REQUIRED 5 i/5d Yes ❑ No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet L'5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 50. sq.ft 4 in. sq.q ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G - (A) porosiVe. roe-f5 ' GY t ,`od-4� 0416 ^ & NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � 'F` 6 Date: PERMIT ISSUED FORMED POURED COMPLETED ` , ``' CITY OF WATERLOO — _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 617 _ g ' 1 I -35- 2)07; 017 :.,V. 'i PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Cr ElYes .No — See reverse side for Defect Codes A F . See below for Defect Code G TRIM VEGETATION 4 ❑Yes _ RI No -- WATER VALVE , ,,,J ADJUSTMENT REQUIRED — ❑Yes IglNo `� ) Q% I PARKS DEPARTMENT — �� ✓ �b {{��� , ,, REVIEW REQUIRED '�6' -g �3 , ❑Yes ►y�.No — //A%V xkl'!x! . tri Y/A [�, A — tom / \ KigYJA ___ LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ig 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK `i ,4 inches CI inches CI inches i AREA TO BE REPAIRED I'i o® sq ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES NI Yes ❑ No No.of Squares with Patches 9 CODE G - X P ,a ca ` yidg-� a e_y�1 oLe- e - P NOTE :Areas marked with an'F may be repaired by patching..All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPEC TION a"AND FORM MADE BY : �A t Date: *tag — PERMIT ISSUED FORMED POURED COMPLETED R tS°P CITY OF WATERLOO D Q c".' ,o SIDEWALK REPAIR SURVEY FORM � � In-ROPER T Y ADDRESS 1711 - 023 K^mac i t • Co5 a i I R J 13 -3s- •3- pow.- - PARCEL CODE l 1 CONTROL NO. I J it Type of Defect A w C. See reverse side for Defect Codes A- CLEAN SIDEWALK See below for Defect Code G I ❑Yes A No 1 TRIM VEGETATION J� ❑Yes I4 No '-.? 0 -, ---0—... OWATER VALVE I ADJUSTMENT REM) I ` p ���� I ❑Yes No `�I.1' 1 PARKS DEPARTMENT — -- -- — �� `I �4.3��[�a� REVIEW REQUIRED d' ''4 r ��;�r!4 1/1.t� Jr ! El Yes No __-_____________________ r 71<„,„0,1 _____________L____ LOCATION OF SIDEWALK A Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK kl 4 Feet O 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK IN 4 inches 0 5 inches D 6 inches AREA TO BE REPAIRED '1 .0 sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. _ CODE F - PATCHES 0,Yes ❑ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired b — reconstruction of full sidewalk panels. y FIRST INSPECTION AND FORM MADE BY : M1 Date: 17., PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO c SIDEWALK REPAIR SURVEY FORM - i air P . (0I ROPERTY ADDRESS 1 t �° I .- ria I�( t - LIP a OW, / CONTROL CODE NO. A. Cm , CLEAN SIDEWALK Type of Defect — See reverse side for Defect Codes A F I ❑Yes No See below for Defect Code G I TRIM!VEGETATION CI Yes glNo WATER VALVE c.ti ""�/�j, _A ADJUSTMENT REQ'D I ❑Yes `14 No `I 4��' ` �� p Am10 PARKS DEPARTMENT REVIEW REQUIRED yes 0� ❑Yes ),No OM P r _ :,4_;21________________ 0. :II , Ave__. LOCATION OF SIDEWALK ❑ Front Yard . X Side Yard .11 Other _ WIDTH OF SIDEWALK il<4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED q• �� ,® s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. , — CODE F - PATCHES X Yes ❑ No No.of Squares with Patches CODE G NOTE:recon tc on of full sidewalk anel marked ru repaired by patching.All other areas shall be repaired by FIRST INSPECTION AND FORM MADE BY i�� : Date: fri5/ PERMIT ISSUED FORMED POURED COMPLETED CITY *F 1,��,TERL•S d SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS I k4 I , .&r�--sue PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G ❑Yes LNo TRIM VEGETATION ❑Yes No 4— im WATER VALVE Ie 1\ ADJUSTMENT REQD ❑Yes gNo 0\ PARKS DEPARTMENT REVIEW REQUIRED • — — ❑Yes No • _ J LOCATION OF SIDEWALK ❑ Front Yard •, %Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet yl 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches 5 inches 0 6 inches • AREA TO BE REPAIRED sq.ft. 4 in. 4-' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes VNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ft-S \1)47 Date: 2 ` ` PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 11 V.-1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect / ❑Yes '1ZNo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I I ❑Yes , ( No WATER VALVE ADJUSTMENT REQUIRED — ❑Yes 'No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes N.No A.C\ LOCATION OF SIDEWALK IA Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet i5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches W5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in.Z 3. p sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes 'No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2-9 5 Date: 3 ®. �®I6 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO tx � 4 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I 1 l- t k) s PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect �' ❑Yes I o Io See reverse side for Defect Codes A-F • See below for Defect Code G I TRIM VEGETATION I ❑Yes [ No WATER VALVE N ADJUSTMENT REQUIRED _ ❑Yes yo No I ( PARKS DEPARTMENT REVIEW REQUIRED ❑Yes IX No ►0. t LOCATION OF SIDEWALK fg Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet M 5.3 Feet ❑ Other DEPTH OF SIDEWALK 144 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 3 � sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes C-No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R-9 W) Date: 3 30 t PERMIT ISSUED _ FORMED POURED COMPLETED .5001 MY OF WATERLOO loitotiI6 SIDEWALK REPAIR SURVEY FORM •ROPERTY ADDRESS 12-g 1 L ✓ . PARCEL CODE CONTROL NO, Type of Defect F — See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G J ❑Yes No — TRIM VEGETATION ` � ❑Yes No --00- WATER VALVE ADJUSTMENT REQ'D V �f ❑Yes No r t PARKS DEPARTMENT ,Z >2 REVIEW REQUIRED A A ❑Yes x No -' t 1' LOCATION OF SIDEWALK ❑ Front Yard I Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet g5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK l 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5?.° .F sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERL•��� C41144y�� SIDEWALK REPAI" SURVEY FIRM PROPERTY ADDRESS Zz7' - -- v PARCEL CODE CONTROL NO, Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G 1 t]Yes S.No TRIM VEGETATION t ❑Yes Na F WATER VALVE + ADJUSTMENT REQ'D ❑Yes kl No 41-1 1 PARKS DEPARTMENT 3.8 REVIEW REQUIRED Yes ❑ No re1^--tdu L ' Ibc)11 LOCATION OF SIDEWALK k Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 5,3 Feet 0 Other DEPTH OF SIDEWALK Id 4 inches ❑ 5 inches ❑ 6 inches V AREA TO BE REPAIRED 9 sq.ft, 4 in, sq.ft. 5 in. s .ft. 6 in. q CODE F - PATCHES 0 Yes No No.of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R.5 ap5 Date: 4 1 d !g PERMIT ISSUED FORMED POURED COMPLETED 041°1' CITY SF W:%TE S S 'o Z4c SIDEWALK REPAIR SURVEY FORM _ .ROPERTYADDRESS 0,06, v-1t1(& bP, V . 