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HWp _n —Cn .— . N N O m > > > c c c c —c co 0 00 2 .R C CC C CC C C C Cp C O O O O O O O O Z m Q m m O T O O 0 0 0 00000 C C C ( No oyNNu (6N - N N N N N N N N NN C co Q5 LU w � � � � � � � � � � � � � � � � 3 � � � � � � � � � 3 � � m M t co o co ro M D r n N O � O r (o r CO t C)O r r _O FFw N N N N O r 0 0 0 0 0 0 r M r m rt ((7 p O O Cl) n) M o7 co C0 Cp O) m r r co r N N (D r [o M of r ----------------- _O 0 r p (D O t ON OM O (D t (D (fl M t M N r N m O m N (D O O O O O O O O O O O O O N ON O O M J O O O O O O O O O O O O O O O O O O c O O W w m (j m O m O � u) CD (D (D CD (D O O m m 0) t t t t (D t0 O O M O Cl) O M O M M co co co r r C0 W u-) (() X) Cp M of co m co co co LO u U m M t t t It It t t t It It It It t It t t t t t t t IT IT IT t IT M M (n O O (6 CD O (6 O (D c6 Co (o O (6 ,6 O Q CD (D (o (D (o (D (D (D . (D co � (O N N N N N N N N N N N N N N N NC, N N N N N N N N N N N N Z M co Cl) co Cl) M M co (+) M m m M co m co co (h M M M M m M M M M M M m m 0) m m m m m m m m m m m m O m m m m m m m m m m m m m c0 00 co co M N of m co M m M co co C o m m co M of M of co m co W N co mo (!') M CD 07 O O m O r N O m r N t N co t � of O Co r m Z O O W of M m m m m O O CD O CDN N N N N N M M M M O > cD m m m co m co r n r r U Z _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS $ql 2(.- 210 -- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect F G El Yes 1[No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No ;° y �, I I PARKS DEPARTMENT •5 ��a` Q I REVIEW REQUIRED Yes No ❑ C�, w 3ra S LOCATION OF SIDEWALK E(FrontYard ❑ Side Yard F1 Other _) WIDTH OF SIDEWALK El Feet ❑ 5 Feet ❑ 5.3 Feet [ l Ott fi inches DEPTH OF SIDEWALK El inches ❑ S inches AREA TO BE REPAIRED sq. ft. 4 in.-sq.ft. gin. l 3Z-8 sq. �6 in. Yes ❑ No No.of Squares with Patches CODE F PATCHES / - '� C CODE G - 1 NOTE :Areas marked with an"F may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. �-G Date: q FIRST INSPECTION AND FORM MADE BY BLS �� I PERMIT ISSUED FORMED POURED COMPLETED r 1 -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9713 -,26 - ,235 - Oct Z PARCEL CODE CONTROL NO. Type Rf Defect k G \ CLEAN SIDEWALK See reve{se side for Defect Codes A-F See belo%iifor Defect Code G ❑ Yes 1 No TRIM VEGETATION v ❑ Yes No \ F N - Ln WATER VALVE ADJUSTMENT REQ'D ❑ Yes No o'er PARKS DEPARTMENT LAV l o� �� �g $• .`` REVIEW REQUIRED ❑ Yes N�No 70 Yeej — LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other DEPTH OF SIDEWALK ;I )�-4 inches )T fit- ❑ 6 inches AREA TO BE REPAIRED 95 T q.ft. 4 in. q.5 in. s ft. 6 in. CODE F - PATCHES M-Yes ❑ No No. of Squares with Patches CODE G - I NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRSTINSPECTION AND FORM MADE BY 2S c--c- Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 313- 315 w. L4 3113 -2(.-,2?-7 - 013 if PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes LKNo See below for Defect Code G t� a.\►� TRIM VEGETATION ❑Yes ;@ No N WATER VALVE ADJUSTMENT REQ'D ❑ Yes No PARKS DEPARTMENT $r Ord REVIEW REQUIRED ❑ Yes No I,y. 14 �"h LOCATION OF OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5,Feet ❑ 5.3 Feet K'Other -- DEPTH OF SIDEWALK $Zj4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED CeZ.y sq,ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. -`- CODE F - PATCHES =-0.Yes j No No. of Squares with Patches 1 CODE G - 1 NOTE:Areas marked with an "F" may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �` '� Date: y_O'VA 1 PERMIT ISSUED -L FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3,72 3zq W yeti - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C ❑Yes XNo See reverse side for Defect Codes A-F I _ See below for Defect Code G TRIM VEGETATION I ❑Yes C�-No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No — ors I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No el 9-1 �1' LOCATION OF SIDEWALK ]4 Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑4 Feet Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK (\:2�5::�-') q. 4 inches , ❑ 5 inches ❑ 6 inchesAREA TO BE REPAIREDft. 