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IIMM• CITY •F WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS lac) eiD(3 - -Oi--t v 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 J� ❑Yes No 11 j ut, WATER VALVE 02 ADJUSTMENT REQ'D ❑Yes o PARKS DEPARTMENT REVIEW REQUIRED 1$Yes ❑ No 4.114 -- LOCATION OF SIDEWALK Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet .,.. ,KI 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 16-1,e sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes % No No.of Squares with Patches CODE G NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3 2-3—Ic PERMIT ISSUED FORMED POURED COMPLETED CITY OFWA E 100 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS \B01 V , `$ _ -0,3 - PARCEL CODE CONTROL NO. - A Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ft ❑Yes No — See below for Defect Code G I . TRIM VEGETATION ❑Yes No — 1 WATER VALVE A-0— ♦ ADJUSTMENT REQ'D — �( ❑Yes No 1 1 _ rt�_ PARKS DEPARTMENT •• REVIEW REQUIRED Yes ❑ No — Ill l2 .5 — I- 3i. 1ss• LOCATION OF SIDEWALK YI Front Yard . ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 1 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 'rl 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 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 : �—`' `7 Date: d� w la — PERMIT ISSUED FORMED POURED COMPLETED — Rcotseb CITY SF WATEr61,00 p v lf: To SIDEWALK REPAIR SURVEY FORM Coi,,11 a 16 PROPERTY ADDRESS IS\C: 4- 4 . 5"I 1s RS g` r 27- 1 - !a\ D ✓ 4- PARCEL CODE CONTROL NO. Type of Defect f CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G TRIM VEGETATION ❑Yes N'No 4— — * WATER VALVE <' ADJUSTMENT REQ'D El Yes No PARKS DEPARTMENT REVIEW REQUIRED _ _A ❑Yes i 'No I , 1 LOCATION OF SIDEWALK ❑ Front Yard I .Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet rg 5.3 Feet ❑ Other DEPTH OF SIDEWALK Li 4 inches 0?1 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. SZ'S 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 : g S2)U `' Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I S i _ - D 1,5 - = 4 - PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — ❑ Yes XNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION — ❑ Yes N.No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes o — I PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes .,ye No 4. LOCATION OF SIDEWALK '.' Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet V5 Feet ❑ 5.3 Feet ❑ Other -" DEPTH OF SIDEWALK IX 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7®•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 : '`7 Date: 3 -2-3 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS l k 1,7 - 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 i TRIM VEGETATION 1 ❑Yes No \ it WATER VALVE ~�y`� ADJUSTMENT REQUIRED 1 4. a ❑ Yes No 1 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 'X No ___± ga 1 LOCATION OF SIDEWALK Front Yard ❑ Side Yard CD Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches AREA TO BE REPAIRED 51 g ❑ 6 inches "' sq.ft. 4in. ----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 reconstruction of full sidewalk panels. be repaired by FIRST INSPECTION AND FORM MADE BY : A:\,-.5 Date: ?-2 _' — PERMIT ISSUED FORMED _, POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS CONTROL NO. - PARCEL CODE G CLEAN SIDEWALK Type of Defect A � ❑Yes No — See reverse side for Defect Codes A-F I ---; See below for Defect Code G I TRIM VEGETATION — Yi ❑Yes X No -' WATER VALVE ADJUSTMENT READ ❑Yes Nots — - ® PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes 'F No r _ ?„3„.„„__________„__________ , _ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — — ❑ 4 Feet C Feet ❑ 5.3 Feet ❑ Other — WIDTH OF SIDEWALK — DEPTH OF SIDEWALK 4 inches 5 inches ❑ 6 inches �2y-� sq.ft. 5 in. _sq-ft 6 in. — AREA TO BE REPAIRED 1 -sq.ft. 4 in. ----- ❑Yes No No.of Squares with Patches ----- CODE F - PATCHES — CODE G - r' — be repaired by patching.All other areas shall be repaired by NOTE :Areas markedti withofful al sidewalkFn may anes. reconstrucon p , — — FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED COMPLETED POURED FORMED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 2 2' - 313 - ,'_ 3 �-bO PARCEL CODE _ CONTROL NO. ` Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK I See below for Defect Code G ❑ Yes No — I TRIM VEGETATION I ❑ Yes o N WATER VALVE ADJUSTMENT REQUIRED ❑ — I Yes I No 1 PARKS DEPARTMENT REVIEW REQUIRED _______L _____i AYes ❑ No s:4 s-,4-- — _ ____ — LOCATION OF SIDEWALK Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK 0 4 Feet ❑ 5 Feet DEPTH OF SIDEWALK 5•3 Feet ❑ Other 4 inches ❑ 5 inches — AREA TO BE REPAIRED ST.2 ❑ 6 inches sq.ft. 4 in. sq. ft. 5 in. CODE F - PATCHES --sq. ft. 6 in. ._. ❑ Yes XNo No. of Squares with Patches CODE G - NOTE:Areas marked with an "F" may be reconstruction of full sidewalk panelspaired by patchin . FIRST INSPECTION AND FORM MADE � 9 All other areas shall be repaired by BY . Date: -a - �; PERMIT ISSUED FORMED POURED COMPLETED 2�visEM C F W',TERLO') qy%— LoNs SIDEWALK REPAIR SURVEY FORM 5 •ROpERYV ADDRESS Z t Z V--f. 1i,i N- c- , 1 . �- 3 3. �J -3 i i -00, CONTROL NO. .- PARCEL CODE - r�► (� 1 CLEAN SIDEWALK Type of Defect ❑Yes lIg No — See reverse side for Defect Codes A-F I See below for Defect Code G d 1 ; n TRIM VEGETATION g ❑Yes A No — At if WATER VALVE — 4-0 3 ? ADJUSTMENT REM)I 0 ❑Ye v` No 0 1 N ,Q.?: PARKS DEPARTMENT REVIEW REQUIRED I/V A L Yes ❑ No — --— 1Vi /il A to,1 1p.a A.' 1 5,6 55.1' 5,,0 . Side Yard ❑ Other _---- LOCATION OF SIDEWALK 1 rontYard — ❑4 Feet ❑ 5 Feet VI 5.3 Feet ❑ Other �- — WIDTH OF SIDEWALK ❑ 6 inches — 4inches5 inches DEPTH OF SIDEWALK � sq.ft. gin. 3�2.o sq.ft. 4 in. �.--sq.ft. 5 in. .-- AREA TO BE REPAIRED �--- — CODE F - PATCHES ' I, 0 Yes No No.of Squares with Patches -- CODE G - �� �� be repaired by patching.All other areas shall be repaired by — NOTE:Areas marked with an F may 3_�3�1� reconstruction of full sidewalk panels. �5 � 9 Date: FIRST INSPECTION AND FORM MADE BY — PERMIT ISSUED COMPLETED POURED .-- FORMED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i ? "' - - ✓ t-5 - L- 3 v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ei ❑ Yes X No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes A No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No I I 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No A VA \d LOCATION OF SIDEWALK (Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1 .3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z3.3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes to 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: 3-2.1 -j -- PERMIT ISSUED FORMED POURED COMPLETED R Ise() CITY OF WATERLOO buc- T° — SIDEWALK REPAIR SURVEY FORM cooT. "8 Z l - 5-1 ✓ 5-ti-13 RS - PROPERTY ADDRESS c ) -34 Z3Z.- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes l�SNo See below for Defect Code G ► — TRIM VEGETATION Cl Yes )A£No — �— —► WATER VALVE ADJUSTMENT REQ'D ❑ Yes J 'No PARKS DEPARTMENT REVIEW REQUIRED fo" C _ _ _ - ❑ Yes 1$No _ 12-3 w. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK '1'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 65'2 ' 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 : '� ©17 Date: r? ( —I PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -34—"vc - co 4- ..-- I -- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect /J, ❑ Yes kNo 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 PARKS DEPARTMENT REVIEW REQUIRED XYes ❑ No 6.t sD so 4-114-r A LOCATION OF SIDEWALK S.Front Yard ❑ 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 REPAIRED e19pVsq.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 : 5 Date: 3-21-t -" PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ` , A ztio - if 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 M No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes No — PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No A ,5 LOCATION OF SIDEWALK lg.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet yl 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED 71 Z 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! -IF PERMIT ISSUED FORMED POURED COMPLETED — �oN�. CITY OF WATERLOO Dui ° - SIDEWALK REPAIR SURVEY FORM _, PROPERTY ADDRESS 2�68 \, '. e�L- c--ii( ✓ 5 (l°�$ 25 p3\3 -34--20i - co8 ' 7.0 - 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 X No — 1 TRIM VEGETATION t "' _ ❑ Yes LNo n 44A:DH10. J 2. WATER VALVE — J jam, ADJUSTMENT REQ'D "' IDYes E No 1 ' et; PARKS DEPARTMENT A A A REVIEW REQUIRED r A ,I El Yes I No 12..z. q .?_ I ) i 0 a.1 `4- /.63 -- LOCATION OF SIDEWALK ji4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet l+15 Feet X 5.3 Feet ❑ Other DEPTH OF SIDEWALK V4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 1Er . 7 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 : 5 Date: 4 "Z 18 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ?- ' 1 3 - 4= t-7 -COS- 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 ❑ Yes g No WATER VALVE t�/ ADJUSTMENT REQUIRED --©--► ❑Yes RI No — I PARKS DEPARTMENT 5,Avl REVIEW REQUIRED ❑Yes No k114 LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet XiOther Z-- DEPTH OF SIDEWALK ❑ 4 inches IS 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. 32-3 `` sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CXNo 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 : V-5 Date: PERMIT ISSUED FORMED POURED COMPLETED CIS O F WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z4,45 W, d- i 255i3 -34- 17G - O03 ✓ .,�, -- PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes ;a"No I TRIM VEGETATION AtNI ❑ Yes fks No 441.0-0. WATER VALVE _ ADJUSTMENT REQ'D ' I ❑ Yes IiNo PARKS DEPARTMENT c AREVIEW REQUIRED �.. � �/�/� ❑ Yes = ►No 9.4 t2,2 ` -t r` LOCATION OF SIDEWALK XFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet [.'Other S DEPTH OF SIDEWALK ,K4 inches X5 inches ❑ 6 inches AREA TO BE REPAIRED ‘5,c4k sq.ft. 4 in. 5O• ' 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. `r FIRST INSPECTION AND FORM MADE BY : 11--5 fl 3 2 J 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 I TRIM VEGETATION ❑ Yes f No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No 4.21 LOCATION OF SIDEWALK X1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK iZ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK I 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 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 : :05Date: e ��/ PERMIT ISSUED FORMED POURED COMPLETED — a CITY OF W',E LOO SIDEWALK REPAIR SURVEY FORM ROPER`I Y ADDRESS 3,r) V : 1.4‘ 54--. I t3 - 33- TT7 - ®O — PARCEL CODE G —75,1 C(c�nwalk CONTROL NO. a i3 Y Type of Defect Aa See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G VW „� th 1 1M P Yes LI No I TRIM VEGETATION JI El Yes IS] No — ♦—Q�-1 ��ice` 1 ;„ WATER VALVE v' . ADJUSTMENT REQD tll -4 ❑Yes I ,No e ,►� . r PARKS DEPARTMENT — ?.7` k'� F REVIEW REQUIRED -- /ice%1E - �` El a No ARM Ill — LOCATION OF SIDEWALK 0 Front Yard T4 Side Yard 0 Other gack WIDTH OF SIDEWALK J 4 Feet ❑5 Feet D 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 4 inches ❑ 5 inches g 6 inches AREA TO BE REPAIRED 535;a sq.ft. 4 in. s .ft. 5 in, L'!.4 q 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 : 3a 'T- Date: 3-30<J — PERMIT ISSUED FORMED POURED COMPLETED CITY tiF WATE'L0O SIDEWALK REPAIR SURVEY FORM _ •ROPER ADDRESS I V" ,5 PI:3 - - 1177-g9J CQNT , NO. PARCEL CODE Type of Defect 6. CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No — See below for Defect Code G TRIM VEGETATION ❑Yes ( No — 0/ pm, µ,wkC®.,^§y 4.7 �, WATER VALVE tea-+► �� • ADJUSTMENT REQ'D — 1� 6h�'" I ❑Yes 12 No PARKS DEPARTMENT REVIEW REQUIRED ALI ® f ,d` ID Yes No r en r , — LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other — WIDTH OF SIDEWALK K4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches Xr 6 inches _ AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. I 1.a 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. ®� FIRST INSPECTION AND FORM MADE BY : Th. Date: _ PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -' PROPERTY ADDRESS t 1.3 - 33 - 4!72 - 0.31 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 gNo WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No I I PARKS ART REVIEWDEP REQUIRED Yes ❑ No 7.?;P LOCATION OF SIDEWALK .Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK r_�,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED `—"4/• sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes rg,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 : DE3 TE Date: ,?3a-I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 390 5 . a4., r9 33 - - Y7 7 -0®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 I No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes it No — I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 47` ` Wry LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK g4 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 : I e 7-T Date: _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS td. it's g i3 - .�- L177 - 001 `- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes t1 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 N ❑ Yes Ur No _ � I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ] No 94 `f4' y.® 1/6 S . LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 544 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED I b.® sq.ft. 4 in. sq.ft. 5 in. 311•y 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 : TEA Date: 30 72 PERMIT ISSUED FORMED POURED COMPLETED CITY F W1kTEr'LO® — SIDEWALK REPAIR SURVEY FORM — 'ROPERTY ADDRESS 103 , 1 ®a, 03-35 - z - 0107 -,/ ,, PARCEL CODE CONTROL NO. Type of Defect ' t CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑Yes No TRIM VEGETATION ❑ Yes No e),„Wjf --7,-Al) .4 WATER VALVE 1704 I ADJUSTMENT REQ°D -- ' ' ❑Yes L;No cio•C (i )i),1, t PARKS DEPARTMENT — a REVIEW REQUIRED .1` �,1` ❑Yes No _ — LOCATION OF SIDEWALK ❑ Front Yard , #Side Yard ❑ Other WIDTH OF SIDEWALK r' 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK „El 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 2D - CODE F - PATCHES ❑Yes N No No.of Squares with Patches — CODE G - (X) f`e gA `' ecel- ' f� pkoeb xism'' ... 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: __03, (LYCS____ PERMIT ISSUED FORMED POURED COMPLETED e..ee CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS <'CI 5 A454o('0l� VI -33 -.275 - 005" PARCEL CODE CONTROL NO. A G CLEAN SIDEWALK Type of Defect ❑ Yes f (No See reverse side for Defect Codes A-F See below for Defect Code G ( TRIM VEGETATION I ❑ Yes gNo WATER VALVE ADJUSTMENT REQUIRED N ;4 Yes ❑ No I I PARKS DEPARTMENT REVIEW REQUIRED GAO' to)- ❑ Yes A No .1 alJdG Aktylvro EAAV1 LOCATION OF SIDEWALK [g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK f1 4 inches ❑ 5 inches ❑ 6 inches t AREA TO BE REPAIRED ( 10 . ( 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 - V z.15 )Auk, ncc9-5 ��Q 'A49.1-e4. 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 : I13 F Tr- Date: 327 18 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS del 41,*.bore)L I - .32- 278 - o 07 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 I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes JX,No 14.0' .0S0d`O - LOCATION OF SIDEWALK k: 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 _112_,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 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS An 5 6rd q-% 13913 -33- a78 - oo PARCEL CODE CONTROL NO. Il CLEAN SIDEWALK Type of Defect I ❑ 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 I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes tA No w.v• AY15 borou.rnyl 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 sq.ft. 4 in. 1 (O•L sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CANo 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: 3'423-1.5' —' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / &' c' c' 13 -333- .27 - 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 TRIM VEGETATION I I ❑ Yes WI No WATER VALVE ADJUSTMENT REQUIRED 41-0 Yes ❑ No — it 01 PARKS DEPARTMENT REVIEW REQUIRED `'�® I®+a ❑ Yes xi No _W Y. t(* - / 11. LOCATION OF SIDEWALK CA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK gi 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 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 : T Date: -/ PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 02I l(g An o om/I1 .. 13 -33 - -17q - 015 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 t No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes INo I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes IX No 11.6► AhS bole oink LOCATION OF SIDEWALK [$Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ig 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches -y 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 78•LI sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes XI 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 _ /V PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 021a 4Hsior, Sc(13 -33- A.?6 - 017 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑ Yes t No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 3 No WATER VALVE ©� ADJUSTMENT REQUIRED f Yes ❑ No — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes gNo C ro;'t W,iwnD c`iP Ansbora • _ LOCATION OF SIDEWALK X 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 17• iO sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches — CODE G - kL c va\vc• nce-r$ crtr 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 : 75 Date: 3-23- 5 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0Zga3t /-Rsborso( S113 -33 - agA - 003 PARCEL CODE CONTROL NO, Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes 2 No TRIM VEGETATION * ❑ Yes I No � I , - ~0 WATER VALVE ADJUSTMENT REQ'D ❑Yes No Q�• PARKS DEPARTMENT lbw • REVIEW REQUIRED — — — — ❑ Yes jg No PocC u q I —' LOCATION OF SIDEWALK V4 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 f 6•'/ sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 02 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 } re: Date: 3:3 I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c2gOT, n5bd`o VI l - - ac - . A- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes KI No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes VI No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 51 No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes IA No 3y —. A-A5beronil _ LOCATION OF SIDEWALK N 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 13.G 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 : D4' --e Date: 3" `1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c2a Ansbordtik 343 - - - oo 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 i.No WATER VALVE N ADJUSTMENT REQUIRED VYes ❑ No _ I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes KNo 4.o` ,4415borotAyi Irk' LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Q 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I to•0 sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes 1K 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 : DR4 t Date: 3-a3-I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS s oro c il S?13 -33- alga - OO7 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 g No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes l No — I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes XI No , Y15 — LOCATION OF SIDEWALK 1Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IC Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK l4 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: -®2 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 07,502s 'to 13 - - ova. - o1 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes 4 No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes [ No - I I I I PARKS ARE REVIEWDEP REQUIRED ❑ Yes Cg No y.l OK AY16.baoot,to VI LOCATION OF SIDEWALK CT Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 51 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED / . 7 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 : T Date: ,R)---Ae PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS v-76 4.sf30e.14 13 -33 - - o50 b = — 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 or TRIM VEGETATION ❑ Yes XI No ♦. 0—.► —o WATER VALVE — \ I ADJUSTMENT REQ'D `al ❑Yes XNo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Al No — / s1t uon 5�lirP� LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK y: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 E 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 'f TE Date: 3 a'"I PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 02%351 At15.6oro g13 -3 - 977 - J02q PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect t ❑ Yes r No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes N.No WATER VALVE N 11 G/ ADJUSTMENT REQUIRED ❑ Yes Li No — I I I I PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes fNo 4k I sir 34 � a 0..4‘ � .3' LOCATION OF SIDEWALK ❑ Front Yard X Side Yard ❑ Other WIDTH OF SIDEWALK [yl 4 Feet C 5 Feet ❑ 5.3 Feet f I.Other DEPTH OF SIDEWALK g4 inches ❑ 5 inches ❑ 6 inches 00 AREA TO BE REPAIRED 0 •/ 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 : A Date: ai PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I \ Ads c - fit= '- 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 gNo WATER VALVE ADJUSTMENT REQUIRED N ❑Yes A No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No vA LOCATION OF SIDEWALK iK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet W5.3 Feet ❑ Other DEPTH OF SIDEWALK rA 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 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 : ?`(' 5 Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS ( 4.7-b -•-t , ✓ - 22-7 - ( - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect f ❑ 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 N ❑Yes No _ I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No Si 3c s, LOCATION OF SIDEWALK XFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 S• I 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 : ?-5 1:=4-> 11)�5 Date: 3 (0 PERMIT ISSUED FORMED POURED COMPLETED CITY SF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l i � i . ✓ 34-2,2,1 -v\ frtr _ PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑Yes y,No — TRIM VEGETATION ❑Yes S/No — ' "� WATER VALVE ,Oko ADJUSTMENT REQ'D — Q �: ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED — — Yes ❑ No — J ;F LOCATION OF SIDEWALK 16 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 19 •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 : 5 U., 3047 Date: 3" ?"--)— PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 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 TRIM VEGETATION ❑Yes g No WATER VALVE ADJUSTMENT REQUIRED ❑Yes y No - I � PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No — — — — VA VA LOCATION OF SIDEWALK tFront Yard ❑ 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 REPAIRED 59•Go sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes tik 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 - 2P PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2- t r • \ -3oc-- - o f 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 �-- � ❑Yes IK No PARKS DEPARTMENT -- REVIEW REQUIRED ❑Yes jg No LOCATION OF SIDEWALK tAFront Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet K5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inch ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED Z °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. 