5. ‘3 -34-- -O7--7 v. PARCEL CODE CONTROL NO. Type of Defect A , CLEAN SIDEWALK See reverse side for Defect Codes A-F * See below for Defect Code G ,L ❑Yes No — 4. TRIM VEGETATION k ' Yes ❑ No WATER VALVE — a ADJUSTMENT REQ'D .3 ❑Yes VZ No ed A g , D' — \ f`" '.1 L" '�' PARKS DEPARTMENT o-u tAk 4 '�;r�� hee�s� REVIEW REQUIRED X Yes ❑ No Is.Z- a.41A. iip Le s op - t ki ) is K�� '.)h 16 I-1M,A- — LOCATION OF SIDEWALK sa.Front Yard , Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet IX 5.3 Feet ❑ Other DEPTH OF SIDEWALK ` 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 1(4".1 f q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 'No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1?-- W5 Date: pe-- t PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM t®f nij .6 PROPERTY ADDRESS 2-1 i I p� A-- Col-c 3 PARCEL CODE CONTROL NO. CLEAN.SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes g No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes XNo I I I PARKS DEPARTMENT , REVIEW REQUIRED l ,I1 tz2 2 Yes No .a, l . \\ 6la,t5 t- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [ 5.3 Feet ❑ Other DEPTH OF SIDEWALK yJ 4 inches E1,5 inches ❑ 6 inches AREA TO BE REPAIRED /64.14 �sq.ft. 4 in.C I.2 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 4 - - PERMIT ISSUED FORMED POURED COMPLETED A is CITY OF WATERLOO `� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2‘ 1e-►iL4.t� '3 -3 -2 07 -o'o -59E PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I bs I ElYes j No \ k0'. Ga �N �� WATER VALVE N �oJ • cN ADJUSTMENT REQUIRED , ft e� ❑Yes No ^t ��` 1 PARKS DEPARTMENT — REVIEW REQUIRED ' ' 1 Yes ❑ No A 10 l2°) - Nab -j LS a L,, fie 1(.41.16:A5004� , LOCATION OF SIDEWALK ti'g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet5.3 Feet ❑ Other DEPTH OF SIDEWALK y 4 inches ❑ 5 inches ❑ 6 inches J AREA TO BE REPAIRED /11.8 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : ?'S Date: 4 - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM i i f 16. PROPERTY ADDRESS 4-0(._ Z, PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes No I See below for Defect Code G • TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED _ I ii,04 ❑Yes JNo PARKS DEPARTMENT ✓/44 le-0 REVIEW REQUIRED f A re c‘; ❑Yes ag No V/) Vt 1/21 4 .5 � 4.4 i �J '` L Via 42rS o �c t LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Ll 5.3 Feet ❑Other DEPTH OF SIDEWALK 17 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 6)(0.S�sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I No No.of Squares with Patches- CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R.5 O.> Date: 4- _ E r PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — � SIDEWALK REPAIR SURVEY FOR ve PROPERTY ADDRESS A4 l PARCEL CODE CONTROL NO. • � CLEAN SIDEWALK Type of Defect A; ❑Yes No See reverse side for Defect Codes A F ] See below for Defect Code G ] TRIM VEGETATION ] 1 ❑Yes >t No WATER VALVE ADJUSTMENT REQUIRED �.-- --► ❑Yes 'No Al 1 1 PARKS DEPARTMENT REVIEW REQUIRED .]g ❑Yes Ilo • A _ _ _ _ I/, LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard _ ❑ Other• WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet l�5.3 Feet ❑ Other — DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 121.0 f sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. • CODE F - PATCHES ❑Yes tg No No.of Squares with Patches _ CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. _ -- • FIRST INSPECTION AND FORM MADE BY : � Date: e IS • PERMIT ISSUED FORMED POURED COMPLETED CITY •F W/ TERL•-• SIDEWALK REPAl SURVEY FORM J r "ROPER T Y ADDRESS 44 1c4 ( b 5%.3 mot 4D PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes ,No TRIM VEGETATION ❑Yes I No tN WATER VALVE � �:- ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED es ❑ No t3,3 ILA ki t, LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet L5.3 Feet Li Other DEPTH OF SIDEWALK fr14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5'7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R-5 ®% Date: 4-5 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 0 /14 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 S® a� PAvg.al J3 JJ ogas3 - Zoq - oaf PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes No JV WATER VALVE ADJUSTMENT REQ'D LI Yes $ No PARKS DEPARTMENT REVIEW REQUIRED Z6-. Yes ❑ No triv — J LOCATION OF SIDEWALK ❑ Front Yard %Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet j'5.3 Feet. ❑ Other DEPTH OF SIDEWALK g4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1%1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes , 1 No No. of Squares with Patches CODE G - te- : work- et,s ,c,,,k pswi- �as�l NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : WAX" Date: 7/51/s PERMIT ISSUED FORMED POURED COMPLETED CITY OF `,','ATERLOO (0727/(9. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /®C 3 k s Its • MM13 -27-3 c - g 0ZA PARCEL CODE CONTROL NO. Type of Defect A, CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes No See below for Defect Code G TRIM VEGETA3ION _ ❑ Yes l No WA VL if 1 I ADJUSTMENT REQ'D ID Yes No PARKS DEPARTMENT REVIEW REQUIRED p Yes No _ 0 'ea* WI vey.„. LOCATION OF SIDEWALK ❑ Front Yard TeSide Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet j5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK j4 inches ❑5 inches ❑ 6 inches AREA TO BE REPAIRED /OS sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 11ZqJ) Date: Wave PERMIT ISSUED FORMED POURED COMPLETED CITY •F W,ATERLSO SIDEWALK REPAI;• SURVEY FORM r RORERTY ADDRESS 8o 7 E' M l23 .3/1, Zl -pc, v 403 PARCEL CODE CONTROL NO. - Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G 1 ❑Yes y No TRIM VEGETATION _ ❑Yes LI No 4-0 -� WATER VALVE — / \ I DJUSTMENT REQ'D A ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED - — — — X Yes ❑ No J — LOCATION OF SIDEWALK ❑ Front Yard ' SideYard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK l4 inches l5 inches ❑ 6 inches — AREA TO BE REPAIRED 540•2 `�sq.ft. 4 in. Z °® ' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 04 No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2-5 \> Date: -S-?-3 ` I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 5124 pi SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS e0G PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I El Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes NiNo I I • I PARKS DEPARTMENT — REVIEW REQUIRED 3 r ❑Yes No VeM )'\A .s l LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other -- - WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet N5.3 Feet ❑ Other DEPTH OF SIDEWALK 04 inches - ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED e21-145 "sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. _ CODE F - PATCHES ❑Yes pqo No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1 5 'C7 biD Date: 3 -23- PERMIT ISSUED FORMED POURED COMPLETED sb CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ` ' 1-tAtt.,5 D!3 -34-121 -bog gf 40S. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C- ❑Yes )i No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes j No — WATER VALVE ADJUSTMENT REQUIRED — N El Yes No I I PARKS DEPARTMENT REVIEW REQUIRED El Yes gNo C- NArks LOCATION OF SIDEWALK T Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1 5.3 Feet ❑ Other DEPTH OF SIDEWALK i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 84 5•I ` sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes Gi No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .5 OC '7 Date: 3 - 2-3 -I a — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 6 l 13) 1 et PROPERTY ADDRESS 'Z- I\APE-'.LA 6913 PARCEL CODE CONTROL NO. Type of Defect A a b`` CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes 11 No TRIM VEGETATION �t ❑Yes IINo� WATER VALVE /♦ I ADJUSTMENT REQ'D ❑Yes I1No �' L10 d 3q� �' �; PARKS DEPARTMENT Z' ', REVIEW REQUIRED iZ.() .4 IQ' 3: 4,3 4,0 ❑ Yes I] No Vi,/4m LOCATION OF SIDEWALK ❑ Front Yard IkSide Yard ❑ Other WIDTH OF SIDEWALK ®.4 Feet ❑ 5 Feet CI 5.3 Feet ❑ Other t DEPTH OF SIDEWALK pi,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I 1 4 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -- CODE F - PATCHES ®Yes ❑ No No. of Squares with Patches 0 CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : APC" E - Date: 3 I0 lcS Et�l t s PERMIT ISSUED FORMED POURED COMPLETED ''; /C1-7 X CITY OF WATERLOO - --)\\°\ x SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS Z10 E, , l( -4.e.-- v 'i3 -35- ( - 03 v 4-1- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ;G i F ❑Yes r1 No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes J No - - WATER VALVE ,';` 'itr 1 AD MENT REQUIRED 1 i!,1 1— Pill"5 Yes ❑ No PARKS DEPARTMENT — 6,9 /,..(5) \, REVIEW REQUIRED 7. 0 Yes No 9 t 3 7 1 W: \ 84.4- - _.... '- ' �� ��+ 9,c, C - LOCATION OF SIDEWALK a Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK rEt.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ]J 4 inches Ni.5 inches ❑ 6 inches AREA TO BE REPAIRED I'. q.ft. 4 in. ti sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES f ,Yes ❑ No No.of Squares with Patches i CODE G - f Al crier s mA5 cAgezA � c i - v — '''.. livt4,4 fthfrt.- reahceive.Sk Weir ] — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. pn q • FIRST INSPECTION AND FORM MADE BY : nA Date: — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO �.. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2/ a- 7 13 - -391 - 0711 ,e 414 PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK Type of Defect e C ❑Yes N No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes (SiNo WATER VALVE ADJUSTMENT ' QUIRED ❑Yes i g No I PARKS DEPARTMENT i (5") REVIEW REQUIRED A.Yes ❑ No d2.1 7-0 I iz, AV AAA. LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK jg4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,PS14 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED '`/ ( 6 sq.ft. 4 in. W sq.ft. 5 in. sq.ft. 6 in. CODE F - P(() TCHES ❑Yes No No.of Squares with Patches CODE G - en' pawteJ q er &I5 NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. fl `�"s ��, FIRST INSPECTION AND FORM MADE BY : i�6 Date: 03/�'70 PERMIT ISSUED FORMED POURED COMPLETED �6. CITY OF WATERLOO to��,� SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 2244 b " 55 —35-3°A — 005 ' 41-1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect �" ❑Yes J No See reverse side for Defect Codes A-F — See below for Defect Code G ( TRIM VEGETATION I ❑Yes Al No At If WATER VALVE ADJUSTMENT REQUIRED — ~��"� ❑Yes to PARKS DEPARTMENT REVIEW REQUIRED A"° ❑Yes XI No L1m0‘' 1/A LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK .4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 71,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED `°f 16 0sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes TA No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 03 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ( SIDEWALK REPAIR SURVEY FORM (o/z 7(H PROPERTY ADDRESS 7� '� s , 4,( PARCEL CODE CONTROL NO. Type of Defect A See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G J ❑ Yes No U TRIM VEGETATION ❑ Yes RI No 41-- ►-10- V) WATER VALVE f, ADJUSTMENT REQ'D ❑ Yes f No i PARKS DEPARTMENT REVIEW REQUIRED — 1HO® ❑ Yes gNo I/ LOCATION OF SIDEWALK 1 °Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1$4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED i a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑LLYes jNo No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. AA� �p FIRST INSPECTION AND FORM MADE BY : M R P ��a� Date: 037 A PERMIT ISSUED FORMED POURED COMPLETED '5.)5Z- CITY OF WATERLOO tii`�� SIDEWALK REPAIR SURVEY FORM - iA �� PROPERTY ADDRESS �, ei/l! FI(( 0�/L' ✓ � Ai i 3-35- 32Lo- lve l PARCEL CODE CONTROL NO. ._ CLEAN SIDEWALK Type of Defect s El Yes M No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes LLLNo — WATER VALVE ADJUSTMENT REQUIRED — ❑Yes pKNo lfA r _ 6°® ck PARKS DEPARTMENT t REVIEW REQUIRED J q✓�� ` ❑Yes X No — — `/i VA ) \ LAc Lk.°' Ee A/6 0 ,(,, — LOCATION OF SIDEWALK yl,Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK A 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK E_4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3Z.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes K No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : M.5 tRe ON Date: 6,___09G� — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 6A7)11 PROPERTY ADDRESS 51 ,bs 1.) 3 - 6197 ,:' 404-- PARCEL CODE CONTROL NO. -- ACLEAN SIDEWALK Type of Defect ❑Yes yi..No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes )4 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No I I . PARKS DEPARTMENT -- REVIEW)M49- ❑ Yes No /4 B ' (ID\ Y 13, iAVFAAA( LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK4 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED V 96.°. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes X No No.of Squares with Patches CODE G - X) '° � ��JJ NOTE s Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �g FIRST INSPECTION AND FORM MADE BY : Mb. IBM Date: :i1/4' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLI0 SIDEWALK REPA SURVEY FORM - ROPERTY ADDRESS BO 3 KO PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G Yes ❑ No TRIM VEGETATION ❑Yes 51;No N j WATER VALVE — ADJUSTMENT REQD ❑Yes Xf No 1 - PARKS DEPARTMENT 5.d ' REVIEW REQUIRED �' � _ _ ❑Yes 1 No t VA 50/ Z_Q` '3 LOCATION OF SIDEWALK El Front Yard S Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 10 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches I'5 inches 0 6 inches• — AREA TO BE REPAIRED 131•I sq.ft. 4 in. 243. 