4 in. sq-ft. 5 in. -sq.ft. 6`,in_ CODE F - PATCHES Yes ElNo No.of Squares with Patches 1 — CODE G - — NOTE --Areas marked with an"F"may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 05 4"C- Date: — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 20� W, S��' S}r e�� ✓ 13 - 2& - 27$ -001 ✓ �� PARCEL CODE , CONTROL NO. Type of Defec�� 3 i ' CLEAN SIDEWALK See reverse side for Defect Codes A-F +q See below for Defect Code G IN ;q° ❑ Yes 10 No F 2a hJ TRIM VEGETATION ` f ❑ Yes W No . ._ QM5` WATER VALVE v% ADJUSTMENT REQ'D q Si' � � S^ Jo 22� �,�;• 3 ❑ Yes i�No y ` � `' �x PARKS DEPARTMENT e, x gt�¢`J��e�`�3}� 1.o REVIEW REQUIRED -9 Yes ❑ No � I F) \ LOCATION OF SIDEWALK KFrontYard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Fee ['Other DEPTH OF SIDEWALK 4 in c inc s ❑ 5 inches ❑7hes AREA TO BE REPAIRED4F<-sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES T� Yes ❑ No No. of Squares with Patch ,I-_/ CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be re pai?ed by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : RS LC Date: y•1 4.1 H PERMIT ISSUED 'L FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 17-2Z ! W. Sty Stree4- eV)3 -24-278 -01Z `' CONTROL NO. PARCEL CODE _ CLEAN SIDEWALK A G El Yes [ No Type of Defect - See reverse side for Defect Codes A-F j TRIM VEGETATION See below for Defect Code G r= `.S - I El Yes ❑ No � , Xz - f WATER VALVE +� ADJUSTMENT REQUIRED t s � PA KS D PAR NT REVIEW REQUIRED 5-, p�'1.\ �1•� ❑Yes No IL J�J �e}er asL �k s�"�'22T LOCATION OF SIDEWALK gFront Yard ❑ Side Yard Other WIDTH OF SID-WALK ❑4 Feet---,. ❑ 5 Feet ❑ 5.3 Feet �>Q Other - DEPTH OF SID ALK _. 4 inches fl 5 inches 6 inches ❑ — s ft. 6 in. AREATOR PAIRED _ -sq ft.- `yjn sq.ft. 5 in. q CODE F - PATCHES El Yes �1 No No.of Squares with Patches CODE G - I NOTE : Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. vs LC Date: FIRST INSPECTION AND FORM MADE BY — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z z� w_ 5 4-1A S reef`/ PARCEL CODE CONTROL NO. h Type of Defect G 19 -Ij °u?-`fi �� See reverse side for Defect Codes A-F k1•, CLEAN SIDEWALK See below for Defect Code G x�' a Yes No y �k� TRIM VEGETATION Y A w ❑ Yes No 'x ot WATER VALVE ADJUSTMENT REQ'D ❑ Yes MNo La a ,t5 6 5 ,` �a �\} f qr�Z �r�, G PARKS DEPARTMENT 6' ` � `� ��14� REVIEW REQUIRED ❑ Yes XNo a LOCATION OF SIDEWALK 6 Front Yard l Side Yard ❑ Other ^ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑-Ot hep-�=7- DEPTH OF SIDEWALK *,4 inches ❑`5 int hes r�(6 inchesf?Z� AREA TO BE REPAIRED3L.3 sq. ft. 4 in. sq.ft. 5 in. sq ft 6 in. ' CODE F - PATCHES KYes ❑ No No. of Squares with Patches CODE G - r. � NOTE:Areas marked with an "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 ADDRES S 3 Do 6 U.J . CONTROL NO. PARCEL CODE _ CLEAN SIDEWALK �? c p ❑Yes �No sx Type of Defect _ — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION �� � � 3 ❑Yes NO WATER VALVE a ADJUSTMENT REQUIRED N ElYes No 3�3 IJ 1 I PARKS DEPARTMENT _ REVIEW REQUIRED j.'S+� ❑ Yes LXNo (A) S}a S+reef LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK El4 Feet El5 Feet El 5.3 Feet Other -- 6 inches — DEPTH OF SIDEWALK- �s `�_ El 5 inches ZL AREA TO BE REPAIRED, =Sq ft.