1 FIRST INSPECTION AND FORM MADE BY : Date: 4 . PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z-(5 - C / PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect r1 ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes NNo WATER VALVE N ADJUSTMENT REQUIRED ®Yes ETNo PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No -5,c A ®o F'`/Jr) A2 LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK S4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7 •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 : 5 Date: 3- -d PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS Ail 5ri / 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 Xi No — WATER VALVE 1` JI ADJUSTMENT REQUIRED �—Q—► ❑Yes WNo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No VA LOCATION OF SIDEWALK tg Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet W5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches 1K5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 22.3 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ler 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 : CODate: 4® _( PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z- t , t - 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 N No WATER VALVE N ADJUSTMENT REQUIRED _ ❑Yes jg No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes X.No - - A LOCATION OF SIDEWALK 1K Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet fZI 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK N 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ( 8.0 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 : 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 TRIM VEGETATION I ❑Yes No WATER VALVE 11/4 ADJUSTMENT REQUIRED /--�—► ❑Yes y.No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ctNo LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet $5.3 Feet ❑ Other DEPTH OF SIDEWALK y 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3.1 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: d ®L PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z 1-9- i---k S i 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 ❑Yes No WATER VALVE N ADJUSTMENT REQUIRED _ ❑Yes A No I I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No — — A 4.7- of fig- 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 411.5 s 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: 3'3a- I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS A F- "L. Z ®e) - - 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 No WATER VALVE ADJUSTMENT REQUIRED F�"" ❑Yes No PARKS DEPARTMENT — REVIEW REQUIRED Yes ❑ No - - A4r 4.5 5 4.5 s.c5:c> S® I — LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet A5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I19 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: 2- - — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS bO rZA LT' mc h`)i..T - iz-7 - ©oi -7o 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 pNo TRIM VEGETATION ❑ Yes [ No IiJ WATER VALVE /1 ,, P ADJUSTMENT REQ'D XLYes ❑ No l — j' 1 4-bf PARKS DEPARTMENT — — REVIEW REQUIRED ❑ Yes CkNo f -64 L--1 tiiACJ' LOCATION OF SIDEWALK USkFront Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK f 4 Feet ❑ 5 Feet ❑ 5.3 Feet J'Other 5 DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /`� -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 - t r VA u0 Do ,t3 NWT- ncA rioAI, I PC-ALE Ail l i P r 1'R N3EA- MA' 1 c 13.v2 "re Cc.4\A 'LA 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'M 6'4 Date: o /Z1(f S PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS %01 110 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 4 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes CIN No I I PARKS DEPARTMENT REVIEW REQUIRED f9 ❑Yes IA No '510® 1 GO .. IN Oy/�n ON, j 144 LOCATION OF SIDEWALK Si Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X 5.3 Feet 0 Other - DEPTH OF SIDEWALK ,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 - 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: 1 kg PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ibtoirr---- ;"13 - 131 - 095v 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 ❑ Yes jgt No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes ,gl No — � I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 2 No ji—J-je3 114 Cti1 LOCATION OF SIDEWALK 14,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK A 4 Feet ❑ 5 Feet ❑ 5.3 Feet LI Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 79 " 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 : 446 e Date: (J i7-4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS "_ tmere---v — /3 -35 - - 1 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 el No f-- --► #:� WATER VALVE I(� ADJUSTMENT REQD ❑Yes 71 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No l)o — Ff., .4 Age- LOCATION OF SIDEWALK 11Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK 14 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK jg.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 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: — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ecji-;44ofe---- *13 )35 - 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes ,gl No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes i 4 No WATER VALVE ADJUSTMENT REQUIRED _ ❑ Yes + No � I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK JA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other �d 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. AA O FIRST INSPECTION AND FORM MADE BY : ivt, %' S Date: 03.A PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS /0)- 14-® 3 -35 - J S - iv' Y 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 0.,No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes ,j,No I I I/ PARKS DEPARTMENT — REVIEW REQUIRED Yes ❑ No ,2` 3` 3 FAW gram'imiim , deffillillMS J LOCATION OF SIDEWALK 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 g-Zsq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 1 No No.of Squares with Patches I CODE G - (xDAWN:oi 4 a ( r� .... or ai e 47,9,- 45 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 igNDate: e' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ffocz, — , -3 - 1 - A 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 Ys ® No .-0WATER VALVE • up ADJUSTMENT REQD ❑Yes ,1 -No PARKS DEPARTMENT ` k° REVIEW REQUIRED A.Yes ❑ No 4 c ". a • LOCATION OF SIDEWALK f Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet E.Other ,fie DEPTH OF SIDEWALK ,1 -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 ❑ 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 : 1114-t1 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 13\,O feIt letivvotr-e__ 8,13 - 5- 17? - 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 I TRIM VEGETATION I ❑ Yes g] No WATER VALVE ADJUSTMENT REQUIRED n] #7 Yes No — I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes gl 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 ❑ 6 inches — AREA TO BE REPAIRED 2%,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 - — — 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: 'if_ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS _ " 13 35- 177- 005 ,1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes p 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 cc,;Ij, r Yes ❑ No - I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes � No 11.E LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 11 6.1/ sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Xi NooQ No.of Squares with Patches CODE G - (x) " �c u�s�'er- Vet eve 4�lj 4ad.�cdo_6 , it Mee f�'t ;vim$, f V E,Icea4eAvt o rnar be regu;rer,i -te c o ya l�/ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. A/�R FIRST INSPECTION AND FORM MADE BY : I'' y t l bm Date: OV'11 Zs" PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /Logaiitoiore., i3-3 /71 - 0li 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 No WATER VALVE ADJUSTMENT REQUIRED 40-4 ❑ Yes No — � � I PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes No - 5?o 5 I Sot l re_ LOCATION OF SIDEWALK X.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK A4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 14aq 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 v ce- 1 CJ -6 m u •. -� _c r rep 1c6,9- peptei — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. QG — • FIRST INSPECTION AND FORM MADE BY : - r/!-7., ;' Date: PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I GIl Z ll vno e 13 -35-177 -O2 95 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 TRIM VEGETATION I 1 ❑Yes $ No 10 WATER VALVE ADJUSTMENT REQUIRED ©� ❑Yes $No i l I 1 PARKS DEPARTMENT REVIEW REQUIRED _ 'run Aare. ❑ Yes No —�� 4, 5.0% — — — _ ./4Q%I 5et it% I e/ LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X(4 Feet ❑ 5 Feet ❑ 5.3 Feet LI Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2t sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes $No No. of Squares with Patches CODE G - kle„, fe y4de- < 5 e,c)` •_,►L- Ccedle,, er- ►U4lves peer— pe r AaseJ-- as • ;betel. 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 :Al 6 e ,►i+ Date: 03 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1 1 gP113 -3 177- 9* V/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes 10 No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 1 No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ,4 No I I PARKS DEPARTMENT — '�� REVIEW REQUIRED (:) r.),1/4 0110 ❑ Yes Ef.No , 1/7 f4 6414-/\ • LOCATION OF SIDEWALK /131 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK JX 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 Cr 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 : AAM i3k) Date: G' A /t6 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 111 Z ,('L i I - - Imo"/- 0 7 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 I TRIM VEGETATION ❑ Yes J No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes % No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ,M No �lr LOCATION OF SIDEWALK i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1I 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ff 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 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 : Bk Date: 03/Z-4/10 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1 13 - - ow 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 fa No �Q—► WATER VALVE \ I ADJUSTMENT REQ'D ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED — _ ❑ Yes Xf,No 0 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK r,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK J 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3/.Z sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - (X) r)616‘:otrot a , , , iry14t — way Ceps"- \ 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 : SAJ Date: '' rI — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 509 _ v e VkL0 re----- -.. 13 - I - r c . ')‘ PARCEL CODE CONTROL NO. t Type of Defect l- See reverse side for Defect Codes A-F CLEAN SIDEWALK —. See below for Defect Code G I Li Yes Nil No I TRIM VEGETATION Ts ❑ Yes No ©`- WATER VALVE — I i.\ I ADJUSTMENT REQ'D ❑ Yes x No I PAR KS DEPARTMENT k, , ' REVIEW REQUIRED ❑ Yes 2., No A 7 - j 1&tI 1 LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK A 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Al 4 inches ❑ 5 inches III 6 inches AREA TO BE REPAIRED' il,,0 sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. — CODE F - PATCHES ❑ Yes L7 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. 11 FIRST INSPECTION AND FORM MADE BY : l f . Date: D3A WI oe/Z0e2_ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Olt( it,more_.--- 06/15 -3 - 171 -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 f:No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 14, No PARKS DEPARTMENT — REVIEW REQUIRED 64:1 ) ❑Yes No bAiviitoC6/ COk. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK IX,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ix(4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED '�% /6,4( 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 : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �l '✓ /3 - -3 - 017 14.75 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes 0 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 1 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 0 No 1/4 LOCATION OF SIDEWALK 14 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 other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1' Date: CV PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 - 13 - -,320- 09 " iota 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 No )i' f-0-0. WATER VALVE i ADJUSTMENT REQD Yes ❑ No — ® ® PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes No J LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ig 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Zoo sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes f2S.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 G — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I V OZ— 1- 1 < z P/3 - 35- 331 - 3 107 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 — ! t iff ❑Yes 2,No ©�.-- WATER VALVE I l� 1, 1I vi. ADJUSTMENT REQD Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED — ' — — — — ❑Yes .No ---5 -3.2 4,1 LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK JEI 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.it 6 in. — CODE F - PATCHES d( ❑ Yes A No No.of Squares with Patches CODE G - V1I�Pi ilia y rG�'h` "` !`T'1` rouupiy 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/i Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 ctO 8 9n3 - - 331 - eV5 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ANo See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes elf No 1 WATER VALVE ADJUSTMENT REQUIRED 41-"-0 ❑Yes No /11 I PARKS DEPARTMENT REVIEW REQUIRED — " C4,.� ❑Yes ..No 41— — - - - - — 5`ba: - LOCATION OF SIDEWALK Front Yard ❑ Side Yard 10 Other WIDTH OF SIDEWALK 4 Feet e,J 5 Feet ❑ 5.3 Feet ❑ Other —' DEPTH OF SIDEWALK X4 inches ;5 inches ❑ 6 inches AREA TO BE REPAIRED f.-)14.sq.ft 4 in. tzri _-5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes JE No No.of Squares with Patches — CODE G - LTV 5 : I P 5AW Cift/ = z — 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: q -"f PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 13-35-331 - ,f � lC� 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 pkt No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 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 ❑ 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 : N18 k Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 19 ZO 13414-)` 135 - 531 - II . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 0 Yes 7 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 N ❑Yes Q No I � PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes [] No I &,\A‘ls • ev-- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ig4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches izt 5 inches ❑ 6 inches — AREA TO BE REPAIRED t 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 : Nib Date: _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - :2 - .r r - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes C No See reverse side for Defect Codes A-F See below for Defect Code G J TRIM VEGETATION ` J 1 ❑Yes ID No t WATER VALVE ADJUSTMENT REQUIRED ~Q—+ ❑ Yes 0 No J I PARKS DEPARTMENT r q f REVIEW REQUIRED i ED Yes ❑ No LOCATION OF SIDEWALK 0,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK C 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 30° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Et 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� Date: 7-1561 _. PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS , . ! — ? ! , 11 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect l ❑Yes Kt No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes k No if WATER VALVE — ADJUSTMENT REQUIRED - 0—* ❑Yes „Fa No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Wf.No `— QJI. 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' IC-- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes , No No.of Squares with Patches CODED - 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 ; {� Date: __1 -t3 t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .5 k -.. 8713 _ 5. 00/ - oi PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect , ❑Yes LNo See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION 1 ❑Yes No WATER VALVE ADJUSTMENT QUIRED ~ --� ❑Yeses ,�No 1,Vd* PARKS DEPARTMENT N REVIEW REQUIRED ❑Yes 6, .No LOCATION OF SIDEWALK IA'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 11.5 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 : 4% Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS Iz - - - 003 ! 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 1 WATER VALVE ADJUSTMENT REQUIRED f4� oxt ❑ Yes No coM PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes tg No _ _14,41 — I LOCATION OF SIDEWALK fiX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet [ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Cl Yes 1No 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 416Date: 03/0' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS iI 7 -3 -0 - 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 ❑ Yes ,RL No t WATER VALVE ADJUSTMENT REQUIRED 44-0-40. ❑ Yes No REVI PARKSW DEPARTMENTQUIRED Yes ❑ No 5;05.15.0k ' 1 4 LOCATION OF SIDEWALK S,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 75.S 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 - ( )- ,L e e (��y /t6 c t'vt vt i4q// D t re q'r- 40 NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. D oi FIRST INSPECTION AND FORM MADE BY : l Date: #l/f , PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 115 ! tfeln, - PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑Yes llo _ See reverse side for Defect Codes A F J See below for Defect Code G I TRIM VEGETATION I ❑Yes INo — WATER VALVE ADJUSTMENT REQUIRED 4 El Yes No 1 1 I PARKS DEPARTMENT REVIEW REQUIRED ® ❑Yes l No 6& f LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑Other — WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK XI4 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 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: e:* PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO -- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 117 3exttAA - 5- I 000. - PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes E°No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION -- 1 ❑Yes No WATER VALVE 7't1 r/rf K. AHDk AD ENT REQUIRED —4. ( Ye )s ❑ No PARKS DEPARTMENT REVIEW REQUIRED 10Zl ❑ Yes g No LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet R5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ail 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED aZI 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 a! at. %: `.<, Q4 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 A E` '' Date: 03/506 PERMIT ISSUED FORMED POURED COMPLETED CIS OF WATEr!LSO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 131 i - - -- OBl ta' f PARCEL CODE CONTROL NO. LAAk Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G i ❑Yes No — TRIM VEGETATION ❑Yes No i WATER VALVE ADJUSTMENT REQD -6 ❑Yes VI No 4I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet ❑ 5.3 Feet E Other DEPTH OF SIDEWALK f $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 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 : q Date: 0 . PERMIT ISSUED FORMED POURED COMPLETED — CifY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -- 13-35 - Ib� - PARCEL CODE CONTROL NO. 3 CLEAN SIDEWALK Type of Defect 1 ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes II No ` f WATER VALVE FQ--► ADJUSTMENT L R UIRED ❑Yes fa No 1 PARKS DEPARTMENT —4 • REVIEW REQUIRED ❑Yes r --4 0N� ov �. 13 Ii LOCATION OF SIDEWALK , 3 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet : l 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK ,LK4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 176.S sq.ft. 4 in. sq.*. 5 in. sq.fL 6 in. -- CODE F - PATCHES ❑ Yes Ft 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. 9 FIRST INSPECTION AND FORM MADE BY : 1v Date: ' , PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 c _ i -3 - i06. - off PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect , A ❑Yes 3 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes JNo - WATER VALVE ADJUSTMENT REQUIRED ��� ❑Yes INo I PARKS DEPARTMENT REVI REQUIRED 14 Yes ❑No 1 .0\ — — (71-Csa'1) LOCATION OF SIDEWALK Ai 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 ` • 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: D ' — PERMIT ISSUED FORMED POURED COMPLETED r.. CITY •F WATE•:LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /53 1A1 (V7 Allpt PARCEL CODE CONTROL NO. Type of of Defect 4 - CLEAN SIDEWALK See reverse side for Defect Codes A-F 0 1g See below for Defect Code G Yes No TRIM VEGETATION ---------fr 0 Yes )31 No WATER VALVE \ ADJUSTMENT REQ'D 0 Yes El No PARKS DEPARTMENT REVIEW REQUIRED 0 Yes No 5.4% bez-LIA A4e. LOCATION OF SIDEWALK LI Front Yard ) Side Yard LI Other WIDTH OF SIDEWALK 0 4 Feet ig1,5 Feet 0 5.3 Feet LI Other DEPTH OF SIDEWALK ,E1 4 inches D 5 inches 0 6 inches AREA TO BE REPAIRED _- 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 - _ t RA10- - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 03 -40 FIRST INSPECTION AND FORM MADE BY I 5 ef'-eti)i\J Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR. SURVEY FORM ROPERTY ADDRESS 0t 3-35 - 107 - 001 15 o PARCEL CODE CONTROL NO. Type of Defect A ! CLEAN SIDEWALK See reverse side for Defect Codes A-F / ❑Yes fg No — See below for Defect Code G TRIM VEGETATION ❑Yes ,q No VOA if all 404 —► WATER VALVE — �( , I ADJUSTMENT REQ'D ❑Yes [gNo PARKS DEPARTMENT 5,0 REVIEW REQUIRED • ❑Yes jNo J LOCATION OF SIDEWALK A 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 ZS' 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 : a`� & Date: 01 t PERMIT ISSUED FORMED POURED COMPLETED r , ,. CITY OF WATERL•O SIDEWALK REPAIR SURVEY FORM •ROPERTY ADDRESS 6t3e1C12--11 ,3_, _5d /0 - Ors PARCEL CODE CONTROL NO. r $ �T d Type of Defect PI See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G Li Yes X.No TRIM VEGETATION '` ❑Yes $No "--51 WATER VALVE ADJUSTMENT REQD ❑Yes No X- X. PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No " , No :51- 1K J mcirRAA LOCATION OF SIDEWALK ❑ Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet lid 5.3 Feet ❑ Other DEPTH OF SIDEWALK IA4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /bit sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches (J f X CODE G �- �ea� i,y _ +/ 5541�V 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 : �,j it-5 e t Date: CI — -1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 - �3 -35- f o7 - c7Z-- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A �- ❑Yes ,gi„No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION _ ❑Yes ja No WATER VALVE — ADJUSTMENT REQUIRED �Q'♦ ❑Yes INo 1 PARKS DEPARTMENT REVJEW REQUIRED ,Yes ❑No LOCATION OF SIDEWALK 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 ° 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. 