4f sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes EX No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �'S � 1613S Date: Z3 d to PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - 6 4- SIDEWALK REPAIR SURVEY FORM 5/2 ) /1 PROPERTY ADDRESS S PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑Yes ix No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes No WATER VALVE .\ ADNT REQUIRED '0 Yes- C7 No • -ARK S-DEPARTMENT ` REVIEW REQUIRED ❑ Yes g No 4-5 4°tJ LOCATION OF SIDEWALK Al Front Yard ❑ Side Yard ❑ Other - WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Xr5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 26.o v sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Q>1:) Date: 3- 2- 3— PERMIT ISSUED FORMED POURED COMPLETED �\/'.5e; — CI OF WATERL OO �� -ro `� . SIDEWALK REPAIR SURVEY FORM � e c_®2-'‹. ottk fa _ to' \t‘r PROPERTY ADDRESS IO2 ors c . i - �3 o - PARCEL CODE CONTROL NO. �( i Nil Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑YesNo See below for Defect Code G T , G TATION _ Yes ❑ No fIN WATER VALVE i ADJUSTMENT REQ'D f , 411 ❑Yes KI No 1 — ` '-' PARKS DEPARTMENT /��`'�� I N REVIEW REQUIRED — ❑Yes ,No IkA 0 ClotAA, — LOCATION OF SIDEWALK ❑ Front Yard . $ Side Yard ❑ Other — WIDTH OF SIDEWALK I ,4 Feet ❑5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK IN.4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED .lb.°.sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes %No No.of Squares with Patches CODE G - - - - v — . — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. Q FIRST INSPECTION AND FORM MADE BY : / , Date: L`T/' , — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ' PROPERTY ADDRESS / roM iq 15 PARCEL CODE ' CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G J ❑Yes IgNo 1 i TRIM VEGETATION ❑Yes No - 0—*i 1 WATER VALVE ADJUSTMENT REQ'D 1 ❑Yes El No PARKS DEPARTMENT — __ Co\ 7.3s_LA REVIEW REQUIRED �� �J 0 Yes cg No _ \ IR „.„,,,6_ . , ..... LOCATION OF SIDEWALK 0 Front Yard , ,Side Yard 0 Other WIDTH OF SIDEWALK g 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑6 inches AREA TO BE REPAIRED' I Zen --=sq.ft. 4 in. sq.ft. 5 in. sq.ft 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired reconstruction of full sidewalk panels. by FIRST INSPECTION AND FORM MADE BY : PLAAL________ i3 , Date: G PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATER:Ai* �� SIDEWALK REPAIR SURVEY FORM \ �,�\ — U7� ROPERTY ADDRESS � - Z-54•" 1 It: �t�-&L t -V1) tr"?j\ �.70� — _ CONTROL NO. 49 PARCEL CODE M Type of Defect CLEAN SIDEWALK • See reverse side for Defect Codes A F ❑Yes No — - See below for Defect Code G j CO'r , TRIM VEGETATION — ❑Yes No � 1 ! � -s — ,,,,, dC�.a e.�. �' S WATER VALVE S tip.. Ai]JIJSTMENT REQ'D Yes ❑ No — i l _� • -_ , �� PARKS DEPARTMENT 4- REVIEW REQUIRED A I6,\ ❑Yes 'No — _ i/l� - - - - ��, il` �5 clsU Y---- ' ;" .5-si b 1 � L 3 eJ ��// i I}e E.lr��. 'PG c k V,e LOCATION OF SIDEWALK tl'Front Yard , ❑Side Yard ❑ Other — WIDTH OF SIDEWALK iI.4 Feet N 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK `II 4 inches . ❑5 inches ❑ 6 inches — • AREA TO BE REPAIRED 6 ZLI,c sq.ft, 4 in. sq.'ft. 5 in- sq.ft. 6 in. / 0 L3< , CI, 4'55 CODE F - PATCHES ❑Yes !rE'No No.of Squares with Patches CODE G . NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. 1 RS /) i � Date: , FIRST INSPECTION AND FORM MADE BY ; r — PERMIT ISSUED — FORMED POURED COMPLETED so _'J' CITY OF WATERL O bkg- qt. SIDEWALK REPAIR SURVEY FOR OVA- 1'ROPERTYADDRESS ZO! - Z55 FA,14‘4,- \i Lvi: - 1 gal IS -35- I55 - v�0, i� q fi l l PARCEL CODE rt� 0 11i CONTROL NO. COI Typec _ I 1 yPF - CLEAN SIDEWALK See reverse side far Defect Codes A F ,.:`4 U See below for Defect Code G N I l❑Yes No TRIM VEGETATION ❑Yes 0No 4 , I_ WATER VALVE 1c- ADJUSTMENT REQ"D `-` ❑Yes Iii No • ' L L- ---ry! PARKS DEPARTMENT — t REVIEW REQUIRED - - ❑Yes L No J kCIc5: ,4 " -5'.'eG- '— t5 c is 0 - — LOCATION OF SIDEWALK 'B'Front Yard . `® Side Yard ❑ Other WIDTH OF SIDEWALK I1 4 Feet ❑5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches , El 5 inches ❑6 inches I(5,4:&, P. C iA.s 'A:. AREA TO BE REPAIRED sq.ft. 4 in. sq.fL 5 in. sq.ft. 6 in. CODE F .. PATCHES El Yes fil No No.of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ;rl;')F) `) Date: i i Eo 16 — PERMIT ISSUED V FORMED - POURED COMPLETED -'11.i., 12-\\61 ve CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS II( Pe rck,m RA. V- ) — 7(3 - 3'I - 3U a °I-1 .- PARCEL CODE CONTROL NO. Type of Defect C— CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G I ❑Yes No TRIM VEGETATION _ ❑ Yes 1 .No 44-0- WATER VALVE jO I i ADJUSTMENT REQ`D ❑Yes l(No Csy i I — iO t. PARKS DEPARTMENT ��' REVIEW REQUIRED 4.s' _ z a.z' so.z' _ ❑ Yes I No 51 ) — SMei,c,.o n Rd . — LOCATION OF SIDEWALK ❑ Front Yard , liSide Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet . 5 Feet Feet ❑ Other DEPTH OF SIDEWALK M 4 inches IK 5 inches ❑ 6 inches — AREA TO BE REPAIRED )23•5 /sq.ft. 4 in. .5l•0 "sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes VeS No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R-s 11 G Date: 3• zm-le — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO Vec/h7 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 593 P t a eer PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes %No See below for Defect Code G TRIM VEGETATION ❑Yes NtNo 4-0—* WATER VALVE ADJUSTMENT REQ'D ❑Yes X No PARKS DEPARTMENT REVIEW REQUIRED — _ ❑ Yes J No 700 l/ 'id 4e,et LOCATION OF SIDEWALK ❑ Front Yard yt Side Yard ❑ Other WIDTH OF SIDEWALK 1 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK (N,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I b•0'sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes l[X No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Di? Date: 5" 1/g PERMIT ISSUED -- FORMED POURED COMPLETED CITY *-F WATERL** 11A�� SIDEWALK REPAIR SURVEY FORM ROPERTY ADDRESS 9 D\3 -3 Z-33eCoo1 PARCEL CODE CONTROL O. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G 1- cs/ ❑Yes No TRIM VEGETATION _ \'` • ❑Yes No g. WATER VALVE — ADJUSTMENT REQ'D Itj ❑Yes ( to — PARKS DEPARTMENT REVIEW REQUIRED — — — — ❑Yes itlo '— • t 4- LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet W.