4,1 R FIRST INSPECTION AND FORM MADE BY : A LAJI Date: OVO 00' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO -` SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 8ct 3- -/L3 - i' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 7 ❑Yes tA No See reverse side for Defect Codes A F See below for Defect Code G J TRIM VEGETATION ❑Yes gNo WATER VALVE ADJUSTMENT REQUIRED ~�� ❑Yes fi No \ J 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No WA _ Ave_ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Zi 5.3 Feet ❑ Other DEPTH OF SIDEWALK IA 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7 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 - f 5“,ti4;1L 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'1011 oft, '"- Date: -H—t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (2415 - 103 - Ot )3 4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes p4No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes No WATER VALVE — ADJUSTMENT REQUIRED El No �� I PARKS DEPARTMENT REVIEW REQUIRED 11� N Yes ❑No Bercl, LOCATION OF SIDEWALK Front Yard El Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet El Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 50• 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 : AAth Date: L ' PERMIT ISSUED FORMED POURED COMPLETED AMR CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zl& C 1 -3 - io - cbiti 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 l No t WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No — I t LOCATION OF SIDEWALK C 9 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ,Z 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ki 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '726'5 sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes E 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 : 11A0 UN Date: 7.1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2,1Z, l — (3 -35- 107- M , vs7 -- PARCEL CODE CONTROL NO. 11 CLEAN SIDEWALK Type of Defect ❑Yes iN No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes ANo t WATER VALVE 36 G ADJU TMENT REQUIRED' t-- —► Yes( ) [1No it I - PARKS DEPARTMENT REVIEW REQUIRED ❑Yes X No t 1u 4 V)0,(47`. LOCATION OF SIDEWALK X,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet LI 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 L CODE G - r,-`� ��`� U lIP-- A `J &up .X iocc 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 : ItA6 Date: 42171 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PRO -35 - io3 ®f d vf PARCEL CODE CONTROL NO. /S CLEAN SIDEWALK Type of Defect I ® ❑Yes Apo See reverse side for Defect Codes A-F See below for Defect Code G 1 TRIM VEGETATION - { 1 ❑Yes o WATER VALVE ADJUSTMENT REQUIRED tea-40. ❑ Yes No 1 PARKS DEPARTMENT YeJREV --W REQUIRED s\ LINO 6(2.--A4 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 IS/. 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: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESSc- — 13 -35- i 67 - 0,97 13`` _ PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect PA ❑Yes , No — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑Yes fEi.No * WATER VALVE — 1 ADJUSTMENT REQUIRED A—Q—* Yes ps No M ' I PARKS DEPARTMENT 'N. 4)�+ REV EQUIRED ,i,t Yes N ❑No — ______L,„,„ — — /.. — ok C., iadA I p� — LOCATION OF SIDEWALK Y1 Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet f 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK A 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED apt Z • sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. — CODE F - PATCHES ❑Yes El. 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 : /lA6 ; I Date: y;/ PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z 7 c.ar i4 15 -,'i-105 - cIR lei-!) PARCEL CODE CONTROL NO. 'T Type of Defect See reverse side for Defect Codes AF- CLEAN SIDEWALK See below for Defect Code G d I ❑ Yes I No tN1— I TRIM VEGETATION 'r) ❑ Yes KNo �Q--► (Z' WATER VALVE i 1\ M1 -4. ADJUSTMENT REQ'D ❑ Yes ,f\No s PARKS DEPARTMENT 0 REVIEW REQUIRED I5:a` 5:149.— — — - �' [ Yes ❑ No /r! /i x as-RTC/4 AVE- LOCATION OF SIDEWALK lAt Front Yard KISide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet k 5 Feet 51 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z' Z'0sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - lxl &L6 Aiz Ar ACr�tu-r-ro Cr Pc rv- Cat Na— q),c5 l iZ�iPi '� o . nGzY-\TE.0 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 : M6 151.\. /Date: 4/W 1 ON .5/3/ Iter77 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE LS-O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -OA PARCEL CODE CONTROL NO. Type of Defect r CLEAN SIDEWALK See reverse side for Defect Codes A F1 Yes INo See below for Defect Code G — TRIM VEGETATION ❑Yes lNo ~Q� WATER VALVE ""S"----. c6 ADJUSTMENT REQ'D — ❑Yes ipNo PARKS DEPARTMENT REVIEW REQUIRED — — Yes ❑ No — Me-- ) - LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet X 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK r!4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED v156.5 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: '_q PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS : D OeXtdirl 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 STATION I 1 Yes ❑ No WATER VALVE �(� � ADJUSTMENT REQUIRED fad ❑ Yes I :No I PARKS DEPARTMENT I R REQUIRED JYes ❑ No $ A ;A-AA 0; LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0,5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 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 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. t� FIRST INSPECTION AND FORM MADE BY : P Date: a4/637- r PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ..;3►D Fzic}i ,I3 -35- iuS - 005 41' PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect 4 REQUIRED See reverse side for Defect Codes A-F I ❑ Yes L No — See below for Defect Code G TRIM VEGETATION I REQUIRED ❑ Yes No 1 WATER VALVE ADJUSTMENT REQ'D — I� Yes t.14 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I\No5.0 — flli� c-f LOCATION OF SIDEWALK Igfront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet VS\5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK [K'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- Z5,0. S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes pkNo 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 Date: 04i'&-ie FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS3eStil l lee - tO1 I/1-5 PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect ❑Yes ICI,No See reverse side for Defect Codes A-F — j See below for Defect Code G TRIM VEGETATION 1 ❑Yes INo WATER VALVE ADJUSTMENT REQUIRED \ ❑ Yes No _ ,, ' 1 PARKS DEPARTMENT �` REVIEW REQUIRED ❑ Yes JI No — — — — — — — — — 1A. LOCATION OF SIDEWALK N.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 " -' 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 : J Date: 011,/vAZAS PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — SIDEWALK REPAIR SUR : EY FORM PROPERTY ADDRESS . O l' / — 6115 -35-v39( - ® ,_P ) s - 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 — V TRIM VEGETATION ❑Yes ®No — \t� Q WATER VALVE t '1 ADJUSTMENT REQ't [ Yes ❑ No PARKS DEPARTMENT �y REVIEW REQUIRED ❑Yes 3 No — 1 L*5,3 1V° % _ 57v141AA-Gt e. — LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK V 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK _�4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED If 11.V sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches f ''H ,� CODE G - (x) . 1 `l _a_' 0 _ _. r w1 Ui1 -lb ri:`.� 4-4 t _ .`9,1 e p 1� . c, �z •a_,, e f 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 : 8� . Date: / ( PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'L4 -* vtj _ 1 - - ( - 03o 153 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ' ❑ Yes I 1 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes 1 "No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes [ No _ I � PARKS DEPARTMENT 7 (11") REVIEW REQUIRED ❑ Yes s No 5.0` IS'®0' Ia 13awcia4 LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK JJ 4 inches JAZ inches ❑ 6 inches AREA TO BE REPAIRED / .0 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 - r.q—cf-y2 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 PROPERTY ADDRESS /0 Li 13 r to Ce. PARCEL CODE CONTROL NO. 103 Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes rx No TRIM VEGETATION ❑ Yes NI No N WATER VALVE ADJUSTMENT REQ'D ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED Jr Yes ❑ No —. o Sfw LOCATION OF SIDEWALK ❑ 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 1 - sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes $No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : A"> Date: 3"-V-1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i V-- f-7 bcz V 5 3 - -- 1? - Co`� I �� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes X No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes X No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No _ � I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No j LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other =' DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. (457,$ sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes LNo 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 f - I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 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 Nt No — I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes y No C— LOCATION OF SIDEWALK S.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK tgr 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z .4 ' sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES LI Yes y 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: f PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 136 P (`©t(. 13 - III - cZy 1s PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes ;q No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 ❑Yes [ ,No WATER VALVE l`\ C i N ADJU TMENT REQUIRED Yse ❑ No PARKS DEPARTMENT Ctil REVIEW REQUIRED ❑ Yes No wziNv.v/ii \ � w!J• LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Z 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED E sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ] No No.of Squares with Patches CODE G - � � j - ep6,_ ow� m 5 al J p94e6 ova e rp .�.� �ay� , rUky I'Vp• 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 S)(81\J Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 11 - f\cow - 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 I TRIM VEGETATION I I ❑Yes ANo WATER VALVE t' a ADJUSTMENT REQUIRED' Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED �I'1��� CI REVIEW No (tirI LW' _ b, CV ° ` LOCATION OF SIDEWALK IJ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK XI 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 7 4 inches El inches ❑ 6 inches 3Z AREA TO BE REPAIRED •0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes rl No No.of Squares with Patches � � l CODE G - . = - y GL, i® r r 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 : Date: 03 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /q7 &j ro(A.- I3 -35-il - PARCEL CODE CONTROL NO. c CLEAN SIDEWALK Type of Defect r1 1 ❑Yes ,RI 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 •11 No � I PARKS DEPARTMENT �l REVIEW REQUIRED ❑ Yes p No - - w:d\ ,2� I77A ( f? 0)1. LOCATION OF SIDEWALK Ij Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1K1 4 inches 1S.5 inches ❑ 6 inches AREA TO BE REPAIRED 16.o sq.ft. 4 in. 21{g sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes Lp 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 : f vn f �0� Date: O 9 23 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 153 r -35- ilk -7Z-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 — 1 l ❑Yes 1No WATER VALVE - ADJUSTMENT REQUIRED 40-14-0. ❑ Yes IQ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No Lia°° - - ' LOCATION OF SIDEWALK fZFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Ia4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ) 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED f 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 : • Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 / lbv,•- -35- �I PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes p,No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes ANo WATER VALVE ADJUSTMENT REQUIRED \ ❑ Yes ElNo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 'No ®\ \Vid LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK S.,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )4 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /6 0 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 : Date: /7. i PERMIT ISSUED FORMED POURED COMPLETED CITY' OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ro1°- d3- - - 0141 11 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect ai ❑Yes N4,No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — I ❑Yes No WATER VALVE l ADJUSTMENT REQUIRED ~Q� ❑ Yes elA,No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 1, LOCATION OF SIDEWALK 11 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK r_+ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 4 inches ❑ 5 inches O 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 1g 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. n A FIRST INSPECTION AND FORM MADE BY : nn Date: PERMIT ISSUED FORMED POURED COMPLETED i, i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM --1 PROPERTY ADDRESS ZIq - ZZ- 13iRC1 1 i Efl(5- 5- ‘'SZ - o©Z ' g 7 PARCEL CODE CONTROL NO. 7 - f.,, Type of Defect A �� See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G z,..= ❑ Yes No _, 7 r v' 7- TRIM VEGETATION ❑ Yes 12] No .;0 -- - ---rk- \t it - , - 7 i.r- ._0_,_.. -c1'i>.-; 7``, NI, 2 WATER VALVE y ADJUSTMENT REQ'D —' ; A - � ° cin Yes ❑ No PARKS DEPARTMENT 7 ..4 REVIEW REQUIRED — — ❑ Yes in No , /I �/ ,c). 6...,c,' \ 5i ) � � y pj g. 1t NA,t,, , -i.3 LOCATION OF SIDEWALK 0 Front Yard . IJ Side Yard LS Other ` ( WIDTH OF SIDEWALK ❑4 Feet 0 5 Feet ❑ 5.3 Feet ] Other ° DEPTH OF SIDEWALK Ll 4 inches ❑ 5 inches p 6 inches — AREA TO BE REPAIRED 3®.a sq.ft. 4 in. sq.ft. 5 in. 210 I'sq.ft. 6 in. .\51' ' -. ),Fr* C° 6` ^Aar CODE F - PATCHES ❑Yes cy1 No No.of Squares with Patches CODE G - >C -DczAtKIA RATE NV- _ OL T 12 CcS Ir a5q /1 4 c 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 Date: 4 3--It.---; — PERMIT ISSUED FORMED POURED COMPLETED CITE OF WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS SyroLA Age. . — 013-35-irr - 0/7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ) ❑Yes JA-No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — 1 ❑Yes 0-No WATER VALVE ADJUSTMENT REQUIRED � ❑Yes I No I � I _ 1 PARKS DEPARTMENT LOW-krdE NUT 54 JED ' REVIEW REQUIRED ❑Yes No ir/22-4/,: 1411/14 ACC 5,004 ectA, Aqe._ LOCATION OF SIDEWALK S Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK S4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 6_61 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - y® SAW C 5 o �- - t� + 2,ci<vde55 cold< aFI ) Gel"" igcevvig:-t`f" 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 YL Date: _9 1 �,l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l C-A /6-`1q PARCEL CODE CONTROL NO. � CLEAN SIDEWALK Type of Defect ' ❑ Yes CNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes 1Z No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes X No _ I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes F.No �� 3,8 C�Ut?tea LL. 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 K2. 1 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 : Date: 3-2 3—1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 o 57) - - OD e 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 I TRIM VEGETATION I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No PARKS DEPARTMENT — REVIEW REQUIRED Yes ❑ No A C 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 25.y 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 0'? Date: 4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L4- ( 5 CA 1411,P AN( 6 - 1--22, , - 00(0, ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect f- ❑Yes IgNo See reverse side for Defect Codes A-F — I See below for Defect Code G I TRIM VEGETATION ❑Yes . y No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes No - I I I REVIEW DEP REQUIRED ❑Yes (No A4 WoL' LOCATION OF SIDEWALK y Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet i5.3 Feet ❑ Other DEPTH OF SIDEWALK tOfr 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 'to• 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 i r a PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes o 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 PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes Xyvo s,o — LOCATION OF SIDEWALK Front Yard ❑ Side Yard D 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 .5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 04o 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 .a " I — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS C ' k -3 4- Zo3-ov3 r 175 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 ❑Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No _ I I PARKS DEPARTMENT REVIEW REQUIRED Jg Yes ❑ No A 5,• ( E LOCATION OF SIDEWALK A,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet N 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED A 1.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: a - `l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS S2-D � - -- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect it ❑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 fQ� ❑Yes KNo — PARKS DEPARTMENT — REVIEW REQUIRED Yes ❑ No A — 4.,0 LOCATION OF SIDEWALK 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 2r.2 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes y 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)3 Date: 4-2-_ l PERMIT ISSUED FORMED POURED COMPLETED C. 46 CITY (OF WATERLOO -fo SIDEWALK REPAIR SURVEY FORM Do .� qg co� 0 PROPERTY ADDRESS 5 3 )0E-- 1/ 0(,Ig 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 ,thiNo �--per—► WATER VALVE — I 0 ADJUSTMENT REQ'D W ❑Yes I' No PARKS DEPARTMENT REVIEW REQUIRED ra/#� — ❑ Yes fNo • 8,Z LOCATION OF SIDEWALK Al 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 `1,5, 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 : Date: 4 '2 - I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS /f Caw gin' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 1 6` ❑Yes No See reverse side for Defect Codes A F — See below for Defect Code G I TRIM VEGETATION ❑Yes ,I No WATER VALVE ADJUSTMENT REQUIRED f—Q—► ❑Yes No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes 61 No WA:7 9, e caoifia tra® - 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 Vt.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' 1 Date: .2®/ — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 735 Ca Pb,e// g913 -3Y - aoi - oo1 101 PARCEL CODE CONTROL NO, Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes1 No See below for Defect Code G N. TRIM VEGETATION ❑ Yes gl..No — AtJ/ L �--Q� WATER VALVE �( I ADJUSTMENT REQ'D ❑Yes XiNo PARKS DEPARTMENT REVIEW REQUIRED 13.6' 6.8' ❑ Yes I No — '///lr/,1/%/rY/4 f,. Cdelp)Gil Aic• LOCATION OF SIDEWALK f Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 01 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ► 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 '0 sq.ft. 4 in. Co S•O sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ca 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 Date: V02-/C? PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM —PROPERTY ADDRESS c0241°..'°` 1�,Fi6r 89t3 -33-c2gl - 0/6 => ' 1 _ PARCEL CODE CONTROL NO. iIV `-^C Type of Defect 6 M \'�� See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes Z No _ i. TRIM VEGETATION ❑ Yes feNo .41....0_0. q WATER VALVE i :- ‘ \ ADJUSTMENT REQ'D — ❑Yes XNo PARKS DEPARTMENT REVIEW REQUIRED S.0 Q II41. — ❑ Yes IXJ No — 7 \ )/ — urim - LOCATION OF SIDEWALK ► Front Yard IX Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ni 4 inches ►I 5 inches ❑ 6 inches AREA TO BE REPAIRED iaa.0 sq.ft. 4 in. 1 I.a 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 d" 'fi"5- Date: 3-- - -IS PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 02 33 (0,,pt ` 8gi3 -33- age - o PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 6 ❑ Yes Xi 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 N ❑ Yes RI No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No — — opt 8.1 u,, /5.11 7 Carr- LOCATION OF SIDEWALK 1Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other 'y DEPTH OF SIDEWALK i$4 inches II 5 inches ❑ 6 inches AREA TO BE REPAIRED 3- - sq.ft. 4 in. `f'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 : 113 Date: 3 a2/8' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 012 J 60. Casiatr gqi,c -33- .2V® - 007 I li 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 X No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes g No LOCATION OF SIDEWALK r7L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [' 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK rg 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ®' 8 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes pj 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: 2'/S PERMIT ISSUED FORMED POURED COMPLETED — R605�D CITY OF WATERLOO Du ►b — SIDEWALK REPAI'. SURVEY FORM co N1., 4 9 y8 S,tl'lg R5 PROPERTY ADDRESS 9 c�3 c.�l_-v v cam- �� � ✓ PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑Yes I No See below for Defect Code G TRIM VEGETATION ❑Yes %No i J °`' 8 WATER VALVE V ADJUSTMENT REQ'D ❑Yes L No • Jam-- PARKS DEPARTMENT REVIEW REQUIRED ❑Yes fp,No LOCATION OF SIDEWALK Pt Front Yard , D Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet pe5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 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 I ,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 : bV5 Date: 3 '{ - ` PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 08 c `A / c 50, - ✓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 At WATER VALVE `� ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes No A VA d.o LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK X.4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 2!,2 f sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ng 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: -a- I PERMIT ISSUED FORMED POURED COMPLETED CITY OF W A,-ERLOO -- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L. 4 c1i ✓ 39‘,3 -3& ZC3 - on 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 L No i 0-* t0 WATER VALVE \ I ADJUSTMENT REQ'D ❑Yes X] No `h PARKS DEPARTMENT REVIEW REQUIRED Ig Yes ❑ No j LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet JI 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1744 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 CD•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 - 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 : ?-• Date: Q Z PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d 1 1, �®� 13 -3 - - ( 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 ❑Yes g No WATER VALVE ` / ADJUSTMENT REQUIRED �Q--► ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes N No 60I uet ai gt 6/f. 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 77 6 sq.ft. 4 in. d° 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 : ÷TC Date: "'ig PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM --- PROPERTY ADDRESS z-3 s cot-ok 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 ❑Yes No I � PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No Ff LOCATION OF SIDEWALK `►s Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet lA 5.3 Feet ❑ Other DEPTH OF SIDEWALK [g,4 inches ❑ 5 inches ❑ 6 inches —' AREA TO BE REPAIRED ZR•7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes y 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 W,ATE*L®®SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .30 4 c � - = ). - 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 .o TRIM VEGETATION t •" ❑Yes VNo WATER VALVE 1 ADJUSTMENT REQ'D — ❑Yes F. No PARKS DEPARTMENT REVIEW REQUIRED — — ( ❑Yes No _ /1,3A LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches N 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.fit. 4 in. U.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 : 5 t� Date: "S _1 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS C `7,1=- - -2,0 - Zo 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 No WATER VALVE ADJUSTMENT REQUIRED 4-0 ❑ Yes No I / \ I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes it No A 4.7_ S'CJr+L \A LOCATION OF SIDEWALK XI 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 2 Z• " 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 :) PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect ❑Yes 16No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 1,No WATER VALVE ` ADJUSTMENT REQUIRED4-0 —' Ai ❑ Yes ANo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No A A VA 4<5 9,3 LOCATION OF SIDEWALK IS Front Yard ❑Side Yard El Other WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet 45.3 Feet ❑ Other DEPTH OF SIDEWALK og4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 13.1 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 : ` Date: 4- — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 k co (- , "1 v - - X - PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect ❑Yes Pio See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes No 1 WATER VALVE ADJUSTMENT REQUIRED t— ❑ Yes ENo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No C- 044 3tA LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet p5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Lk q•3 'sq.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 areasshall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : '7 Date: _. -tam, PERMIT ISSUED FORMED POURED COMPLETED r CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS S\ c.C2-, \3 -3L - -7 - OD-7 ✓ 01 PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G _ TRIM VEGETATION Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED Yes • .:a_ VA 14 'i" 1 4ia 4.d 4.! 404o 4 y LOCATION OF SIDEWALK 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 ►? .g 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 : 5 147 Date: "' 18 PERMIT ISSUED FORMED POURED COMPLETED Jy CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5 4- - '° - ca-1 — \ -36,--zol - co1 v PARCEL CODE CONTROL NO. CLEAN SIDEWALK ` Type of Defect A4r ❑ Yes X No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes ix No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes [ °No I I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No ;Act" — — — — t1.:3 so 0 \ LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard yl Other - WIDTH OF SIDEWALK ❑ 4 Feet LI 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches El inches ❑ 6 inches _ AREA TO BE REPAIRED 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 : 'S%5 Date: 4- 2 " t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,S(5' ,:k ,3 -33 - 110 - oca ZIi 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 VI No WATER VALVE N ADJUSTMENT REQUIRED — ❑Yes yl No I I PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes No VA De161.4e, LOCATION OF SIDEWALK $A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1$.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 9r 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I4- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes i2 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 /l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS , oz - YO6 - OO Z J� 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 g No ... I I PARKS DEPARTMENT REVIEW REQUIRED %Yes ❑ No LOCATION OF SIDEWALK ( Front Yard Li Side Yard ❑ Other WIDTH OF SIDEWALK lyj 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK %4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 •0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 74 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: .3-4,f-a PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 27o'1 A/she $'7/3 - ?- 5'Od - o i/ • 2 Ile 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 D Yes XI No — TRIM VEGETATION ❑ Yes t1No -Q ' WATER VALVE _ o ADJUSTMENT REQ'D ♦ <, ❑Yes No PARKS DEPARTMENT y $ REVIEW REQUIRED — _ ❑Yes k71 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 gi 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 19• a 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 : D6 TC Date: 3 /-4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d`TO t)t1okitt_ cP9t3 - 33- y115- - dfza i7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes O. No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes ® No t WATER VALVE ADJUSTMENT REQUIRED --► ❑Yes ® No ,Ok I PARKS DEPARTMENT ...� REVIEW REQUIRED ❑Yes No 3.5 cOaAc, LOCATION OF SIDEWALK l Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK iI14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED MO 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 : srg Date: 3- 1-O PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 6 16 ?h , ' (i iZc — 005 ! ) PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A Yes 11 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION l El Yes EiNo 1 WATER VALVE ADJUSTMENT REQUIRED El Yes N-No l /jam PARKS DEPARTMENT REVIEW REQUIRED ❑Yes C rNo 1 'Li • ,r i e (1 cif'I LOCATION OF SIDEWALK Z1,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet cl 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 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 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 : 116 Date: t et / PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS P3ZC5i1\,`� 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 l ❑Yes No WATER VALVE ADJUSTMENT REQUIRED 41-0 - ❑ Yes No a I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑No 001 f 5 y LOCATION OF SIDEWALK k Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IX5.3 Feet ❑ Other DEPTH OF SIDEWALK t7 4 inches '►'+ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7q.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 : l Dater ) PERMIT ISSUED FORMED POURED COMPLETED CITY OF WITERLAO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L-! , afis?, - - Z. -o7 PARCEL CODE CONTROL NO. Type of Defect E' See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes allo — TRIM VEGETATION ❑Yes 0 No — t-0—* j WATER VALVE — ^ ADJUSTMENT REQD ❑Yes i)j No ., C-c PARKS DEPARTMENT s REVIEW REQUIRED • 7 'Yes ❑ No — \'331�j LOCATION OF SIDEWALK k9 Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet [fl 5.3 Feet ❑ Other DEPTH OF SIDEWALK Al,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 f F ho 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 : 11)h) i Date: 14 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Aq - ; - - oo- - g PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect 1i ❑Yes C No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes 11No t�0 ATES VALVE ADJUSTMENT REQUIRED :1(fat� ❑ Yes [�No cox, I 1), PARKS DEPARTMENT REVIEW REQUIRED ... ❑Yes [ ,'No fop j, ip c4 v LOCATION OF SIDEWALK Q'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IN 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0.4 inches ❑ 5 inches ❑ 6 inches 110 AREA TO BE REPAIRED ,®2r 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 : ivi Ic . 1 S Date: q/W / PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ROPER i Y ADDRESS ' E P el " 55- it - j \ z PARCEL,CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I El Yes No TRIM VEGETATION El Yes X No — WATER VALVE 14, + ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED • ❑Yes '►_ No f`•k, s J LOCATION OF SIDEWALK j`Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 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 ../A1 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 : 111 )' 3 Date: oft i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i07 `:; ! 611) - 010 = -- PARCEL CODE CONTROL NO. Type of Defect i" CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes No See below for Defect Code G TRIM VEGETATION ❑Yes i No f JI WATER VALVE --► ADJUSTMENT REQUIRED ❑Yes ('No PARKS ART REVIEWDEP REQUIRED — — —. —I El Yes No n' LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet P_ 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 Ar 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'' S ' r� Date: �.. ��+ E r 8 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c r\ _ € - 37- 133 - r ' _ .. 44, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect i. ❑Yes E'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes GL]No * WATER VALVE -- 1 JI ADJUSTMENT REQUIRED ❑Yes i1 'No ,Ok I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes J i,No ! ( — — 1 LOCATION OF SIDEWALK 2 Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El"5.3 Feet ❑ Other DEPTH OF SIDEWALK .,0a4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 ` ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. - sq. 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. 1 FIRST INSPECTION AND FORM MADE BY : t r cc `- R S Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO -� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f I i '(we( PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect AI ❑Yes I 'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes XINo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ,y No /11 - I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 14No LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet X5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1Z 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED = .r'• sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes XI 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 t 5 Date: i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ca°i -35 - l 3 i - 005 7,30 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes AN-No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION — 1 ❑Yes No \ WATER VALVE � ADJUSTMENT REQUIRED ❑ Yes P No _ a s I PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes .No • 6 t l \ 1. )e ` vet" 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 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in, CODE F - PATCHES ❑ Yes XI 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 I Date: q1/20,4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM !ROPERTY ADDRESS 7)E uk,e PARCEL CODE CONTROL.NO. Type of Defect f CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes :Li No See below for Defect Code G 1 TRIM VEGETATION ❑Yes 'L No 4 --► 0 C. WATER VALVE ADJUSTMENT REQD - ❑Yes 1 No 1 PARKS DEPARTMENT --. REVIEW REQUIRED — 5.8 53 — — ❑Yes v TNo LOCATION OF SIDEWALK 32 Front Yard , ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet i i 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ID inches , ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ®) `h sq.ft. 4 in. sq.ft. 5 in, sq,ft. 6 in. CODE F - PATCHES ❑Yes ER 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 : H S i [��� Date: q/kV f —' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS iCt,L7 MV — 13 - 35- 135 -DI0 I PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect i ' ❑Yes r.No See reverse side for Defect Codes A-F J See below for Defect Code G J TRIM VEGETATION J J ❑Yes ,,11 No — 10 it WATER VALVE Z h — AD t ENT REQUIRE Q--► Yes ❑ No 1 `� J PARKS DEPARTMENT 5 REVIEW REQUIRED � �� Yes No 5. 13, 1/ I off LOCATION OF SIDEWALK ix Front Yard ❑ Side Yard , ❑ Other ... WIDTH OF SIDEWALK ❑ 4 Feet . 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,-14 inches 2,5 inches ❑ 6 inches AREA TO BE REPAIRED 5 I sq.ft. 4 in. Co 5 C' 'sq.ft. 5 in. sq.ft. 6 in. '! CODE F - PATCHES ©Yes ❑ No No. of Squares with Patches CODE G - +ea` t941La� rw4, (� Gp �m� ,te._ 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 69,4, Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'r - „ 13-m - 1 — Y 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 $1,No t WATER VALVE ADJUSTMENT REQUIRED ~42)-- ❑Yes XI No 1 PARKS DEPARTMENT R QUIRED ® ® Yes ❑ No 514 `d,1 \14 WYA DPytkie LOCATION OF SIDEWALK a Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet A 5 Feet ❑ 5.3 Feet ❑ Other -- DEPTH OF SIDEWALK 0,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 77' 5 }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 : _' > Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /01 M'5 -3 - 1 - il / :435 — 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 l ❑Yes No — WATER VALVE — ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED 14 Yes ❑No LOCATION OF SIDEWALK IJ 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 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 : Date: /C 4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF CIA T ERL•O SIDEWALK REPAIR SURVEY FORM •ROPERTY ADDRESS 1071- 015 -35- f ._ af, 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 51 No IV 1( �— —► 'j WATER VALVE \ ADJUSTMENT REQ'D 1 •ir ❑Yes ,N° PARKS DEPARTMENT REQUIRED • Yes *No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet R.5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK i4 inches , El 5 inches ❑ 6 inches 0 AREA TO BE REPAIRED r 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 : VVii Date: 005/ PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERL•Q SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I()CS ►mot;ver- ‘;c'13-35- t35 7 PARCEL CODE CONTROL NO. Type of Defect A See reverse side for Defect Codes A-F See below for Defect Code G t CLEAN DEWALK DIE YesSI No N � TRIM VEGETATION � pJ ❑Yes No � --► WATER VALVE ►�. ADJUSTMENT REQ'D ' ❑Yes No PARKS DEPARTMENT O.I® I0®1, REQUIRED _1(7)4_ DueAc LOCATION OF SIDEWALK 14,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 /('d C sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ,V1,,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 : A48 Date: 04 , PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l evo/75Ire, R13 - - 444 - oso PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes IN No See below for Defect Code G TRIM VEGETATION ❑ Yes ►: No WATER VALVE N ADJUSTMENT REQUIRED -- I ❑ Yes A No PARKS DEPARTMENT REVIEW REQUIRED IV — — �0® Yes ❑ No el DCVInikr LOCATION OF SIDEWALK 1)4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Y1 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK fM 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 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 : D3 4- Date: 22-1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS ( vdn hl`i° 91 - - y.,26 - 0 4 PARCEL CODE CONTROL NO.CLEAN SIDEWALK Type of Defect ❑Yes KNo 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 g.No I I I PARKS DEPARTMENT — REVIEW REQUIRED /gg El Yes No 9.i evoolh;re LOCATION OF SIDEWALK [At Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK %.4 inches tyl,5 inches ❑ 6 inches — AREA TO BE REPAIRED 19.a sq.ft. 4 in. LI®.g 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 : `- -rp Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS MALI De.vo'i 5 ,'re, 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 N ❑Yes No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No cl.a Li.O1/4 — — LOCATION OF SIDEWALK E 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 3 a.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 : D3 it- TE Date: 3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4430 hi5ti;re 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 WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes jg No —" PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes 1 No 5:0s COOK5k ire LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [4 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED °•O 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 : 7-46 Date: - '/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ii3ct Dtvoitchire„ M13 -33- 9Z7 - 007 , 243 r PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect ❑Yes hiA No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes Dit No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes $41No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 1141 No � o D LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK y,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED •O 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 : T� Date: 3 24-/8 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `IS_ Pevanpiire 13 -33 - '427 - 00G, ,`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 TRIM VEGETATION I ❑ Yes X No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes 1 No I I PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes X1 No ( _ f0•®® *5:6 — ok Pe,u6n5,A'e. LOCATION OF SIDEWALK Dif Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK TA 4 inches ❑ 5 inches ❑ 6 inches — f 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 : 1113 76 Date: J ZZ `/,9 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS LI 5( $cio'jI®re. (sgl5 -33- `/.2? - o®s-' Z4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes IX 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 g No — I I I PARKS DEPARTMENT REVIEW REQUIRED D ❑ Yes N No wv. ti Df,von 51 irc. LOCATION OF SIDEWALK 11,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK l%,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IX 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 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 zz-if PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L(“ u on5hilre 1(3 - - - 03g z ( PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 6 Yes 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 ADJUSTMENT REQUIRED N ❑ Yes IX No I I 1 PARKS DEPARTMENT -- REVIEW REQUIRED ❑ Yes gNo 9j.o� — LOCATION OF SIDEWALK 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 I '0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 40 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 60. Date: 3-Al-is PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L173 e v or4i rr PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect ❑ Yes EX No See reverse side for Defect Codes A-F a I See below for Defect Code G I TRIM VEGETATION I ❑ Yes gNo WATER VALVE ADJUSTMENT REQUIRED N ❑Yes IX No PARKS DEPARTMENT REVIEW REQUIRED f a� ❑ Yes No - v.4° e,vo✓I 5411'6 LOCATION OF SIDEWALK Front Yard ❑ Side Yard LI Other _ . WIDTH OF SIDEWALK LI 4 Feet ❑ 5 Feet ❑ 5.3 Feet LI Other DEPTH OF SIDEWALK ❑ 4 inches ir5 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 : Date: ®j PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS qg,92 De,uo45..hite- .613 -33 - cia6 - o ® ; ' 04 PARCEL CODE CONTROL NO. Type of Defect Ap L �c See reverse side for Defect Codes A-F �i CLEAN SIDEWALK See below for Defect Code G I ❑ Yes 4 No TRIM VEGETATION -- ❑ Yes No WATER VALVE ADJUSTMENT REQ'D ♦ d ❑ Yes XNo PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes F No J — e ner — LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK N 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches X 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 : rEDate: a."/g #P f tea -??, PERMIT ISSUED _ FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9 Num 11 ire, cs91a - - 0/0 a/ z 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 WATER VALVE ADJUSTMENT REQUIRED N Yes ❑ No — I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No . q i.` — i. • M /V7f l6.1 ,e,von 5 roc. LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK S 4 inches X 5 inches El6 inches AREA TO BE REPAIRED 11°. t 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 : c )ti e Date: 3' ®!$ PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS De dr) , . - i'®s- - / Z PARCEL CODE CONTROL NO. Type of Defect f G CLEAN SIDEWALK ❑ Yes gt 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 y No I I PARKS DEPARTMENT _- REVIEW REQUIRED ❑ Yes X No LOCATION OF SIDEWALK 1Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK P4 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK I 4 inches 5 inches ❑ 6 inches u, -- AREA TO BE REPAIRED 'l 7• 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 : 1D B T Date: 3`Zf PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 555 DevoNSkkrre 5/13 -33- ifo6 - CPIs Z5 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 I ❑ Yes lX No I TRIM VEGETATION t ❑ Yes 11 No WATER VALVE ADJUSTMENT REQ'D ❑ I PARKSYes Ds /S. `I 7�� J REVIEW REQUIRED i� Yes ❑ No J ,zvod 5h,' LOCATION OF SIDEWALK $Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches cif 5 inches ❑ 6 inches AREA TO BE REPAIRED 6°• sq.ft. 4 in. 3°' S sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes fyi 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 /-/g PERMIT ISSUED FORMED POURED COMPLETED CIS O F WATE'1 OO SIDEWALK REPAI". SURVEY FORM ''ROPERTY ADDRESS Ifs s1`0i Bel l3 -35- 351 - CO( V Z` - PARCEL CODE CONTROL NO. n"4 — 4 N/ Type of DefectA l� , CLEAN SIDEWALK See reverse side for Defect Codes A-F ? ems . No See below for Defect Code G v�l N 1 El.�-g vJN TRIM VEGETATION ❑Yes In No — 10 1( "1„cr's -" . 404111.40. a WATER VALVE j \ 7i ADJUSTMENT REQ'D 4 ❑Yes N No PARKS DEPARTMENT REVIEW REQUIRED _ _ 53 10•- Ira' ❑Yes p No — LOCATION OF SIDEWALK + Front Yard , IA Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK $14 inches 'A 5 inches ❑ 6 inches — 3 AREA TO BE REPAIRED ` c�.L' Z.�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 - `:.D u Sam cnt 1 a y Sty)„J 644-5 ;A RpPr , Io 54J6 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 : ,�,qq5 k''Vl - Date: 2 i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1) Pb--20A- %*13 1 - z-- 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 gNo 1 WATER VALVE ADJUSTMENT REQUIRED 1-0—* ❑ Yes g.No PARKS DEPARTMENT REVIEW REQUIRED 5A® ❑Yes .No LOCATION OF SIDEWALK M.Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1%5.3 Feet ❑ Other DEPTH OF SIDEWALK yi 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: - 7% 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 10 zN.v , — B5c5-3k— S— Z57 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 I No TRIM VEGETATION 100 ❑Yes X No — 0—* WATER VALVE I \� ADJUSTMENT R ' —► _ � EQ D ❑Yes tX No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No 1-1/ 4 I 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 1l•7 •!sq.ft. 4 in. 79.0 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 : 125 a o) Date: Q PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS a 3o5 Fairway 'V3 -33 - PO - CO I PARCEL CODE CONTROL NO. _ Type of Defect A f CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ` ❑YesJ No TRIM VEGETATION ❑ Yes fxsNo �—Q--► 3 WATER VALVE j `t. ADJUSTMENT REQ'D • ��� Q' ❑ Yes XNo PARKS DEPARTMENT REVIEW REQUIRED .20•"7 _ _ ❑ Yes No � JS' S 2` OP h14 LOCATION OF SIDEWALK I�Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IA4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )44 inches X,5 inches ❑ 6 inches AREA TO BE REPAIRED i y�•1 sq.ft. 4 in. .agj sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Cat.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 : TT. Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c2311 FA►rwa 9 a -33 - 020 - 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 ❑ Yes XNo WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes tgl No PARKS DEPARTMENT _ REVIEW REQUIRED L AA 3"(" ❑ Yes No LOCATION OF SIDEWALKFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet LI Other DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 3V.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: 3 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS -4 I — 333 gra -33-dgo - of, / Z(pl PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G _ I TRIM VEGETATION El Yes l No WATER VALVE N ADJUSTMENT REQUIRED El Yes Ii<No _ I I I REVIEW DEP REQUIRED El Yes NI No y.o 1.747/7 7 root, LOCATION OF SIDEWALK Iyt Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches IX 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 5 6.( 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 : Date: 31212 4f PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 455g a3 lit rix;sP a1 ort/ gg73 -33- ono - O PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect l ❑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 �1] ❑Yes X No I � PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No (''Z' O�/fir / °‘. i`c'46, LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [A 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches IX 5 inches ❑ 6 inches AREA TO BE REPAIRED 1g sq.ft. 4 in. ®2®° °sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes VA 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-(22-/g PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS V> t Av e fr — �\:5 - 3 -Zoe - cc \ 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 No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No _ I � PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No - - (71 A-.s oaf LOCATION OF SIDEWALK )4 Front Yard ❑ Side Yard El Other . WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 16 4 inches $4, 5 inches El 6 inches AREA TO BE REPAIRED 20.5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ` Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 10 t - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes INo — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0.5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED 3 -® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: ®2 ` ( PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 5� l [ l$-35 101 - 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 T VgGETATION ) Yes ., ❑ No WATER VALVE ADJUSTMENT REQUIRED n] ❑Yes No _ I � PARKS DEPARTMENT REVIEW REQUIRED CI Yes C No k-N\ �3 LOCATION OF SIDEWALK tg,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IA.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ' t) 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 PARCEL CODE CONTROL NO. CLE.ANzSIDEWALK Type of Defect Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code GTRIM VEGETATION ❑Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ql 0 v lics ❑Yes ❑ No FOCe5-1— LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK %4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK /®/4inches CI 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 - 0•44 -to 1 140141 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 : bg6M Date: 0 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1-1 F. - 5-1- 713 -3 - JO - oil -0.7 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 ❑Yes [ No WATER VALVE it ADJUSTMENT REQUIRED ♦"0-10. ❑Yes rfZ No 1 PARKS DEPARTMENT ZJ REVI i REQUIRED XI Yes ❑ No 1°° ,Q` LOCATION OF SIDEWALK ] Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK N1,4inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 6, 111,0 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 IF WATE LSS- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 11 ILIbi4 9?1,3, - 5 — — 2-- PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes t No TRIM VEGETATION t ®= ❑Yes Not �Q WATER VALVE ® ADJUSTME Q'D — t \ ❑Yes No PARKS DEPARTMENT a _ REQUIRED — J1 Yes` ❑ No C <Pti 5.0\ a v LOCATION OF SIDEWALK %Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet >. 5 Feet ❑ 5.3 Feet 4 Other ,1 — DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /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 : &Oki° Date: PERMIT ISSUED FORMED POURED COMPLETED -• _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .25-7 1,10;4t 913 - 33 - Vof - Oo PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I El Yes XNo WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes XNo - I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes lX No look LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [ .4 Feet ❑ 5 Feet ❑ 5.3 Feet El Other DEPTH OF SIDEWALK f$.4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 16 .0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes X No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : DO 4- 7-5 Date: 3 - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS , "3i &to/ .1, qi 3 -33 - 'loj - 0.1® Zi3( PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes X1 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes ► No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No I I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes X No v• goo` _ oK 1k Gl'r;q LOCATION OF SIDEWALK I$f Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 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 : 17 4- -r,b- Date: �" PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a5,37 G(oteia _ 5913 -33- y03 - GAO - PARCEL CODE CONTROL NO. G/ ` 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 I I ❑ Yes JX1 No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes 1gNo — I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No /0 3\ 3.1 7/or+6k LOCATION OF SIDEWALK 1)4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK y 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ig 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 56- 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 - /lay ieJ ' /44 A.c )Lrce Ma1p. 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 +` 75 Date: 3.Z"-/8 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS V (ori Via - 3 - NO! - oaf . 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 ADJUSTMENT REQUIRED N ❑Yes X No I I PARKS DEPARTMENT REVIEW REQUIRED IX Yes ❑ No Li,1 A LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK t,d,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 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 : 5 4- Date: - ®®/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 075.0 Gldr,ot, `°/3 -73- API - 0 v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes k> No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 1XNo _ I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes rx No LOCATION OF SIDEWALK 0 Front Yard El Side Yard El Other WIDTH OF SIDEWALK `it 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches X 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. l 4•g 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 : D5. s' T£ Date: 3 1"-/.0 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS G toy'e 51/3 - 3.3 -WI - 00 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 TRIM VEGETATION ❑ Yes Ig.No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes 0 No I � 1 PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes No 4 1.0t _ LOCATION OF SIDEWALK I 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 I •11 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 : poTE Date: 3 4"—/8' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (Mria 9/3 - 03 - 00Z7 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes 1 No See below for Defect Code G TRIM VEGETATION ❑ Yes X No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes I No I PARKS DEPARTMENT REVIEW REQUIRED i. 7L � ❑ Yes �► No j orgtk LOCATION OF SIDEWALK X.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IX 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 : D5 ' TE Date: 3.2°/3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS P-6I /0 r' 913 - 11- il®s - avio -7;57 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Co, ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes I No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes X1 No � I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes X No 11,1' Gt06-c( LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK tyi 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 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 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 : Vf TE Date: 7140 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 026 OS. World, — €113 - 33- 903 -02 'r 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 e-No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes °V No — I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes INNo ,:D" JoV'r� LOCATION OF SIDEWALK Ex Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 'f 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK c4 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 +` Date: N ®/S' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 6 22 0` 81 - Yoe - 003 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 gNo WATER VALVE ADJUSTMENT REQUIRED N Yes ❑ No I I PARKS DEPARTMENT — REVIEW REQUIRED i'k." hit ❑Yes X No Irv. rr®1 LOCATION OF SIDEWALK CA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 15• d 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 : 41� d' 75 Date: 3-.2O PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS ®26 ( ie, 13 -33- '(03 - oaa, o 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 TRIM VEGETATION ❑Yes No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes ► No _ � I I PARKS DEPARTMENT REVIEW REQUIRED a ❑ Yes I�No OK G — LOCATION OF SIDEWALK % Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK g 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1p.4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED a• a 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 : + Date: '2a` g — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3,-f ofat,,A 3113 -33- yO2 - c 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 I TRIM VEGETATION I I ❑ Yes NI No WATER VALVE N ADJUSTMENT REQUIRED — X Yes ❑ No I I PARKS DEPARTMENT REVIEW REQUIRED hy, ❑ Yes dUlNo \ 34; Cal Or Ca, LOCATION OF SIDEWALK TA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK tit Feet LI 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 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 ❑ 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 : bp4 Date: 3" 15° PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a ( L( / G USic SR 13 -3 3 - Yo 3 - 0 ! 9 , PARCEL CODE CONTROL NO. Type of Defect A 0CLEAN SIDEWALK See reverse side for Defect Codes A-F -°- ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes 1%1 No q) N S WATER VALVE J ADJUSTMENT REQ'D ❑ Yes 14 No _ PARKS DEPARTMENT REVIEW REQUIRED �V3 _ tl•a 1°► •`k ❑ Yes gNo 10i11/11/A`/ (5 lei GI ovia.. LOCATION OF SIDEWALK l Front Yard Xl Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches 15 inches ❑ 6 inches AREA TO BE REPAIRED V7'•0 sq.ft. 4 in. 7`I. 6, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [XL 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 Q TE Date: 3 - a l -1 8 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS - n I - - PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G El Yes No TRIM VEGETATION \At it ❑Yes X No I `• \ WATER VALVE i ADJUSTMENT REQD ❑Yes E4 No PARKS DEPARTMENT REVIEW REQUIRED _ ❑Yes ,No do LOCATION OF SIDEWALK ❑ Front Yard XSide Yard ❑ Other WIDTH OF SIDEWALK 7+ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK e 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 il4 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 : "U it Date: IV 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS „ / f - - ) - 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 I ❑Yes JXI No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes No I I PARKS DEPARTMENT REVIEW REQUIRED — �+�` ❑Yes to Pkvf LOCATION OF SIDEWALK syl Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches jst 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 liNo 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: / 10 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 115 1 - - ( - O7 - 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 — 1 ❑Yes No WATER VALVE \ ' _� `� ADJUSTMENT : QUIRED fe Q, " ©—* ❑Yes ii,ok I I PARKS DEPARTMENT REVIEW REQUIRED — 4,® ID Yes ANo ® _ 3f7` ou4.��.® ® \ 0,09, LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK , j 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 : f5gY Date: 031416 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I?,1) Oat = ry - - 35- ill - co3 7-67-7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes C. No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 ❑Yes C No WATER VALVE ADJUSTMENT REQUIRED ❑Yes g No � 1 _ J I PARKS DEPARTMENT RE.. - A -EQUIRED JYes ❑ No - Pat LOCATION OF SIDEWALK ).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 Ibla 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 : Mr) 1.J Date: (9 // A G PERMIT ISSUED FORMED POURED COMPLETED_ CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 111 11 : - '-Rive-- 0/5 -55- l _ 0242 z� - 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 TRIM VEGETATION ❑Yes El No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Jf No — I PARKS DEPARTMENT REVIE REQUIRED Z. Yes ❑ No vrA s — LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK -0 4 Feet ❑ 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 ,. ,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 : to Date: °, PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 114,: Pc- t - Ul\ - a25 soo 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 F,No WATER VALVE f r3 ADJU MENT REQUIRED ♦- —► t - ❑ No -- I PARKS DEPARTMENT RE REQUIRED Yes ❑ No A-( 4.x/'&04a. _ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,li 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 - x) 0 Id.` 4 Ualtti k4 ritomtr t/t�li tter Q9Atalsa. t N 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: 0424/i___ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -35 - JO' - PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect C ❑ Yes j No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes K1 No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes $ No I PARKS DEPARTMENT r (s")) REV REQUIRED�� Yes ❑ No 011/ G6`60i PJACiite LOCATION OF SIDEWALK , Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IN,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches s 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 ,ICJ 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 : v Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 133 Hrd r_- -35_ 11k - VO(� ti PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes j&No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes -No WATER VALVE t if ADJUSTMENT REQUIRED A-0—* ❑Yes MINo I PARKS DEPARTMENT R4)=cQUIRED❑No \ `fcl.%(-17/* LOCATION OF SIDEWALK $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 q 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 - rt �" y �� Ce to i- Ceo-7 �r oW -y4.449 A a fr re. led[wow.I 1� aktely NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. A /� rlJu"1 FIRST INSPECTION AND FORM MADE BY : '" Date: 03/ Ziltg PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I 14 to - 3 -35- its - 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 — ADJUSTMENT REQUIRED ❑ Yes No No I PARKS DEPARTMENT REVIEW REQUIRED ie ❑Yes igi.No 14.0 LOCATION OF SIDEWALK ] Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 1 .4 Feet ❑ 5 Feet ❑ 5.3 Feet El Other — DEPTH OF SIDEWALK , j 4Jinches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 16.t 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 : o Date: LID PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 20Z e-e2o d` PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect �' ❑Yes r1 No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes g No WATER VALVE t ADJUSTMENT UIRED 4-0—► ❑Yes No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes $ No v/A '67 \ ilk LOCATION OF SIDEWALK )Z Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK pt4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 31. a 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 otherareas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: C323P-*/6___ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS � � n t -35 - -OJO 3 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — ❑Yes ANo See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION I ❑Yes JjNo t WATER VALVE fl:gA AD _ ENT REQUIRED 4-0—* ,Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED _ A ❑ Yes KNo Nwj LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK /KJ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK A,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 I No No.of Squares with Patches CODE G - x P s be — e f /[ / • 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 : ¢t` Date: ?Jk PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1' 1 7 - ii1 -oil 3Iz PARCEL CODE CONTROL NO. —' CLEAN SIDEWALK Type of Defect , ❑Yes C No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes ixNo WATER VALVE r�1 St1R41 t)I ADJUSTMENT REQUIRED �Q--► Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED �R ° ❑Yes ► `No 1\® _ - - [1,44Pfike---- LOCATION OF SIDEWALK xi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK $4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK yt,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Lig.q sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches -- CODE G "! NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. � � FIRST INSPECTION AND FORM MADE BY : Rbk) Date: G �/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2,7_0 ikcji6crTA-C__ - PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G TRIM VEGETATION ❑Yes No 1`t JI WATER VALVE - Q� ADJUSTMENT REQUIRED r a LiYes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No — LOCATION OF SIDEWALK AFront Yard III Side Yard ❑ Other WIDTH OF SIDEWALK S,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 2(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /6 0 sq.ft. 4 in. sq.ft. 5 in. q sq.ft. 6 in. CODE F - PATCHES ❑ Yes )-' No No. of Squares with Patches _ CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPER ADDRESS - g. 4-2, - -2-,4- col - OD1 v PARCEL CODE CONTROL NO. CLEAN SIDEWALK ❑Yes No Type of Defect See reverse side for Defect Codes A-F 1 TRIM VEGETATION I See below for Defect Code G I ❑Yes `No I WATER VALVE — ADJUSTMENiNE0QUIRED ❑Yes N I I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ItL No _i__ k P...' VA Vol VA ,.7_ 0$�� lit LOCATION OF SIDEWALK Front Yard ❑ Side Yard 0 Other — 0 4 Feet ❑ 5 Feet 5.3 Feet 0 Other ----- _ WIDTH OF SIDEWALK 0 6 inches 4 inches 0 5 inches DEPTH OF SIDEWALK f— sq.ft. 6 in. AREA TO BE REPAIRED q�1.'A _sq.ft. 4 in. -----sq.ft. 5 in. --- CODE F - PATCHES 0 Yes No No.of Squares with Patches -- CODE G - repaired by patching.All other areas shall be repaired by NOTE:Areas marked with an"F"may be �- t reconstruction of full sidewalk panels. �� Date: 4 FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED POURED FORMED CITY OFWATE.4 • SL EWALK REPAI* SURVEY FORM - PROPERTY ADDRESS PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F — See below for Defect Code G CLEAN SIDEWALK I 0 Yes Xf No 1 — 1` f` TRIM VEGETATION 4.0 ❑Yes 1 No WATER VALVE 1 V ADJUSTMENT REQ'D — • 1 ❑Yes xNo _____A___. _ _ PARKS DEPARTMENT — 1�� -- _ REVIEW REQUIRED 4-b. ❑ Yes ► No LOCATION OF SIDEWALK ,d Front Yard , 0 Side Yard -- WIDTH OF SIDEWALK � Other ❑4 Feet $5 Feet 0 5.3 Feet ❑ Other _DEPTH OF SIDEWALK ------ 4 inches 0 5 inches AREA TO BE REPAIRED Z i o,o 6 inches sq.ft. 4 in. sq.ft. 5 in. CODE F - PATCHES �-sq.ft. 6 in. ❑Yes •Or No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F" panelsbe paired by patching.All other areas shall be repaired by reconstruction of full sidewalk FIRST INSPECTION AND FORM MADE BY : 25 4?,t) — Date: A -2 - (6 PERMIT ISSUED FORMED - POURED COMPLETED CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM �. PROPERTY ADDRESS 7(7 J c %1I3 - 33 - 407 - COS' ;,,r Z17 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 g No WATER VALVE ADJUSTMENT REQUIRED N Yes ❑ No I I PARKS DEPARTMENT REVIEW REQUIRED k5k ❑Yes No yki 11,2, let eie, LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK g 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED I g sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes XI 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. 4- 7 Date: 312411 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7 3 i n e 6913 -33 - 407 - 06y j,.. 1 PARCEL CODE CONTROL NO. Type of Defect A,G CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G _ TRIM VEGETATION ❑Yes NI No WATER VALVE N ADJUSTMENT REQUIRED %Yes ❑ No I PARKS DEPARTMENT _ REVIEW REQUIRED my®P ❑ Yes 'No /2.2` AI' W.V. X21 - (.0:4/%7 1 r/T/r/r414 MI ,\ LOCATION OF SIDEWALK N Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK fca4 inches 5 inches ❑ 6 inches — AREA TO BE REPAIRED f l 3- sq.ft. 4 in. -r 8. Y 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)1 4- TE Date: 3"Alf PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7 ct u. t3 -33 - 407 - 063 3t PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect r G ❑Yes 0.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 N ❑Yes 0No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes [ ,No LOCATION OF SIDEWALK 71 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK y1.