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches y 5 inches El 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. PO.4s `' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2.,> B� 5 Date: 3-2 2-` 49 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ,fiz21)9 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 ), k3 —3 4 — 2,3 —c).3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect d ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes gi No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes LNo I PARKS DEPARTMENT REVIEW REQUIRED \V Yes ❑ No i® '® \ - - PC-OSPE-Cr LOCATION OF SIDEWALK tyl Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet C5.3 Feet ❑ Other DEPTH OF SIDEWALK I7t 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 137.3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes N'No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All otherareas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 05 Date: 3- 22- .t PERMIT ISSUED FORMED POURED COMPLETED o A;vti�\`\ CITY Y OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I IS P1Z-C)_SW--cx— s ,/ i3 - 34= 2.3 -®3 ! V &p, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes to See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes €No WATER VALVE ADJUSTMENT REQUIRED — N ❑Yes No I I _ I PARKS DEPARTMENT REVIEW REQUIRED es ❑ No LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK I13a4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 53•S sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ` '‘) Date: 3� �' _ �a — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO 512,2,1 Ie SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I t.3- 34-z33 -o ff -S7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes LANo See reverse side for Defect Codes A-F J See below for Defect Code G J TRIM VEGETATION J ❑ Yes fNo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes E No 1 I J I PARKS DEPARTMENT _ REVIEW REQUIRED VS,/ 52 ❑ Yes No A ts. 1 o c l sr cm. LOCATION OF SIDEWALK 1X.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet CC5.3 Feet ❑ Other DEPTH OF SIDEWALK V. 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 13 3.4. u sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 30 Z Z. -t g PERMIT ISSUED FORMED POURED COMPLETED ��\�� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1(00 4 ' - l`3 -3 _ Z -(7 Ll PARCEL CODE CONTROL NO. - Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes INo TRIM VEGETATION ❑ Yes No N WATER VALVE � O r ADJUSTMENT REQ'D 1 t1! Yes 5114(1 - ) e 1-6 c j t 4 PARKS DEPARTMENT REVIEW REQUIRED -❑Yes '\lo LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other —" WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK 1)14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED f-C4°5* v sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes 'A No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S Date: `2_t " I PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 5/uili PROPERTY ADDRESS Z 3 5 5'7 5 C2› - 34---276--- 6 L, 4-4:6 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No I . PARKS DEPARTMENT -- REVIEW REQUIRED ,3 10°O ❑ Yes No A Vrit ,.3 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet '5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ►5 inches ❑ 6 inches AREA TO BE REPAIRED 2 Z' q.ft. 4 in. 5—0 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [ No No.of Squares with Patches CODE G - 4 NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : I:5'c>`7 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 2' 1� SIDEWALK REPAIR SURVEY FORM -- 2 fr) PROPERTY ADDRESS Z3 atc, P �o t4 -3L--2-76 -of- otO ✓ 44 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes `� No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 1.No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes Gi o I I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No - - ail' LOCATION OF SIDEWALK j Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet It 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED ?5.8 V sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES CI Yes IS No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2S bD 5 Date: 3 —2--3 _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 16 SIDEWALK REPAIR SURVEY FORM 5/121 (c PROPERTY ADDRESS 2- i PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes F No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes X No PARKS DEPARTMENT • REVIEW REQUIRED 5,4 ❑ Yes [ No A- - - - _ VA 4B LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK t'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 25•61 '°' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : �� 5 Date: 3-2-3 A 8 PERMIT ISSUED FORMED POURED COMPLETED 0---) C OF W TERW O — 16 ,vI SIDEWALK REPA! SURVEY FORM PROPERTY ADDRESS Z1 ( ?Ct.(55? ,g) 1 PARCEL CODE CONTROL NO. Type of Defect A 4-C CLEAN SIDEWALK cof See reverse side for Defect Codes A-F ,. t.Ic \'5' See below for Defect Code G I ❑Yes y No b � TRIM VEGETATION — r t�X�,s v, ❑Yes 1X1 No 4i— --► WATER VALVE — 1\ ADJUSTMENT REQ'D 4 ❑Yes (:No — 'I PARKS DEPARTMENT / i / t`i REVIEW REQUIRED 11,7 {U, {. ^ 5/ _ _ r4 ❑Yes l No — V4/,-1 ��/) V4 . I (0.0 \s. co s,41 P 5i' cam' LOCATION OF SIDEWALK i 'Front Yard , ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK r4 inches X-5 inches ❑ 6 inches — AREA TO BE REPAIRED 14O4 ` sq.ft. 4 in. 53.o sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes g No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 12.5 Dc, '' Date: 3-2-3 - 12) — PERMIT ISSUED FORMED _ POURED COMPLETED CO3 E„, ,� 107 Pv+-- CITY IIF E/ R\LI1 0 oy\ {-,---,,cicf1,-- SIDEWALK REPAIR SURVEY FORM 'ROPER ADDRESS 1.6 �5 `�'-r— v — �';A EL CODE CONTROL NO. — A Type of Defeat /CLEAN SIDEWALK See reverse sid�f Defect Codes A F / See below for De fbc Code G Elg Yes o — \ 7'f TRIM VEGETATION El Yes llo g Ie -40--42y. , ..,0 AD UST IViENT REQD ❑Yes f No PARKS DEPARTMENT REVIEW REQUI'ED — — — r, ❑Yes in No _ WA. / VA \, l V.L. j /43 \ \ i /; LOCATION OF SIDEWALK ❑ F4inf Yard 'Side Yard ❑ er WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet tyl 5.3 Feet in Cher DEPTH OF SIDEWALK ,>$4..inches 5 inches ❑ 6 inch AREA TO BE REPAIRS 59•"1 '-'/sq.ft. 4in. 4 .® "',sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCH ❑Yes No No.of Squares with Patches \, CODE G - — NOTE:Areas arked with an"F"may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2 " '1=> 5 Date: 3-2-2- - Q't PERMIT ISSUED FORMED POURED COMPLETED O CITY OF WATERL•® 1,01111 SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS �— S - — �, \3 .34-?As-oOZ 1 PARCEL CODE CONTROL NO. Type of Defect • See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G j ❑Yes 15110 TRIM VEGETATION ❑Yes No lf WATER VALVE — � ADJUSTMENT RE Q'D c; ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED A— — — — ❑Yes No — Vf LOCATION OF SIDEWALK tX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet L '5.3 Feet ❑ Other DEPTH OF SIDEWALK N'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 53.5 L"sq.ft. 4 in. sq.ft. 5 in. sq.IL 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by —` reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � ' Date: 3 1c9 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERAIO SIDEWALK REPAY SURVEY FORM PROPERTY AD RESS 672.5 L3 3 A 4-03 -01As �� 1; PAR L CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side or Defect Codes A F See below for Defect Code G ( ❑Yes `No TRIM VEGETATION ❑Yes No At WATER VALVE 1 I �\ ; ADJUSTMENT REQ'D ❑Yes Igf No 1 _ PARKS DEPARTMENT REVIEW REQUIRED • �` Yes ❑ No g o� _ J LOCATION OF SIDEW t K ❑ Front Yard • Side Yard ❑ Other WIDTH OF SIDEWA ❑4 Feet ❑5 Feet 5.3 Feet ❑ Other DEPTH OF SIDE ALK 4 inches ❑ 5 inches ❑ 6'riches AREA TO BE '.PAIRED ZSO.asq.ft. 4 in. sq.ft. 5 in. \sq.ft. 6 in. CODE F - P l CHES ❑Yes a No No.of Squares with Patche\ CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaire by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Ilia Date: �� _ �� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - tA SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 'coo t R;Jut,a. , 13 -33 - LI77 - 471 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes X.No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes XNo WATER VALVE t ADJUSTMENT REQUIRED N / )'Yes to PARKS DEPARTMENT REVIEW REQUIRED klf°1 ❑Yes Ai No ti , e ` g i � Y - J LOCATION OF SIDEWALK i .Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IEj,4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED ` a• ' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No.of Squares with Patches CODE G - — NOTE :Areas marked with an OF"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: '-21-/W — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO f rz-1 l� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (1). Rzlicgo.YcrLI 461t3 -33 - 4?7 - It+ t9-?- 7L PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ' Cgl.No See reverse side for Defect Codes A-F • See below for Defect Code G ( TRIM VEGETATION I I ❑Yes jl No WATER VALVE ADJUSTMENT REQUIRED ❑Yes It No I PARKS DEPARTMENT — a i REVIEW REQUIRED ❑Yes 12No 3 IA). Ai4s,-,,AA y LOCATION OF SIDEWALK 14 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK M 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK i 4 inches ❑ 5 inches ❑ 6 inches — / AREA TO BE REPAIRED 15:G sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 1T_4 No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : d- TE Date: 3`��-l� PERMIT ISSUED FORMED POURED COMPLETED avoN CITY OF WATERLOO — 42\011 SIDEWALK REPAIR SURVEY FORM- PROPERTY ADDRESS &32 k4 • v �5a3 ' 34 ' 321 - oto 4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ] No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑Yes ) No — WATER VALVE ADJUSTMENT EQUIRED 4-0 . a32- Yes N4 No I I PARKS DEPARTMENT —' \ REVIEW REQUIRED L`qX Yes ❑ No pck LOCATION OF SIDEWALK OKFront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K.t..3 Feet ❑ Other DEPTH OF SIDEWALK .k'4 inches Li 5 inches ❑ 6 inches AREA TO BE REPAIRED Z64 C) v sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes g.No No.of Squares with Patches CODE G - -- NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : t-5 Date: 3 'Z® `$ — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO I REPAIR SURVEY FORM ���Zl �� SIDEWALK PROPERTY ADDRESS 2.°7o slhe kd • - 3`i - 32-1 - O n 4g PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes 7 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 'No -- WATER VALVE ADJUSTMENT REQUIRED N -2`7 0 ❑Yes 9 No o I PARKS DEPARTMENT REVIEW REQUIRED ®.0 '\ Yes ❑ No / \ / s \ LOCATION OF SIDEWALK IX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches x5 inches ❑ 6 inches AREA TO BE REPAIRED 52.5 Vsq.ft. 4 in. .921.9 .'sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Ai No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 • Date: 5-2° g PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO t� SIDS V111 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Rot g9I3 -39 -321 a®dq v 4 PARCEL CODE CONTROL NO. Type of Defect C- CLEAN SIDEWALK See reverse side for Defect Codes A F _ See below for Defect Code G 2.1) ❑Yes ,I No 231 • TRIM VEGETATION ❑ Yes g No `- WATER VALVE i cs' ` ADJUSTMENT REQ'D ❑Yes 'No PARKS DEPARTMENT REVIEW REQUIRED — — — — gYes ❑ No — N S;dew�,V e r g,Or4 re Q.a -- LOCATION OF SIDEWALK XI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet '5.3 Feet ❑ Other DEPTH OF SIDEWALK ,>1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I10.0 'f sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : g D Date: 3. 2°- 't PERMIT ISSUED FORMED POURED COMPLETED C •F WATERLOO SIDEWALK REPAIR SURVEY FORM � lZ� I°t PROPERTY ADDRESS 3 60 R24 - cg9 _ ?21 —0 ►S 406-1 PARCEL CODE CONTROL NO. -- Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑Yes , '' No 6°2- TRIM VEGETATION ❑Yes No s t WATER VALVE 14, I ADJUSTMENT REQD ❑Yes J'No �- • PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No �1n Id LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Xi 5.3 Feet ❑ Other DEPTH OF SIDEWALK -04 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED gri.c. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes V No No.of Squares with Patches CODE G NOTE=Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY S C3 Date: 3 —20—o I' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 7 \ti SIDEWALK REPAIR SURVEY FORM"\ PROPERTY ADDRESS 4 2O S 1ne r-)Acor, �Q t3 -39 - 37 - 022 ✓ � PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑ Yes CNo _ WATER VALVE ADJUSTMENT REQUIRED — N �Z(7 ❑Yes I No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No501 \ 3IIv° — S her; Qc -' LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .K 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z co•= sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes g No No.of Squares with Patches CODE G - -- NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ® Date: 3-2®-1g PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIzZ) SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .3 PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes No TRIM VEGETATION ❑ Yes 1No 03 WATER VALVE ADJUSTMENT REQ'D ❑ Yes No PARKS DEPARTMENT 4. ' REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet , 5.3 Feet El Other DEPTH OF SIDEWALK IV4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 2.5• `_` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑'Yes C No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3 - t PERMIT ISSUED FORMED POURED COMPLETED CITY OFWATERLOO . ti Pk SIDEWALK REPAIR SURVEY F0,16:AA _ J PROPERTY ADDRESS . PARCEL CODE CONTROL NO_ 00 Type of Defect C- J CLEAN SIDEWALK See reverse side for Defect Codes A-F _ _ See below for Defect Code G 3= ue J I ®' ❑Yes No TRIM VEGETATION 6 ® ❑Yes No —► WAT 4TVE It \ ,Ai/JUST T REQ'D E4 Yes', No DEPARTMENT ,7 REVIEW REQUIRED • — — — — El Yes INo Z1•5 too,1 LOCATION OF SIDEWALK ❑ Front Yard AI Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 74 5.3 Feet ❑ Other DEPTH OF SIDEWALK >44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I 2•Z. `'sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes le No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : a D5 Date; 3 2— t g PERMIT ISSUED FORMED POURED COMPLETED 3 r +j CITY OF WATERLOO o/, l►� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS $o7 S 5 - . �r PARCEL CODE CONTROL NO. Type of Defect A c- See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes y,No TRIM VEGETATION 0 ... Yes ❑ No ♦'4� 3 WATER VALVE \ V) ADJUSTMENT REQ'D ❑Yes [ I No • ,� �, PARKS DEPARTMENT a REVIEW REQUIRED C- A ;g1,Yes ❑ No (1,141 t�r1 i ioy 6.4 LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet f .Other 5.L( DEPTH OF SIDEWALK Ii 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 09.9 q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 15 8 ADS Date: 3 .1a--/F PERMIT ISSUED FORMED POURED COMPLETED e CITY OF WATERLOO 12/ SIDEWALK REPAIR SURVEY FORM � m _ PROPERTY ADDRESS 5 M73- 31i- z56- .5-01 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect Ai ❑Yes ''No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes IS No WATER VALVE ADJUSTMENT REQUIRED ❑Yes �,No - I I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No �1,1 5°4' rr//iA sv LOCATION OF SIDEWALK Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ID5.3 Feet )Other °q\ DEPTH OF SIDEWALK ❑ 4 inches Ai 5 inches ❑ 6 inches AREA TO BE REPAIRED 105,3 sq.ft. 4 in. L'7°5 sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - PANiDeAd ag.11 if s- 49- Il NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : 1;94 Date: 06®ti al PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 5"/2 Z/i SIDEWALK REPAIR. SURVEY FORM PROPERTY ADDRESS 5Y1 Sikels&f Rd. 1- PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect ❑Yes Vl.No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes LLNo WATER VALVE ADJUSTMENT REQUIRED ❑Yesi No I PARKS DEPARTMENT REVIEW REQUIRED Z 1,z ,g' ❑Yes I ,No 1 /1 l®I V'1 .a .a 3.8 / SwAs LOCATION OF SIDEWALK Front Yard ❑ Side Yard , ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet El 5.3 Feet [,Other 5 1 DEPTH OF SIDEWALK tp1,4 inches IX 5 inches ❑ 6 inches AREA TO BE REPAIRED 8 7• 5 , . sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : se 5 a Ds Date: 3-01 a®/6 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERL•-0 or SIDEWALK REPAIR SURVEY FORM . - PROPERTY ADDRESS .23 ? 0/0/44d %v e1 s 13 -37-agO - ®ea -S PARCEL CODE CONTROL NO. s Type of Defect CLEAN SIDEWALK • See reverse side for Defect Codes A-F — See below for Defect Code G 1 ❑Yes [ .No I TRIM VEGETATION ❑Yes JNo • ,..., t f' r1 WATER VALVE i3O I ADJUSTMENT REQ'D ❑Yes 1 'No io rz1 — ` PARKS DEPARTMENT• REVIEW REQUIRED 4. — — ❑Yes IMNo I / eas pet. LOCATION OF SIDEWALK IA Front Yard , 1+ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ix 4 inches ❑ 5 inches ❑ 6 inches 1 AREA TO BE REPAIRED /5 7•a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes IX No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : -D 5 rt- Date: 3"422/S" -_ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ,/rti 1ek PROPERTY ADDRESS %13 'N(v oi\ 8 ►S -35- of\ v' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A, ❑Yes k No See reverse side for Defect Codes A F See below for Defect Code G 1 TRIM VEGETATION I I ❑Yes LI No �' TE ADJUSTWAR ADJUSTMENT REQUIRED ❑Yes a No t I PARKS DEPARTMENT REVIEW REQUIRED '6 ,5 ® 1 Yes ❑No 55 rr) • - Ve r V1nvv1 • LOCATION OF SIDEWALK 'a Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X 5.3 Feet ❑ Other DEPTH OF SIDEWALK :I '4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5- 7 sq.ft. 4 In. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 321'No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : ' ►_) �' �, Date: Li ff l61 lb E ' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO :9 SIDEWALK REPAIR SURVEY FORM (at\6\\ PROPERTY ADDRESS 7/ (eco-‘o;\- .. 8c03 - 3 5- 12.6 - v i0 b' 507 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A ❑Yes E No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I I ❑Yes .No WATER VALVE ADJUSTMENT REQUIRED 5 _ ❑Yes tiR(`No \ I - PARKS DEPARTMENT REVIEW REQUIRED 6j"6 ❑Yes IX No 6,6 LOCATION OF SIDEWALK IN'Front Yard ❑ Side Yard . ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet — 5.3 Feet ❑ Other DEPTH OF SIDEWALK tNr4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '- ` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : 11ll 4- Date: 1"//1D1 l'5 PERMIT ISSUED • FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS qi I°. n -35- ;q - 0,3 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A ❑Yes g No See reverse side for Defect Codes A F I See below for Defect Code G I TRIM VEGETATION I I ❑Yes %No WATER VALVE ADJUSTMENT REQUIRED Q—► Li Yes j No I � �1 r PA)° RKS DEPARTMENT m REVIEW REQUIRED i ❑Yes No \kvvio cc ' LOCATION OF SIDEWALK J[Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑4 Feet 145 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK j 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z 1 sq.ft. 4 in, sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes :NI No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. f,� /'' J FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERS,! ,• - SIDEWALK REPAIR SURVEY FORM ` �\�'n \ "ROPERTY ADDRESS 2,5 0e o4 • PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G l ❑Yes irNo — TRIM VEGETATION ❑Yes VNo Q '4.. WATER VALVE — c0$0 i 4,\ ADJUSTMENT REQ'D V. ❑Yes QNo . \J `�s2 �l�` ` PARKS DEPARTMENT .I d.d REVIEW REQUIRED — -- ❑Yes g No Jf 0 . ( j V e Vi io9N ti _ LOCATION OF SIDEWALK X Front Yard , 0 Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet J ',5 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK A.4 inches . ❑5 inches 0 6 inches AREA TO BE REPAIRED 7 , sq.ft 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES )(Yes Q No No.of Squares with Patches 1 CODE G . NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ,, , I FIRST INSPECTION AND FORM MADE BY : MAD D V�V Date: WO/Pk PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM �! - PROPERTY ADDRESS //, kfict15rau 13V3 -35- tol - oo5' 575 H PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect 4 ❑Yes N.No See reverse side for Defect Codes A F See below for Defect Code G 1 TRIM VEGETATION 1 ❑ Yes i2 No '� WATER VALVE 'f ADJUSTMENT REQUIRED ❑Yes NI No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes C .No - - - - - - 4O • LOCATION OF SIDEWALK 111,Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet r Other S i Z DEPTH OF SIDEWALK EA inches ❑5 inches ❑ 6 inches — AREA TO BE REPAIRED ZO$3 sq:ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes M No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching_All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 't Date: 3-50`l PERMIT ISSUED FORMED POURED COMPLETED 11,‘-,j7\tlxv.),V\ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I3 a beit ti-js a4 0670. -3 - /00 - 000 14,0' PARCEL CODE CONTROL NO. CLEAN SIDEWALK -` Type of Defect 4 ❑Yes t No See reverse side for Defect Codes A F „ ,, ) See below for Defect Code G TRIM VEGETATION I 1 ❑Yes {No WATER VALVE )� ADJUSTMENT REQUIRED ❑Yes M No —' l PARKS DEPARTMENT REVIEW REQUIRED ❑Yes INo ���/fre-ieVP t LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet GV 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches C j 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in o sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Ll Yes ❑ No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by _ reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : l 614 Date: 3-O-18 PERMIT ISSUED FORMED POURED COMPLETED CITY OF W. TERLSO _,13/"g SIDEWALK REPAIR SURVEY FORM ( 1 a`��'� PROPERTY ADDRESS /6i 7-- ai t-L4- • 1( -3 - kg-- i & w% Sic ., PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F �' CLEAN SIDEWALK See below for Defect Code G I El Yes No TRIM VEGETATION ❑Yes No - ~ F ; - WATER VALVE iij� I • 100 I — Ab,]USTMENT REQD ❑Yes ,I] No ti aD p Z PARKS DEPARTMENT 5 ® REVIEW REQUIRED e - illb___4 " �,� flECYes ❑ No / ____. , x 1:.)