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches $_5 inches ❑ 6 inches r _... AREA TO BE REPAIRED TZ (P sq.ft. 4 in. 31* sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes gNo 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 2r—/ t PERMIT ISSUED FORMED POURED COMPLETED - up( OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 735- 0a17e - 'fc7 - 00.2 . ` z PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK f 6, L ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION — ❑ Yes °O No WATER VALVE N ADJUSTMENT REQUIRED Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes iX1 No 2.7.3` ifor/rx, troAm-40:, Idetife LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14.4 inches X 5 inches ❑ 6 inches AREA TO BE REPAIRED I®9 sq.ft. 4 in. il I.a 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 : Dt3 ¢ Date: 41®13 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 7YI 54pe. 69/3 - 37- 6107 - 1/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 1 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 N ❑Yes X No I I . PARKS DEPARTMENT REVIEW REQUIRED El Yes yl No uot1e LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK V.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other j DEPTH OF SIDEWALK [i4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 I 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 : t-)6 re Date: iti/S PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS FO3 Sane. 5113 - 33- 3Z7 - ol r - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes 011 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 NI No I I I PARKS DEPARTMENT REVIEW REQUIRED SiNt. ❑Yes XI No pv„A 3r 2.7` }w,-p G1YIG LOCATION OF SIDEWALK y Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Xj 4 inches X 5 inches El 6 inches AREA TO BE REPAIRED I 0 1.0 f sq.ft. 4 in. /6. g sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I4 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,' 4' "rt. Date: 3.2/18 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ... PROPERTY ADDRESS '&3q Z-.1/4siA. gl(3 -oo ? :, 3Z1- _ 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 No WATER VALVE --• ADJUSTMENT REQUIRED �] ❑Yes No I I . I PARKS DEPARTMENT REVIEW REQUIRED 5 � ❑Yes g No — — — — — �' 4,2' LOCATION OF SIDEWALK IXX,Front Yard ❑ Side Yard ❑Other _ WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IX inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 •8 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes fg 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 `a` T Date: 3® /—/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 51.. 3,44c PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — ❑ Yes CI No See reverse side for Defect Codes A-F See below for Defect Code G 1 — TRIM VEGETATION 1 ❑Yes JRI No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes INT No — I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes X'No Banc LOCATION OF SIDEWALK 'ICI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK r.4 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches X1 5 inches ❑ 6 inches AREA TO BE REPAIRED 33.a sq.ft. 4 in. 301•® 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 : 6 * TI Date: 3"°a/-fg PERMIT ISSUED FORMED POURED COMPLETED — CI` Y RE OF WATERLOO FORM PROPERTY ADDRESS q17 v/ 013 -33 - 327 - oa- 317 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes M No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED El Yes No 1 PARKS DEPARTMENT . REVIEW REQUIRED ❑Yes No LI roj vie. LOCATION OF SIDEWALK IX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Il 4 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 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 : DO 4. ! Date: -141®J87 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS of (7.e '3113 -33- - 007 ' 3ZO, PARCEL CODE CONTROL NO. Type of Defect Ar CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes I ,No See below for Defect Code G — TRIM VEGETATION ❑Yes Jai No 1` JI WATER VALVE �Q--► ADJUSTMENT REQUIRED / \ ❑Yes 0No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes g No - - - - 123® / 5. 1 ® LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard LI Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK l-4 inches XI 5 inches ❑ 6 inches f AREA TO BE REPAIRED IO•61 sq.ft. 4 in. d/? 2 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 : I- TV Date: -?® I ` g PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5.23 ��„i. S543 -33 -J,77 - o to 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 1 No ..- WATER VALVE ADJUSTMENT REQUIRED N ❑Yes NINo I I PARKS DEPARTMENT , REVIEW REQUIRED ❑ Yes No `a� - -- I ® I — — — � 3.7`\ F �a4e LOCATION OF SIDEWALK yi Front Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK IX 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK j 4 inches 5 inches El 6 inches AREA TO BE REPAIRED /5. 6 sq.ft. 4 in. a 9• 63 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES tyl 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 : ©y Ta Date: 3V 4/8 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 3113 -3, -327 - oo6 t/ 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes AT No See reverse side for Defect Codes A-F I See below for Defect Code G I TRIM VEGETATION I I ❑Yes K.No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes X No — 1 PARKS DEPARTMENT REVIEW REQUIRED El Yes gNo r/4 _ _ LOCATION OF SIDEWALK IX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK t(4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ix 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 1ID. 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 : V 4- IT Date: 34//g PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Tmvue e1(3 -33 - 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 I ❑ Yes g No --� WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED I.%' ❑ Yes No P • 00 35; r LOCATION OF SIDEWALK 111 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 I LI. ® 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 : 1--e Date: 3"Z PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 53.2 3-.44. t3 -33 -32? - 005 �3a- PARCEL CODE CONTROL NO. C✓ 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 No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No I I I I PARKS DEPARTMENT , REVIEW REQUIRED +Vcvy Lar/q b X Yes ❑ No ogode �% / /,1 Ja4L - LOCATION OF SIDEWALK (Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1)1 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED E(1•11 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 : Di3 Date: 3 2/"/S PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS azi, PARCEL CODE CONTROL NO. Type of Defect �/ CLEAN SIDEWALK ❑ Yes ly No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes f ,No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No PARKS A REVIEWDEP REQUIRED ❑Yes X No C. i'(A - - 9.41 \ LOCATION OF SIDEWALK IFront Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches f5 inches ❑ 6 inches -- AREA TO BE REPAIRED sq.ft. 4 in. 50.9 /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 : D-5 "C>". GP> Date: 3 2-3- /g PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2S9 RENILwoRrN . R.) - ✓ 8913 33 — PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Ai ❑Yes A No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes -J No 1 WATER VALVE if ADJUSTMENT REQUIRED �—Q—► ❑ Yes No -- I PARKS DEPARTMENT REVIEW REQUIRED CIYes No .5.5 — — /5.3 : — 1 b.I' 0 cak`N P'.c% 1/7M1 KO /c \ A A K G nJ I L w o f&T N LOCATION OF SIDEWALK {K Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K5.3 Feet ❑ Other DEPTH OF SIDEWALK SA-4 inc s Vj 5 inches ❑ 6 inches AREA TO BE REPAIRED 13`{•Co sq.ft. 4 in. 2 9.2 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes j4 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All othersareas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �s D g b5 Date: 3 .23- I $ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 3 t+oRTH RD . . $`1IS -34 - 90l - OZ2i Ali -- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes 'No See reverse side for Defect Codes A-F J See below for Defect Code G J TRIM VEGETATION I ❑Yes lANo WATER VALVE ADJUSTMENT REQUIRED ~W� ❑ Yes R'No \ PARKS DEPARTMENT oca� REVIEW REQUIRED 1 \ 5,0' ❑Yes I No RDn►iL.woRYN R� LOCATION OF SIDEWALK f2I Front Yard ❑ Side Yard . ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet N.5.3 Feet ❑ Other DEPTH OF SIDEWALK y14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2eo.5 . sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 5'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 .b G 6 b s Date: 3-23-18 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS HO 5 en+ Cr. 9/3 -33 - 177-O /7 / F,4 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 TRIM VEGETATION ❑Yes CJ.No WATER VALVE ADJUSTMENT REQUIRED f"Q\ ❑Yes No PARKS DEPARTMENT (.i0 REVIEW REQUIRED ❑Yes 1 No — V4/AYk I %/1 X 1.711. �►�� c . LOCATION OF SIDEWALK X.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 164 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Jl 4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 1/04 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 : .O Date: 3 36' I b1 `7- P'-1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I 16 \<trylt Cc'. _ A\3 - 33- - 0 4 . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect G ❑Yes Il No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes 17.1 No WATER VALVE ADJUSTMENT REQUIRED �""Q'♦ ❑Yes !No -- I Ie I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes VI No PiWA KGnA" (Jr LOCATION OF SIDEWALK $1.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IP 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK V 4 inches ❑ 5 inches 116 inches AREA TO BE REPAIRED 5f sq.ft. 4 in. sq.ft. 5 in. 8'1' 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 1 Date: 3-36_15 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Mg KC/4 GP Wi13 - .33- q77 - 011I v e 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 I I ❑ Yes 'A No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes + No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes g No `t.0 /f-5'• $.`d' 11,0' 6" LOCATION OF SIDEWALK 1A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK TA 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ' i 4 inches ❑ 5 inches g 6 inches ! vi AREA TO BE REPAIRED (A a sq.ft. 4 in. sq.ft. 5 in. 78.® 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: PERMIT ISSUED FORMED POURED COMPLETED CITY REPAI®F W O SIDEWALK ,TERSURVLOEY FORM PROPERTY ADDRESS 2 l K v14,6, I( . ?Pi/ 3 35- /05- 00 ( 6 PARCEL CODE CONTROL NO. Type of Defect A _ n CLEAN SIDEWALK See reverse side for Defect Codes A F s��/4.,L,---- 4 ❑yes No See below for Defect Code G JJ TRIM VEGETATION J ❑Yes— `� T I,No t/ . f�` N WATER VALVE • _t AD TMENT REQ D . 1 x Yes ❑ No %V (54) PARKS DEPARTMENT — \\IREVIEW REQUIRED �{o�` — — — — ❑Yes ,No \ t t , ) — Be,c—JA _ LOCATION OF SIDEWALK $.Front Yard . Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet II5 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK $4 inches X 5 inches ❑ 6 inches — AREA TO BE REPAIRED .5 ysq.ft. 4 in. a's° s co( q.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. n,� Q, FIRST INSPECTION AND FORM MADE BY : !"`6`� Date: 6 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 / Km./ ol 1 -3 - 105 - z . PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes j No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes X No I SPARKS DEPARTMENT REVIEW REQUIRED ❑Yes ptho 11,5 I /103 LOCATION OF SIDEWALK ,�Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet !t 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,t��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: /kili PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 t 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 ADJUSTMENT REQUIRED ❑ Yes IN/No I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No 3.5 A 14.It� LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet q 5.3 Feet ❑ Other DEPTH OF SIDEWALK X14 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 15.to sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes 1x 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: 3 - t a PERMIT ISSUED FORMED POURED COMPLETED -rCITY OF WATE L•O p 0 G A apt& — tpi SIDEWALK REPAIR SURVEY FORMc 0 psi_' 't; `R RS — r + 5 ''ROPERTY ADDRESS 6125 1��01,Gw lJit mie5 - 35- !o5 - 00. ,7 5z., — 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 — WATER VALVE i j I Q ADJUSTMENT REQ'D — ❑Yes $ No PARKS DEPARTMENT 1 REVIEW REQUIRED . �'3 ❑Yes )6 No — Co , ,i 5 _ 'wU — LOCATION OF SIDEWALK P3 Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet j 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Tg.4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED V 2 1 +5Isq.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 : ��,6k f2�+" Date: r, 10 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WA ER S• SIDEWALK REPAIR SURVEY FORM •ROPERTY ADDRESS WO i Kt4ttri H Ave- - 13 - -- i A COI PARCEL CODE CONTROL NO. Type of Defect A;G ) _ - See reverse side for Defect Codes A F CLEAN EWALK See below for Defect Code G ❑Yes ,No 0 � ---- TRIM VEGETATION t�, '3 ❑Yes ,No — .4-42)—+.. 0- Q,7 41/4.) . 1A WATER VALVE i \ . ` ADJUSTMENT REQ'D K ❑Yes , No • . 611,Ael'b ReAtcA1 PARKS DEPARTMENT i _ � REVIEW REQUIRED '�— r`' ,✓ EYes ❑ No �//Z/7//////// IX 'I k-i 0' ��) I\ — ‘.-----) e\---N-''') I 1 574-g.P.11 j ___ r---,r� A LOCATION OF SIDEWALK X Front Yard . 101de Yard ❑ Other WIDTH OF SIDEWALK A 4 Feet15 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK A inches ❑5 inches ❑ 6 inches AREA TO BE REPAIRED ZP1,3 sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes ,Io No.o.of Squares with Patches CODE G0vC11=�1i- �?I— �'ktc'1 54L�^!�iC� ;e, �t"+� ?� (� ic_ RricP-N I rvec ( k' ` 1G L I Yap' -1't;pp '►eo) 4o K — 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 : kQ l'iS2C-EC 'l Date: 9-8- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I 00 s Kss.AGLA--- SD 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 I 1 ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes lg No I l PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No S k LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK XI 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK s 4 inches 5 inches ❑ 6 inches -- AREA TO BE REPAIRED 5( .0 vsq.ft. 4 in. Z0,4 " 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 : l3D Date: ^2 3® ( PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO -- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /017 K,4ttxtil Ave_ 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 El Yes 1 No WATER VALVE �4� ADJUSTMENT REQUIRED ❑Yes No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No svl� , l Ave, LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet X5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK A 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 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 : e 1 d1-5 t;th'1 Date: Wig PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS )c7ZZ® am N.3 -3b-- z 3 S -D eo 3560 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 L No I I PARKS DEPARTMENT -- REVIEW REQUIRED ❑ Yes No 4, , 4.0 - VA 0 spur LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK `4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches C5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. Ila.ck v 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: _ ® lam PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t ®C2 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 TRIM VEGETATION ❑ Yes No -" WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No r � I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ° No 4,0 VA A A LOCATION OF SIDEWALK ly 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 I(.•D sq.ft. 4 in. I R.2 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 : � i Date: 1•® PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS HIT r 1, 7 5 - oft 34,0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes )6 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes No 1 WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No y' I I PARKS DEPARTMENT — 4 ---, REVIEW REQUIRED ❑Yes f -No L _ LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK LY,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED )5.6 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes y 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. Ai 1��/ FIRST INSPECTION AND FORM MADE BY : Date: e 4 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF A,TER_•0 Si REWALK REPAIR SURVEY FORM PROPERTY ADDRESS 112Z- k:vv& t f 91 1 -5 -23 - 0 I PARCEL CODE CONTROL NO. Type of Defect ®(' k C See reverse side for Defect Codes A-F LEAN SIDEWALK See below for Defect Code G s I El Yes No TRIM VEGETATION ❑Yes No WATER VALVE I�4,St ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes i No ALA-14Aklik- LOCATION OF SIDEWALK AFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IX 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1)2.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes IN No No.of Squares with Patchesitsrk _ E G ) tit I CO 4 W 45 6.4-0 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 : RP-IgNJ Date: 4*--00 PERMIT ISSUED FORMED POURED COMPLETED CITY OF W4\7E\L O — SIDEWALK REPAIR SURVEY FORM ROPERTY ADDRESS 9)?, a , �( - ,t - lli 0219 ��Z - 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 14 No TRIM VEGETATION 1 ❑Yes No WATER VALVE 31 1/6 /0. ADJ ENT REQ'D - Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED — — El Yes gf No • K; Ij( LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK igt 4 Feet ❑S Feet El 5.3 Feet ❑ Other — DEPTH OF SIDEWALK A4 inches . ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ite• 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 : N Date: _ PERMIT ISSUED FORMED POURED COMPLETED _... CITY OF WATERL•• SIDEWALK REPAIR SURVEY FORM .,ROPER Y ADDRESS e Z°7 Y, I Octi5-35- J 1 - 00 / 3b PARCEL CODE CONTROL NO. Type of Defect AP C CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑Yes l No TRIM VEGETATION \A `o [ �} ❑Yes No WATER VALVE itADJUSTMENT REQD ❑Yes ps,No • PARKS DEPARTMENT REVIEW REQUIRED �✓ 09 is ❑Yes No -- yCoV\- LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK jg 4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )X1'4 inches . ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 19 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES L?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 : i Date: 03/12/ 6 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I t-* li i stolp PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes yr,No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I l ❑Yes No WATER VALVE c ,1e A ENT REQUIRED /4 t` r)Yes ❑ No eks) Or cfrK,`4441641' PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes to xi' I . beiA LOCATION OF SIDEWALK Front Yard LI Side Yard ❑ Other WIDTH OF SIDEWALK V 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK l] 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 37 2-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 - Cx� PAddltiY'c'GG[�� v; eftgefat r e, f}'nf eu inod Y T NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. I l FIRST INSPECTION AND FORM MADE BY : Date: % PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / 1 - q - ZOf - 00 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes I No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes yl No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes , No Ie 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes gNo WVA :wt�� l LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALKl 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 32.21 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. A i 001 *Le FIRST INSPECTION AND FORM MADE BY : /�' 1 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1226 D r y -. - L -007 370 --- 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 pf No WATER VALVE ADJUSTMENT REQUIRED ❑Yes )No PARKS DEPARTMENT REVIEW REQUIRED ® El Yes fr&No B r K:\Atioati LOCATION OF SIDEWALK N Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet El 5.3 Feet El Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3Z.11' 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: 01tg PERMIT ISSUED FORMED POURED COMPLETED — CITY •'F WATERLOO SIDEWALK REPAIR SURVEY FORM 'ROPERTY ADDRESS I'03 K',4,11,t( d`13 .55- 151 - 09I 67I - PARCEL CODE GO ROL NO. s�\ 1 A - Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I ❑Yes ik No TRIM VEGETATION ! El Yes JNo At/I • % WATER VALVE ADJUSTMENT REQD -- J ❑YesJ No PARKS DEPARTMENT REVIEW REQUIRED • _ _ ❑Yes , No No C6►f oitvw. - LOCATION OF SIDEWALK pi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet a5 Feet ❑ 5.3 Feet 'I Other 5.1 I DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in.'fcZ5'5 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. D FIRST INSPECTION AND FORM MADE BY : 8 �` f Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE SO SIDEWALK REPAIR SURVEY FORM "ROPER T Y ADDRESS !1/0 K+v tl - - PARCEL CODE CONTROL NO. Type of Defect l t3G' t -" See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes No — TRIM VEGETATION S . ❑Yes E: No kA WATER VALVE 1�� j, ADJUSTMENT REQ'D — ❑Yes f)No PARKS DEPARTMENT _ p . ) 1 REVIEW REQUIRED `,� — — ��' �,� ❑Yes TX No ��Xl� r, lf: vk4 ri) . LOCATION OF SIDEWALK j4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet )1(1,5 Feet ❑ 5.3 Feet El Other DEPTH OF SIDEWALK )2(4 inches . ❑ 5 inches ❑ 6 inches Y AREA TO BE REPAIRED 5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES JYes ❑ 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. q — FIRST INSPECTION AND FORM MADE BY : f I/��`�(.XSki Date: 63 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ! KAA, ,I 3 - -003 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 [ No WATER VALVE — \ ADJUSTMENT REQUIRED ❑ Yes Elg No PARKS DEPARTMENT REVIEW REQUIRED ,A.Yes ❑ No • 5 a5d . - - J\1 U LOCATION OF SIDEWALK %Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 105 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 'g 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 50°O sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes KNo No. of Squares with Patches q CODE G - ��) t‘t/�e- rot ®1' de° (0,--e j j I C e_ 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: tei PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 117 t( - 112) -35- -2,07.5 017 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C., ❑Yes 2 No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑Yes tR1 No j' WATER VALVE ADJUSTMENT REQUIRED _ 2 ❑Yes n No ✓ ;0 it 0 Q` I PARKS DEPARTMENT ^- REVIEW REQUIRED ❑Yes 0,No 32`- 32) 17.3` 3: i' — V//.4oV/A'AI�clxIxIxI lPt Y/A a/,���� tew, I \ _ LOCATION OF SIDEWALK TL Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK 71,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I 1#4 a® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES XYes ❑ No No.of Squares with Patches CODE G - (A r m0 Gill- I'irt� ( emerit o4e- /® _ ceie, Davie :r- —NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. pp' � FIRST INSPECTION AND FORM MADE BY : . f) Date: *iltig PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE!L••O Doe- 4 coo SIDEWALK REPAIR SURVEY FORM LoN1• Rs •RORERTYADDRESS r7ic1 " 1723 ii - -ll'i$ B13 -35- O3- ca2- t' zgo _ PARCEL CODE CONTROL NO. Type of Defect A. L See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes J No — I TRIM VEGETATION ❑Yes II No — tiff - -Q— WATER VALVE l ADJUSTMENT REQ'D — I ❑Yes igtNo _ PARKS DEPARTMENT ,5a K REVIEW REQUIRED z� gib LIB v 4.3$do ❑Yes IA No X/ ri I�4K!,A Ix��A In 3�` Sag � li vtn,104 L( LOCATION OF SIDEWALK A Front Yard . ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ) i 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 12S1 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED °' 180.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES $Yes ❑ No No.of Squares with Patches I CODE G - (X) M a(Zr ) 1cme- Abriv (>.-ptt'/cei Oep cite— -4 rp NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Q�,� j FIRST INSPECTION AND FORM MADE BY : 11k U,3 Date: *IAA- - — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE-.L00 _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2) z!az K 6 1( - c139 t 3 194 - 1177 - Ott- ;t`' SS PARCEL CODE CONTROL NO. Type of Defect A)C" r % CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I ❑Yes 15KNo _ I TRIM VEGETATION ❑Yes j,No -41— —+ ‘ WATER VALVE 1\ I A ADJUSTMENT REQ'D _ Li Yes tNo � Pi'r dl PARKS DEPARTMENT V- REVIEW REQUIRED • 1/Ot — ' 0 1. ❑Yes XNo — V/ in 44 s-ri I` iit 7 J .... ,,, . to, ,: P Avg Li / _ LOCATION OF SIDEWALK ❑ Front Yard X Side Yard >a Other WIDTH OF SIDEWALK Xl 4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ;K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED V 50.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES >?1 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. AA FIRST INSPECTION AND FORM MADE BY : /' L > ii Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF W!kTERLOS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'co l 5 j` " PARCEL CODE CONTROL NO. Type of Defect C- CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G ❑Yes No TRIM VEGETATION ❑Yes y4.No ~YJ� f). WATER VALVE ADJUSTMENT REQ'D �� ❑Yes No ®` PARKS DEPARTMENT �9 REVIEW REQUIRED - - - - ❑Yes No J 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. 24.E ``' 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 : �� TCSVY? Date: 3 —, @# PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS DS Vs t) 1,3 - - 0 is de7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C/ ❑Yes 'gNo See reverse side for Defect Codes A-F • _... See below for Defect Code G I TRIM VEGETATION I ❑Yes o WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes No U — 1 61• LOCATION OF SIDEWALK TA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X.5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches W5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in.Z3.9 s' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes lNo 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 _3� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ( I k), ,s 5t3 -out, ." sae PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' f ® o See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes L(No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes X No to. I fir bisq,b LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 3. 5 V q,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 S &bi> Date: 3 30-I�U PERMIT ISSUED • FORMED POURED COMPLETED CITY •F WATER12•O SIDEWALK REPAIR SURVEY FORM ROPER` Y ADDRESS I2-g lc-- t.5 Q , ✓ — v)t� 3 z0 -0\`) ✓ 3e,D 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 X No — TRIM VEGETATION �� � ❑Yes No � WATER VALVE ♦ I ADJUSTMENT REQ'D — ❑Yes L No PARKS DEPARTMENT REVIEW REQUIRED A A ❑Yes y No — KA 17 cLc�v LOCATION OF SIDEWALK ❑ Front Yard f;4 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet X5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 14 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 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 : 7 s Date: 3 -�- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATER •O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 52-4›, a/ . PARCEL.CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑Yes KNo TRIM VEGETATION ❑Yes y4 No WATER VALVE .0( ADJUSTMENT REQ'D ❑Yes No I PARKS DEPARTMENT A REVIEW REQUIRED - - - - °Yes El No 4.0 4.t 3,`1 J LOCATION OF SIDEWALK 1K Front Yard 14 Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet N,5.3 Feet ❑ Other DEPTH OF SIDEWALK It 4 inches ❑ 5 inches ❑ 6 inches V AREA TO BE REPAIRED $9•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 : Rs BD5 Date: 4•i s PERMIT ISSUED FORMED POURED COMPLETED CITY •,F WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS z©t, PARCEL CODE CONTROL NO. Type of Defect A • See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G r ❑Yes f fNo TRIM VEGETATION : Yes ❑ No — WATER VALVE 0 ADJUSTMENT REQ'D ❑Yes No �8`� PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No _ I LOCATION OF SIDEWALK J Front Yard Ig Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK "t 4 inches ❑ 5 inches ❑ 6 inches ICCo J o AREA TO BE REPAIRED .I 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 : g s 5 Date: 4"Z-- PERMIT ISSUED FORMED POURED COMPLETED — • CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t \ I � e3 mat a07- 3 °1 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 tg No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes X No _ I I PARKS DEPARTMENT REVIEW REQUIRED ,Yes ❑ No I . 3. / .c)t\ LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C5.3 Feet ❑ Other DEPTH OF SIDEWALK yj4 inches I45 inches ❑ 6 inches AREA TO BE REPAIRED Io y.4 sq.ft. 4 in.Z 1.2 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 : tA1)5 Date: 4 - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2-k le-` 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 I I ❑ Yes Xt No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes No I i I I PARKS DEPARTMENT REVIEW REQUIRED l Yes ❑ No a°) 4. - - LOCATION OF SIDEWALK II Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK ig 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED !1 f•8 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 : ?5 5 Date: 4 -1 "t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4-c= \e-i -k.> b� Seo - - .o4- 003 A' 3')(a PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes lc No See reverse side for Defect Codes A F • • See below for Defect Code G TRIM VEGETATION I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ~Q� ❑Yes Q No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes )4 No 4 .1 4.4 14 I a6ivq A> LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK f ]4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED (3(D.g 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 : � 'D) Date: 4- s _ lU PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS A4 t 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 TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED — 44-0-10. ❑ Yes t, No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes o - - —• lA,\ - - - - •S 1 — LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK 0 4 Feet ❑ 5 Feet 5,3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED e?7•® f sq,ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. ._ CODE F - PATCHES ❑Yes Nr 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 CITY NSF WATERLOO - SIDEWALK REPAIR SURVEY FORM "ROPERTY.ADDRESS 44 LI> lam, 55\2, -mot r LV I PARCEL CODE CONTROL NO. A Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F I ❑Yes No See below for Defect Code G TRIM VEGETATION ❑Yes l No ~Q� WATER VALVE j ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED A — — 'es ❑ No 13,9 ILA 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 1-5,7 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 : R-5 1)'4? Date: 4'S 1 0 -3 - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 450 1,1% i,1 Blvd. 0'11 34 - 204 - o Z 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 ❑ Yes X No WATER VALVE ADJUSTMENT REQ'D ❑Yes No I ` PARKS DEPARTMENT ryry//; REVIEW REQUIRED Z6 r ... Yes ❑ No t j 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 04.1 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 - te-rnwrit- cloy p(443-- 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: 71-5/' PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /OC 3 ',ia 6 day 4ie 09'3 -Z7-3if5 - co0 4PZ A -' PARCEL CODE CONTROL NO. Type of Defect 4,L CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑Yes ,No TRIM VEGETAJION ❑ Yes eV No WATER VALVE j, ADJUSTMENT REQ'D I I ❑Yes ,INo • PARKS DEPARTMENT REVIEW REQUIRED ZI — — ❑ Yes A'No ,rcxl• bxlt 1/eArrart LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet J '5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED A'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 : 7/2 I)0 Date: . w PERMIT ISSUED FORMED POURED COMPLETED CITY OF W-4,TERL$O SIDEWALK REPAIR SURVEY FORM ROPERTY ADDRESS ? Ua , ec) `2-a -34-- z2:7 -coc, 403 - 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 y No TRIM VEGETATION ❑Yes No C) A fQ' < �"� c- WATER VALVE �(I\' I '✓� ADJUSTMENT REQ'D U ❑Yes yi No PARKS DEPARTMENT REVIEW REQUIRED Yes El No — J — LOCATION OF SIDEWALK ❑ Front Yard °Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X15.3 Feet ❑ Other DEPTH OF SIDEWALK 11.4 inches X 5 inches ❑ 6 inches — AREA TO BE REPAIRED 540•2 1sq.ft. 4 in. 2c o ` sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I 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 : 2-5 Date: ®?-3 ® { PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY I ADDRESSr 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 ❑Yes r4 No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes !i No A )'\Aik.s LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK [ p 4 inches 0 5 inches ❑ 6 inches AREA TO BE REPAIRED oh•t.* y sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes to 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(r 3`7 Date: 3 -23— ( 9-5 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a t ?. AR_5 t3 -3 Z Z1 -co � PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect I- ❑Yes X 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 gl No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes MNo C- — 14/1 NAks 1. LOCATION OF SIDEWALK l Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Y.5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED M 5•( sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes lva 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 : � OC.r C,?>b'7 Date: 3 - L 3 _1 2' PERMIT ISSUED FORMED POURED COMPLETED CIS (Of WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS r 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 '® No TRIM VEGETATION \tif ❑ Yes Ca1) No WATER VALVE i 1\ ADJUSTMENT REQD ❑Yes ® No ` PARKS DEPARTMENT REVIEW REQUIRED 1Z.0 _ AaO' :P 4,3 4�,c ❑ Yes ® No LOCATION OF SIDEWALK ❑ Front Yard CkSide Yard ❑ Other WIDTH OF SIDEWALK 0.4 Feet ❑ 6 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I 1 Z14 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES d 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 Date: 3 I G`)lte PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS DO E, t�1�;"� A( 4cr`x_ v 8503 -35- 3 ( - 003 v 41 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A�L i r ❑Yes r_ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑ Yes C No ZP II WATER VALVE "" �` , AD VENT REQUIRED I �rtI_ N AAA Y ❑ No 1 PARKS DEPARTMENT — 60 K( \') REVIEW REQUIRED I / ❑Yes 0 No 3\' 1fi PP — I/ vrijj.,. . NW A0e7 _ LOCATION OF SIDEWALK CM,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK N.,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK IA 4 inches Ni.5 inches ❑ 6 inches — AREA TO BE REPAIRED 15.(9 sq.ft. 4 in. t4 1 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES I .Yes ❑ No No.of Squares with Patches t CODE G - `)) Ei��G'�'a I&A �,i&& JceA.k Co e (� Ni vt e — Wl k,� r ck ( " & A 9 off. 44 - ails. u 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 : AlA )MI Date: 0 /U t' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2/S 5: Alette,11 _ M - 0241 41Z-- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ii;G ❑Yes 1g No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes C No WATER VALVE ADJUSTMENT QUIRED N ❑Yes No I - 6‘ ) PARKS DEPARTMENT , REVIEW REQUIRED XIYes ❑ No 113 MAO Miles LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches j 5 inches ❑ 6 inches AREA TO BE REPAIRED V. q 7, 6 sq.ft. 4 in. 10.14 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yeses No No.of Squares with Patches CODE G - (x) f er'of�1�'�t' pktvLe.-I GrV��� ark r�h". '&/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 : ,"`� ZS1 V Date: 03/r4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . . , s +AAA -35-3®1 - 00 :;1 4,-)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 I TRIM VEGETATION I I ❑Yes mi No WATER VALVE N ADJUSTMENT REQUIRED — ❑Yes No I I I I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes Al No y„0‘. — 17/1 rd - 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 / 16_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 : Affi Date: / PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS :` /1'U ( _ §qi3 -35-30I - ' 9-11,0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect I L; 6 ❑ Yes JM No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes K1No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT l6N REVIEW REQUIRED ❑Yes No IF- 33.51 �{ KA/YA/YYJ/A If! — — C A41.41e,IA LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other - WIDTH OF SIDEWALK J4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK jg J 4 inches ❑ 5 inches ID6 inches AREA TO BE REPAIRED V 131.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES $Yes ❑ No No.of Squares with Patches CODE G - Cin.{,‘Otriots$ I;✓le( G0+ n 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) 4 ��! Date: Cr PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3, s A -35 - I - wg 417 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A Yes °i No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes Ai No WATER VALVE N ADJUSTMENT REQUIRED — ❑Yes �,No I I I PARKS DEPARTMENT 61) (6%) REVIEW REQUIRED ❑Yes No - - - - - 351 1-1/1 /i r/ e. *0,J — LOCATION OF SIDEWALK 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 v "••ti sq.ft. 4 in, 11'sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes if81 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 : gr aa) Date: 6134 — PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 319 E 41:4614e0 _ 0113 -35 - 30( - 019 ,/ �p PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A Yes A.No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I l ❑Yes 14 No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No - I I PARKS DEPARTMENT ��� REVIEW REQUIRED 11�* ❑ Yes No Z _ 10 , \ 441-1 ( LOCATION OF SIDEWALK IK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK q 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED l'r' •7 sq.ft. 4 in. 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. R p FIRST INSPECTION AND FORM MADE BY : ��t 1 !X 3k) Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS th L'` itaciteif 3 -3 - 171 - f9/ 42,19 PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect !'9 ❑Yes g No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes CX,No WATER VALVE ADJUSTMENT REQUIRED - a Yes IN No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 10.1-7/ \\\41 l° I. ,( - LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑Other WIDTH OF SIDEWALK El 4 Feet .0 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK $ 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 51'6 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 : -14t6 2 Date: 6:3 /W PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ✓ PROPERTY ADDRESS 1-176 a E ' 1f o - - � , 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 ❑Yes g No WATER VALVE �( o ADJUSTMENT REQ'D I� ❑ Yes gNo PARKS DEPARTMENT REVIEW REQUIRED �•®® _ ❑Yes g.No ° AL4( a IVe P LOCATION OF SIDEWALK 1X Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK T$4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED nsq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes jg1„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 : IV6 Q! Date: 03/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS * i/l i 1 ✓ 13-55- 32- 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 TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes p"No ) e? 1 Q 1 PARKS DEPARTMENT REVIEW REQUIRED �O' ❑Yes No 21-1,0‘ LOCATION OF SIDEWALK 14 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 3Z°" sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES LJ Yes .5k 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. x FIRST INSPECTION AND FORM MADE BY : � uv Date: LW:7 6 3 / PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 515 gi /44 3 ) - 'i/ 4Z - - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes yiNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION i ❑Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes ,No _ I I PARKS DEPARTMENT REVIEW REQUIRED ��5�1 ❑ Yes jXNo 14,7; to tie R-1-0[A&U LOCATION OF SIDEWALK lA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK J 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )4 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED vile) sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes X No No.of Squares with Patches CODE - (X)-"14 i NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. QQ � �1 FIRST INSPECTION AND FORM MADE BY : . A/BIV Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY *F WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 803 IC U kz__ T L 20\3 -36,,-:ZZ-1 - OO 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 X Yes ❑ No — TRIM VEGETATION t� El Yes t .'No — 6 WATER VALVE ADJUSTMENT REQ'D — ❑Yes fNo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes XNo k - 5.07 y Z.-CD` 5 3 LOCATION OF SIDEWALK ❑ Front Yard $Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK , j'4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 13 9 i " sq.ft. 4 in. Zla,. S' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes (No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : Date: 3-Z3 6 to PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS SL '� - 53\3-34-- 22,1 - 003 Z.7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes I No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ]1] Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes g No V—I LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Id 5.3 Feet ❑ Other DEPTH OF SIDEWALK CX 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED t•o y'l sq.fL 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes iN No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : i ''' C!)b 5 Date: 3_ 7, 3- 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOOca co ,1-0 — SItEWALK REPAIR SURVEY FORM ��o�� a�+$� � PROPERTY ADDRESS /00 /1/61-( v'i col" 5-kl-‘' '— et1`5 -3 35i / , c 4 — PARCEL CODE CONTROL NO. CType of Defect kY See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G I ❑Yes Ig No — T , GETAT►ON I s if ,Yes ❑ No — ~ � WATER VALVE i \ ADJUSTMENT REQ'D I — y II ❑Yes x No \.4", 7 PARKS DEPARTMENT N\‘,.- REVIEW REQUIRED ❑Yes X No — • ) _ A.o than, — LOCATION OF SIDEWALK ❑ Front Yard , $ Side Yard ❑ Other WIDTH OF SIDEWALK t 4 Feet ❑5 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED lb-C 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 : /14. Date: D. �� PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 103 Aft9r,,,A. _ - - 1 - 1 ., 4,z PARCEL CODE CONTROL NO. "" Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F I Ill Yes ( No See below for Defect Code G — TRIM VEGETATION S ❑Yes No WATER VALVE ©\ ADJUSTMENT REQ`D a ❑Yes �,No i PARKS DEPARTMENT 0' 3 �® REVIEW REQUIRED 5a _ _ ❑Yes L No VA IYA A _ 4. 641,,A, . LOCATION OF SIDEWALK ❑ Front Yard Ai Side Yard ❑ Other — WIDTH OF SIDEWALK xi 4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK xi.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED/ I ita sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes 1I 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,.A‘i �`�� �FIRST INSPECTION AND FORM MADE BY : 6 > Date: / PERMIT ISSUED FORMED POURED COMPLETED CITY OFW:ATE L.O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zoo - Z-54 Ebel ire:-d 13L.Aii3 — l- - 35- i 5 q - co z 450 A PARCEL CODE CONTROL NO, V fr LU Type of Defect - — ( - , See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G 0 Yes 1 :No 4 ;, TRIM VEGETATION �.�.� A .Ao.•� -E ❑Yes 0 No i 1 S WATER VALVE S r ADJUSTMENT REQD — L, Et Yes ❑ No -� ; I I PARKS DEPARTMENT — 1,,,n- A _______ Fl_____. REVIEW REQUIRED I W a ❑Yes c`'No — I- �v 1 he C.oti€b. Pack \I,c LOCATION OF SIDEWALK 1 Front Yard , 0 Side Yard 0 Other WIDTH OF SIDEWALK IN 4 Feet Ll'5 Feet ❑ 5.3 Feet 0 Other — DEPTH OF SIDEWALK 'N 4 inches . ❑5 inches 0 6 inches .77 AREA TO BE REPAIRED !?`I,() sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. 180,0, fli. C lcog '- CODE F - PATCHES 0 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 : fv 16 t R S Date: 17p/`O I/ PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERL*0 10 AA SIDEWALK REPAIR SURVEY FORM ',II'` � (_5 6- I.ROPER1`YADDRESS 20 - 255 e6,%rd. qL — .LJD gc7 6 -SS- 155 - 020- q PARCEL CODE 1\t`l J)w CONTROL NO. 71 Type of Defect C kT u CLEAN SIDEWALK See reverse side for Defect Codes A-F : See below for Defect Code G ❑Yes7`No S A'• ____&, TRIM VEGETATION l ❑Yes No Is At, Q--► e ,_ii . ft i WATER VALVE 1,04. -,: e ADJUSTMENT REQ'D ❑Yes El No — 1 • ' \LPARKS DEPARTMENT REVIEW REQUIRED �` _ _ ❑Yes l l No I ' \ ;______ -- �Ec,45 � f �ai�•�e��cal�� ;5 cease _ 111� Cup I�. —. '2Ck c \if e' LOCATION OF SIDEWALK '2 Front Yard , all Side Yard ❑ Other • WIDTH OF SIDEWALK N 4 Feet ❑5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK i 4 inches . ❑ 5 inches ❑6 inches 115,6, . n. C I`55 `'' 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 other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5'`i i?+`-' Date: *1/101 16 PERMIT ISSUED FORMED - POURED COMPLETED— CITY •F WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS � Pe rsk RA. ✓ k 5(3 ` 3 H ` 3?6 - 0 f " 4-57- PARCEL CODE CONTROL NO. Type of Defect C- See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes C No — TRIM VEGETATION At Yes I 'No it 4-0 WATER VALVE �,►�_ ADJUSTMENT REQ'D '� ❑Yes [ No PARKS DEPARTMENT y.5 ro.z' REVIEW REQUIRED zo.z` — — ❑Yes C No — i�% Ft/A 5,/ SMer,c a,\ 1�A LOCATION OF SIDEWALK ❑ Front Yard j�Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet X5 Feet .r3 Feet ❑ Other DEPTH OF SIDEWALK kl 4 inches j:Kr 5 inches ❑ 6 inches AREA TO BE REPAIRED )Z3.5 f sq.ft. 4 in. I. vr 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 : Zs G Date: 3-Zo-id PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5'3 Pr enter — f�1 - 37- vas-- Oc / 3 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 (X No 4-0—* WATER VALVE s I — ADJUSTMENT REQ'D ❑Yes X No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes XNo /00 Flo riter 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 I".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 : � Date: 341/ii — PERMIT ISSUED FORMED POURED COMPLETED — CITY •F WATT :L.O - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS O] t`'fr-o5PE.c r- . \3 -3 • Z-33- (9oi PARCEL CODE CONTROL O. Type of Defect See reverse side for Defect Codes A-F ,,! CLEAN SIDEWALK See below for Defect Code G I tij ❑Yes No _ TRIM VEGETATION t • ❑Yes Xi No — '� m WATER VALVE ADJUSTMENT REQ'D ❑Yes lXNo PARKS DEPARTMENT REVIEW REQUIRED • — — ❑Yes Ilo — \ki d- LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches )4 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. P21 q 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.FIRST INSPECTION AND FORM MADE BY : 2> B45 Date: 3 22 - I ' PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS I II �9 %3 -34- 2,33 -D3 ' V 465 -- 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 J ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [ No _ I i I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No ;.