-'LI \ 1-10e1\40 ,,te„ j AA,hc„ LOCATION OF SIDEWALK A Front Yard . ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet $5.3 Feet ❑ Other DEPTH OF SIDEWALK 7 4 inches jgil S inches ❑ 6 inches - - AREA TO BE REPAIRED ' ` 7sq.ft. 4 in. 07 sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes X,No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f l Date: �� G8 r • PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO• 6.0)(1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Cx2) t i �It i 5 �r /°. B91" -35— ic3 - 00z._ 5Z. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ' ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I 1 ❑Yes j8rNo • WATER VALVE ADJUSTMENT REQUIRED ❑Yes IKNo — Pf 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes P<No • 5.5' , ; �� %\ jf-J✓l LOCATION OF SIDEWALK Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet i `5,3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches .19.I AREA TO BE REPAIRED sq,ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes Io No,of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by — reconstruction of full sidewalk panels.• FIRST INSPECTION AND FORM MADE BY : M 5 6- R Date: ///01 6 PERMIT ISSUED FORMED POURED COMPLETED T CITY t_PF WATERI •® b') aAg SIDEWALK REPAIR SURVEY FORM Coo'`' .,S 5-1'V — •ROPERTY ADDRESS 02 i'iaa L. toi. PARCEL CODE CONTROL NO. ti,`�LA e- Type of Defect A . E CLEAN SIDEWALK See reverse side for Defect Codes A F I ❑Yes - No See below for Defect Code G TRIM VEGETATION _ ® El Yes K-No t WATER VALVE _ i 'Ct i I ADJUSTMENT REQ'D ❑Yes )No 14: L'e t,3 ZS..e y , PARKS DEPARTMENT • q ry 8.1 - REVIEW REQUIRED Li.7 at! - _ /Jaa ® � e� ❑Yes f'No v _____) \ 5,,,,,,-) , , LOCATION OF SIDEWALK 1 Front Yard , $Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet St 5 Feet 0r5.3 Feet ❑ Other DEPTH OF SIDEWALK ,Q 4 inches X 5 inches ❑ 6 inches AREA TO BE REPAIRED'" •2`1` .D sq.ft. 4 in, 02g.5 sq.fit. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes ( ;No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels, (� �U FIRST INSPECTION AND FORM MADE BY : 1�1 t) Date: I h1/, g PERMIT ISSUED FORMED POURED COMPLETED /6:0)3Y\ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOR . PROPERTY ADDRESS 5 4 0 shed v 8 i I-c - 35 - - 005 ,/ 5z7 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect / ❑Yes [XNo See reverse side for Defect Codes A-F See below for Defect Code G 1 TRIM VEGETATION 1 1 ❑Yes NNo WATER VALVE ADJUSTMENT REQUIRED F "'� ❑Yes krNo l % \ 1 PARKS DEPARTMENT REVIEW REQUIRED ;� ❑Yes J No ,,L1 21,,f 1, 1 • LOCATION OF SIDEWALK a Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK Jkl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z Ysq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes NiNo No,of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by — reconstruction of full sidewalk panels. �} J • FIRST INSPECTION AND FORM MADE BY : f i� c Date: £1 tof f — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO l t SIDEWALK REPAIR SURVEY FOR' C I L L-1M PROPERTY ADDRESS ;,,1 -sc,- to - oJ`- . . 5?-g PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A. ❑Yes No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes X.No WATER VALVE ADJUSTMENT REQUIRED �"Q"'� ❑Yes No off\ l PARKS DEPARTMENT REVIEW REQUIRED LI Z ❑Yes No _ 4,11 - - - - — k a ii t ty0S0 LOCATION OF SIDEWALK ► Front Yard ❑ Side Yard , ❑ Other • WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK '4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 21[7 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by y reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : RC Date: Iri '0! tr`2: PERMIT ISSUED FORMED POURED COMPLETED y CITY OFW,A,TE L•• A SIDEWALK REPAIR SURVEY FORM (Pk "ROPERTY,ADDRESS Z"'t LF ' PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑Yes Er,'No TRIM VEGETATION At if ❑Yes No �Nr_ N WATER VALVE 4N. �-� ADJUSTMENT REQ'D -' ❑Yes 1`No PARKS DEPARTMENT REVIEW REQUIRED - - - - ❑Yes No \lPa,4v1 i LOCATION OF SIDEWALK cgiFront Yard , ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet N-5.3 Feet 0 Other DEPTH OF SIDEWALK A inches , ❑5 inches ❑ 6 inches AREA TO BE REPAIRED 211•- °/sq.ft. 4 in. sq.fL 5 in. sq.fI. 6 in. CODE F - PATCHES 0 Yes No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ' RS Date: ,i 10//h PERMIT ISSUED FORMED POURED COMPLETED CITY OF wATERL.o SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS %r J, 1 ,z Lei .,rd j cl 6)16/ q -35- lZ2, -Oc)a. ..f PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A; C El Yes p(No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I El Yes 7tNo WATER VALVE „, ADJUSTMENT REQUIRED ~0—* ❑ Yes .l ;No — 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes _R No 1_ > ;7 Iv' • LOCATION OF SIDEWALK I1 Front Yard ❑ Side Yard , _❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0,5.3 Feet ❑ Other DEPTH OF SIDEWALK Ai 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5` . sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes A.No No. of Squares with Patches — CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. _ ' FIRST INSPECTION AND FORM MADE BY : 1116 4- K.S Date: Li /lv) 16 PERMIT ISSUED FORMED POURED COMPLETED • fan CITY OF ATERLSO 1 SIDEWALK REPAIR SURVEY FORM 'ROPER`I Y ADDRESS q l \,, i ;S (3,,-N • e913 -35 - 12.6 b co3 ,,� Sz_ PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G ❑Yes GLNo ‘71'1 TRIM VEGETATION ❑Yes a No — N ` WATER VALVE IC 1 ADJUSTMENT REQD `3 ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED • — — — — ❑Yes C No mye LOCATION OF SIDEWALK I Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet l`5.3 Feet ❑ Other DEPTH OF SIDEWALK Dk 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z7 sq.ft. 4 in. sq.ft. 5 in= sq.ft. 6 in. CODE F - PATCHES 0 Yes 'No No.of Squares with Patches CODE G NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �� Date: )• PERMIT ISSUED FORMED POURED COMPLETED