° t®.% 1 .\ — — 1,2 LOCATION OF SIDEWALK Is 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 1373 '"''f 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 : Date: 3` 2'2- -1 PERMIT ISSUED FORMED POURED COMPLETED CITY' OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS MS 1?- 3 - 34- 233 -®3 t v 31p PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes o See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes gNo WATER VALVE N ADJUSTMENT REQUIRED ❑Yes No I I J I PARKS DEPARTMENT _ REVIEW REQUIRED Wes ❑ No A _ LOCATION OF SIDEWALK f Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g 5.3 Feet ❑ Other DEPTH OF SIDEWALK t 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 53.3 ``` 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: 3"1 L _ t 6 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS \ S — 34—Z33 —03 AS7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 1÷ ❑Yes L .No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION i J ❑Yes gNo WATER VALVE ADJUSTMENT REQUIRED ❑Yes L No I I PARKS DEPARTMENT REVIEW REQUIRED El Yes yNo C - s• . i S ,o S 1 p51c e LOCATION OF SIDEWALK `Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C(5.3 Feet ❑ Other DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED !3 3.cc `` 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 - c 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'�`7 Date: 3'Z - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 1(00 �a ob k.3 -34-= - Z -c, t v 44-61- 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 — ❑Yes No N WATER VALVE — O ADJUSTMENT REQ'D 1,0 `Yes Iirtrre— PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes '\lo J — LOCATION OF SIDEWALK 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 2 °'� v sq.ft. 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 : 11& 0 5 Date: - l PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z 3 :*5 0 g'5t-2› - 34--274--- 6 t3 k4� 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 TRIM VEGETATION I I ❑Yes Y No WATER VALVE N ADJUSTMENT REQUIRED El Yes 0.No I . PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes y No G- A 4.3 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet '5.3 Feet ❑ Other DEPTH OF SIDEWALK Xi 4 inches LP inches ❑ 6 inches AREA TO BE REPAIRED 2 Z.8' s q.ft. 4 in. 53.0 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No.of Squares with Patches CODE G - 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 : �5 15'5 Date: `18' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS -34--2:76 - 0l0 ✓ 46r1 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 TRIM VEGETATION I ❑Yes i .No WATER VALVE ADJUSTMENT REQUIRED n] ❑Yes ( Io — I PARKS DEPARTMENT REVIEW REQUIRED XiYes ❑ No A A — k2L V /4 .c75?Ee - LOCATION OF SIDEWALK 0. Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet M5.3 Feet ❑ Other DEPTH OF SIDEWALK rj 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 15.8 vsq.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. FIRST INSPECTION AND FORM MADE BY : � b' 5 Date: 3 `2 3 ` l — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zi O5 ' 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 I ❑ Yes Fik No WATER VALVE )� ADJUSTMENT REQUIRED ~©� ❑Yes No Ie PARKS DEPARTMENT REVIEW REQUIRED -- ❑ Yes INo A VA 4AB ?t2.c17?-c LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet St 5.3 Feet ❑ Other DEPTH OF SIDEWALK '4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED 25.41 u f 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 : 2S 16- 5 Date: 3-2-3 -l PERMIT ISSUED FORMED POURED COMPLETED CITY OF W:A,TE•1L00 — SIDEWALK REPAI:m SURVEY FORM PROPERTY ADDRESS Z1 t 9-b5? T PARCEL CODE CONTROL NO. Type of Defect A 4- CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G j ❑Yes sit No TRIM VEGETATION ❑Yes > No t �""�,�;►� , WATER VALVE / \1 I r ADJUSTMENT REQ'D 5 ❑Yes VNo PARKS DEPARTMENT REVIEW REQUIRED 111) • ❑Yes ] No — to.c) 1 S.c. 5.4 11 � ` J P5 -c-.7r LOCATION OF SIDEWALK Iront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X 5.3 Feet ❑ Other DEPTH OF SIDEWALK (4 inches tkr 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. ,5 3.O 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 : �� �`� Date: 3-2-3 - l� PERMIT ISSUED FORMED POURED COMPLETED — CITYF WATERLOO SIDEWALK REPAIR SURVEY FORM •ROPER Y ADDRESS 3 l 2 5 -- PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I DJ Yes o TRIM VEGETATION 1`'�` ❑Yes U WATER VALVE — j I g- ADJUSTMENT REQ'D i. ❑Yes KNo c -- PARKS DEPARTMENT REVIEW REQUI-ED ❑Yes No �.� 4.3 1 J LOCATION OF SIDEWALK ❑ Front Yard Wide Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet IX 5.3 Feet ❑ Other DEPTH OF SIDEWALK 744 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 59•'1 `i' sq.ft. 4 in. Z •® sq.t. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes LNo 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 : tYs Date: 3 lv PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE LO0 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L3 -34— c.)02- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes to See below for Defect Code G TRIM VEGETATION ❑Yes No — *-4 WATER VALVE ADJUSTMENT REQ'D — �' 60 ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED h A ❑Yes No — fl S,! S.0 „ T LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK IX 4 inches ❑ 5 inches El 6 inches — AREA TO BE REPAIRED 5 3.5 t 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 � ).m Date: 3®?"2" —16 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAY. SURVEY FORM PROPERTY ADDRESS (02 s; t i � °� - e3 15 - 34L o3 -o to PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CO CLEAN SIDEWALK iNr See below for Defect Code G J `� ❑YesNo TRIM VEGETATION a ❑Yes )gNo j era WATER VALVE `� � ADJUSTMENT REQ'D 1 ❑Yes jgf No PARKS DEPARTMENT REVIEW REQUIRED XI Yes ❑ No cos# J LOCATION OF SIDEWALK ❑ Front Yard ,i Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet )V 5.3 Feet ❑ Other DEPTH OF SIDEWALK fX4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 250'a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 13 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 : 1 �- ��5 3 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS WOO l '� �w1 Vi 13 -33 - 117 7 - :, ° 4-7 ) 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 14 No WATER VALVE ADJUSTMENT REQUIRED N Yes o — I PARKS DEPARTMENT — REVIEW REQUIRED V/2:t g� ❑Yes No 4:' (./) Lij,vutcy LOCATION OF SIDEWALK tFront Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK L 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK t.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: 1®21-/0 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (T/O Ra iccootY / tait3 -33 - L77 - 111 ®- a?. 7Z, PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes D. No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes JI2 No WATER VALVE ADJUSTMENT REQUIRED if♦\ ❑Yes M.No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes DINo 35 Mal= HOI�Lwar LOCATION OF SIDEWALK IY1 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:G sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 17.4 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 : DB 4. s'E Date: 3' .9-1� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c23z k4 . z gi%3 - 34, 121 o to 1 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 I TRIM VEGETATION I ❑Yes Al No WATER VALVE ADJUSTMENT J�EQUIRED — N 231 ❑Yes X No I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK ►'I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ►`'..3 Feet ❑ Other DEPTH OF SIDEWALK . 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 .° V sq.ft. 4 in. 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 �.5 Date: 3 •z® 48 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ?a Rck • 3 - 3.1 - 32-1 - o`1 6- 41 7— 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 N -2-7 0 ❑ Yes 9 No I I . PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No / 5 .\ LOCATION OF SIDEWALK IX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet LI 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK g4 inches q5 inches ❑ 6 inches AREA TO BE REPAIRED 52.5 �f sq.ft. 4 in. 421.9 ,,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 : 5 6- Date: 3-2 0 1 S PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WAY ERL IO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .294. Ske-;cAn Rol g913 - 34 -321 -o\ 9 v 4-;a5 PARCEL CODE CONTROL NO. Type of Defect _ C, See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes ,I No 2" I mo, TRIM VEGETATION ❑ Yes >1No -6 - . WATER VALVE ADJUSTMENT REQ1D `1,S ❑Yes 'No PARKS DEPARTMENT REVIEW REQUIRED N'Yes ❑ No AJ O Szciewc\Y\ ep re Rd , LOCATION OF SIDEWALK g1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet '5.3 Feet El Other DEPTH OF SIDEWALK .JX 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I14 .o sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Cl 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 Date: 3. 20" '8 PERMIT ISSUED FORMED POURED COMPLETED CITY O,F WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY.ADDRESS 3 s h„-,Ap. . Q.4 R9 i - - 321 -c 15 '' �= PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F Li Yes l No See below for Defect Code G I -- c I TRIM VEGETATION ❑Yes XNo s t� �-- i WATER VALVE \ c ADJUSTMENT REQ'D — I ❑Yes . No PARKS DEPARTMENT _ REVIEW REQUIRED ❑Yes No I S er,ao.r 12.4. LOCATION OF SIDEWALK ❑ Front Yard iK Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet XI 5.3 Feet ❑ Other DEPTH OF SIDEWALK .Z4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ' 7.Co '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 -2 0-I g' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 20 S MnQ r-,da" k , gq t3 -3t1 - 37G - ®02 ✓ 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 ❑ Yes [ No WATER VALVE N ADJUSTMENT REQUIRED IZO ❑Yes 12cNo I I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 1No 5.0' ber,d4A Kd LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet *K 5.3 Feet ❑ Other DEPTH OF SIDEWALK )41-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 40•6 vsq.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®-18 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 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 I ❑ Yes No TRIM VEGETATION ❑ Yes y No — N WATER VALVE ADJUSTMENT REQ'D ❑Yes l No PARKS DEPARTMENT REVIEW REQUIRED — — ❑Yes , No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,k5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 •cl 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 •F WATERLOO SIDEWALK REPAIR SURVEY FORM !"ROEERTY ADDRESS cir su b gc"p �ir2S --017V 49 - PARCEL CODE CONTROL NO. Type of Defect J !r CLEAN SIDEWALK See reverse side for Defect Codes A F b ❑Yes X-No See below for Defect Code G J v " TRIM VEGETATION —0 ❑Yes ! No 4--► by WATER VALVE i i\ 5.3 ADJUSTMENT REQ'D Yes ❑ No 0 PARKS DEPARTMENT REVIEW REQUIRED - _ _ ❑Yes X No 21.5 loo.1 301--tsET i 72:1 LOCATION OF SIDEWALK ❑ Front Yard 3 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet pK 5.3 Feet ❑ Other DEPTH OF SIDEWALK )44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED (22.z 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 : �'v5 Date: 3 t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5o7 S, "sd-- f . 'i l 3 3V-0254 - oo? ✓ 5co d� PARCEL CODE CONTROL NO. Type of Defect A d-C See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes ,No TRIM VEGETATION A W.Yes ❑ No ~ay* WATER VALVE ADJUSTMENT REQ'D ❑ Yes [ I,No PARKS DEPARTMENT • G _ — REVIEW REQUIRED t1/ � yz Yes ❑ No ID. S.o Ib,3 J LOCATION OF SIDEWALK ❑ Front Yard y,Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet fl Other 5.`f DEPTH OF SIDEWALK yi4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /39.c) q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑YesCj,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 : t5 BOSS Date: _ 3 "t --Ib7 PERMIT ISSUED FORMED POURED COMPLETED • CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS : Z5 - T _ - Z - rod 50 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A, G El Yes g 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 ❑Yes ,FgNo _ 1 PARKS DEPARTMENT REVIEW REQUIRED `� ❑Yes No VM ///, ® V//I/ LOCATION OF SIDEWALK y4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet )Other '41 —' DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 10'5j 5 sq.ft. 4 in. 01,6 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 14 No No.of Squares with Patches CODE G - piqerly r , _ 5-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 : 3 t'i Date: 0 ®1Z'1° PERMIT ISSUED FORMED POURED COMPLETED ._ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .Y// St&'1 Set Rd ' !13 - 3 f-a 5(- o®(o. ✓ ,, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 1-No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes ILNo _ ! WATER VALVE ADJUSTMENT REQUIRED 0—* ❑ Yes ' 1 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes X,No .a y.a 3.8 / S5 e- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 14d.,Other S q DEPTH OF SIDEWALK 1 ,4 inches cgt 5 inches ❑ 6 inches AREA TO BE REPAIRED 8 7. 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 : l S S Ds Date: 3'a .—I ? -- PERMIT ISSUED FORMED POURED COMPLETED CITY SF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY.ADDRESS 023 ? Of t44 el/3 -33- a7 - Coa :,° 5s PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G � ❑Yes [ NoI _ TRIM VEGETATION °- ❑Yes J No — �—Q c WATER VALVE \ I ADJUSTMENT REQ'D ❑Yes l 'No c*-•l PARKS DEPARTMENT REVIEW REQUIRED — — — — ❑Yes Cyr No — Ce 5pei` LOCATION OF SIDEWALK rA Front Yard 1.5 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 7•a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Cgs 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- Date: 3-22/f' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �r 1S Vet,vino, 4- v 5 -35- - 01 t PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect <, ❑Yes f`No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I I ❑Yes RI No WATER VALVE — \ � ADJUSTMENT REQUIRED ❑Yes tx No I PARKS DEPARTMENT REVIEW REQUIRED AiYes ❑No ,o Ver LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Ji 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ❑ 6 inches f AREA TO BE REPAIRED. 5 5.7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 15it'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 " 1�'> Date: 4 f` ) le) PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 715 \ie 010r, 86173 - 35 - (LL - 010 507 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A Cl Yes Q'No See reverse side for Defect Codes A F J See below for Defect Code G J TRIM VEGETATION ❑Yes 6 No — WATER VALVE \ � ADJUSTMENT REQUIRED ❑Yes CR'No Jr,04 J 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes rg No — LOCATION OF SIDEWALK Imo'Front Yard ❑ Side Yard , ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet — 5.3 Feet ❑ Other DEPTH OF SIDEWALK trEr4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 29°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 : )3 Date: .q//4 ic5 PERMIT ISSUED -- FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ofarimpwr 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 TRIM VEGETATION 1 ❑Yes ) No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No j\ °r Pb . _ I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No • 24. ate' Par 1A— LOCATION OF SIDEWALK J(Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 'fit5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7 `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. p • FIRST INSPECTION AND FORM MADE BY : MP i► Date: / P PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERLOO - SIDE ALK REPAIR SURVEY FORM 'ROPERTY ADDRESS el 2,5 V6104 • _ PA s 03 A CO7 , ?! 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 ❑Yes 1 No "* 4 WATER VALVE • tpa /1\ ADJUSTMENT REQD — f," VR'' --- Yes X No 6 PARKS DEPARTMENT \i 5.1 10.7, — REVIEW REQUIRED _ _ ❑Yes No - Vavvizikk LOCATION OF SIDEWALK X Front Yard , ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet K5 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK X 4 inches . ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7(,5 sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES X.Yes Q,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. — FIRST INSPECTION AND FORM MADE BY : _ '9 Date: ,, PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i/ tJict_I5rau 8 i3 -S5- 101 - 00,5- 573 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK -- ❑Yes IL No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes No 1 WATER VALVE ADJUSTMENT REQUIRED 1 ❑Yes fl No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes LJ No — - 40 l c h LL$TClJ. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet El Other S i Z DEPTH OF SIDEWALK 04 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED LO,h 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 : MS 150- Date: 3-30 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 136, Ji u.-iS v4 0i,5-35- /O - 000 511, — PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect fT ❑Yes [ No See reverse side for Defect Codes A F See below for Defect Code G 1 TRIM VEGETATION — 1 ❑Yes [71,No t if WATER VALVE ADJUSTMENT REQUIRED �— —► ❑Yes IM No l PARKS DEPARTMENT REVIEW REQUIRED ❑Yes lkNo WI 6-ro LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LliT 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches Cgl 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 : 416 Date: 3.5O PERMIT ISSUED FORMED POURED COMPLETED CITY *F WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / 7, w;11,-- --1-0,4_ • i -3,- IO - ( & V sly PARCEL CODE CONTROL NO. - Type of Defect See reverse side for Defect Codes A-F f CLEAN SIDEWALK See below for Defect Code G ❑ Yes gl No — TRIM VEGETATION t ❑Yes d No 41—Q -'- -'r JO - WATER VALVE ADJUSTMENT REQ'D 0 ❑Yes ,L1 No i1) �� !� z. PARKS DEPARTMENT y m' ��' � '1 REVIEW REQUIRED VA 5.0' ,A�Yes ❑ No / \ 4\ 152' Ice-- J /I/IaA Gt, — LOCATION OF SIDEWALK i X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet A 5 Feet A 5.3 Feet ❑ Other DEPTH OF SIDEWALK 7 4 inches f ,5 inches ❑ 6 inches AREA TO BE REPAIRED `'4`= 78,S � sq,ft. 4 in. 07 ' 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 : AA,� 2 }'J Date: 4 yc©� — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,?6 U 1 4 s)-0 r, e -35- [us - c ow f sz� - 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 + No WATER VALVE JI ADJUSTMENT REQUIRED �— —► ❑Yes No _ 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes XNo s LOCATION OF SIDEWALK Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK If 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 Xislo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.Ali other-areas shall be repaired by — reconstruction of full sidewalk panels. / FIRST INSPECTION AND FORM MADE BY : 11�� R') Date: /10/ t PERMIT ISSUED FORMED POURED COMPLETED CITY •F WATERLO* fl u' IA crkg SIDEWALK REPAIR SURVEY FORM Col ' a 5,I t I$ �5 •'ROPERTYADDRESS o� �T • �,�,?ilj,1 ,t. 13 -35- 103 - or 5 . PARCEL CODE CONTROL NO. — Type of Defect A r E . See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I 0 Yes X No I TRIM VEGETATION 1't ❑Yes No "Z.— -40-42) , e WATER VALVE "� 1 I ADJUSTMENT REQ'D ❑Yes Ai No — �U11) PARKS DEPARTMENT 'I.5' ` / - _ 21,5s ad 8.� 7 REVIEW REQUIRED �,,f�/ — — ❑Yes *No V 50` VW I f I \ 3,y,,,,,,,), - LOCATION OF SIDEWALK 1 Front Yard , jA Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet X 5 Feet Q,5.3 Feet 0 Other DEPTH OF SIDEWALK A 4 inches l 5 inches ❑ 6 inches 29 I AREA TO BE REPAIRED'f . 5vo sq.ft. 4 in. Q? 5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes f0: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 : A.6-iV Date: - — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS )0 kA, I i s 69 - 35 - (CAI - 005y . `PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Is ❑Yes XNo See reverse side for Defect Codes A F See below for Defect Code G ) TRIM VEGETATION ❑Yes ReNo l WATER VALVE JI ADJUSTMENT REQUIRED �—Q--► ❑Yes No l PARKS DEPARTMENT REVIEW REQUIRED -~rx Yes AK No i t) G (-J - - LOCATION OF SIDEWALK u Front Yard ❑ Side Yard , ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK tgl 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 `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 FC 0 Date: q ii6,14, PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS z,1 w !t 4 1 -3S-- IC- - 00'4. V 5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect .4 ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION — I 1 ❑Yes X No t JI WATER VALVE FQ� ADJUSTMENT REQUIRED I �I ❑ Yes X,No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 1 'No I — LOCATION OF SIDEWALK ► Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .N'5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑6 inches AREA TO BE REPAIRED 21.7 v'sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Ii'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 : iv I) 4 <' < Date: LI AO/(< • — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -ROPERTY ADDRESS ;3 LC) ;t '��� e: • ell's `55 a tot-i' A 0o6, .S. 5z-P)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 I — I TRIM VEGETATION ❑Yes No - WATER VALVE I —!� ADJUSTMENT REQD ❑Yes C 1`No • PARKS DEPARTMENT REVIEW REQUIRED _ — ❑Yes ij No vervvral- LOCATION OF SIDEWALK tgr Front Yard ❑Side Yard D Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet W:5.3 Feet ❑ Other DEPTH OF SIDEWALK fi..4 inches . ❑5 inches ❑ 6 inches AREA TO BE REPAIRED 2%4 " 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. FIRST INSPECTION AND FORM MADE BY : 1 J) ., <, Date: q ha/5 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /=.1 i < PA - 35- tZty -OOP PARCEL CODE CONTROL NO. Type of Defect �t CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes piNo j See below for Defect Code G TRIM VEGETATION j ❑Yes t1?No 1` I J/ WATER VALVE ADJUSTMENT REQUIRED j c«t j ❑ Yes .L ,No j , 1 PARKS DEPARTMENT REVIEW REQUIRED ! ❑Yes 1 No • - - _ _ 5,1 ,l \ , 10k1i- , LOCATION OF SIDEWALK Front Yard ❑Side Yard 1] Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet q5.3 Feet ❑ Other _ DEPTH OF SIDEWALK .N7 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3`(,j ' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 7 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 : J111 15 4 5 Date: Li /t6) l6 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATER' •SIDEWALK REPAIR SURVEY FORM ROPERTY ADDRESS VI, 6 — olis -35 - lZ' - co3 .v — PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes Palo below for Defect Code G I i` TRIM VEGETATION c, ❑Yes ANo WATER VALVE ADJUSTMENT REQ'D _ ❑Yes , No PARKS DEPARTMENT — REVIEW REQUIRED Mies No LOCATION OF SIDEWALK Et Front Yard . ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet 'g 5.3 Feet ❑ Other — DEPTH OF SIDEWALK t'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 00 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 : u 4 5 Date: ` f� I PERMIT ISSUED FORMED POURED COMPLETED _