-4 in. sq.ft in. 6 in CODE F - PATCHES El Yes [ No No.of Squares with Patches CODE G - I I NOTE=Areas marked with an"I'" may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels_ [.C. Date: FIRST INSPECTION AND FORM MADE BY _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Soy W SIli }re2+ $q13 - 2�- �77 -Dos ✓ lc'� PARCEL_CODE CONTROL NO. Type of Defect A C, r e See reverse side for Defect Codes A-F ��% CLEAN SIDEWALK � 25 See below for Defect Code G �$ �' ->_ ❑ Yes No � d '8 3 TRIM VEGETATION `aka\ r a ❑ Yes No N c WATER VALVE 4 ADJUSTMENT REQ'D / b I �- - Z` jet ❑ Yes J No a +)LO, PARKS DEPARTMENT 5, REVIEW REQUIRED ❑ Yes K No W . Sad LOCATION OF SIDEWALK Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other DEPTH OF SIDEWALK K4 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 XNo No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching_ All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R 5 M Date: 4-1-1-14 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 3Z - 32s w +" S4-r 44�z -2l„- �XO iR z7i o i J - U CONTROL NO. PARCEL CODE CLEAN SIDEWALK El Yes No Type of Defect See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes No WATER VALVE ADJUST TNT REQUIRED Ye ElNo — P ' KS DE ARTMENT — REVIEW REQUIRED ❑Yes No • � 0 5�'-ee{ C�Front Yard ❑ Side Yard E] Other LOCATION OF SIDEWALK //\\ — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet [15.3 Feet ❑ Other 4 inches ❑ 5 inches El inches DEPTH OF SIDEWALK El _ sq.ft. 4 in. sq.ft. 5 in. sq.ft., AREA TO BE REPAIRED /Z ✓ ,_„ Yes ❑ No No.of Squares with Patch CODE F - PATCHES , CODE G - aired by patching.All other areas shall be repaired by NOTE :Areas marked with an"I"' may be rep reconstruction of full sidewalk panels_ Date: FIRST INSPECTION AND FORM MADE BY -- PERMIT ISSUED COMPLETED FORMED POURED f 1 CITY OF WATERLOO c� SIDEWALK REPAIR SURVEY FORM PROPS%TY ADDRESS \L_:� Zt, 4 3 c) z 5 PARCEL CODE CONTROLNO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for D fect Code G ❑ Yes 01 No TRIM VEGETATION — ❑ Yes No WATER VALVE ADJUSTMENT REQ`D ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No Lon-, �l _ / 1 LOCATION OF SIDEWAtA [a Front Yard ❑ Side Yafd ❑ Other 1 WIDTH OF SIDEWAL ❑4 Feet ❑ 5 Feet Q�.3 Feet ❑ Other DEPTH OF SIDEWALK 2 4 inches ❑ 5 inches ❑ 6 inches AREA TO 7ATCTCHES EPAIRED &7•J`sq.ft. 4 in s , q- 6 in. —sq.ft. 6 in. CODE F - ❑ Yes No No.of Squares,with Patches `t CODE,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 ; fii i= Date; 14_ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes N'No at Is See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes l5 No — WATER VALVE ADJUSTMENT REQUIRED X A N ❑Yes No k I I PARKS DEPARTMENT REVIEW REQUIRED / ❑Yes F?MO LOCATION OF SIDEWALK eFrontYard ❑ Side Yard Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet N'5.3 Feet ❑ Other DEPTH OF SIDEWALK �K4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAI &7• ft. 5 in. sq.ft.s 4 in. —sq. 6 in. — CODE F - PATCHES ❑Yes RNo No. of Squares with Patches CODE G - NOTE: Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ 31 FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 115, ('j. 0�n PARCEL CODE" CONTROL NO_ CLEAN SIDEWALK Ty p of Defect Yes ❑ No See re erse side for Defect Codes A-F See belo for Defect Code G i` TRIM VEGETATION f, I )XI Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes O No � r � ° PARKS DEPARTMENT %F REVIEW REQUIRED f El [ No cones• \� �c R� ie1` l f f � J: LOCATION OF SIDEWALK i&Front Yard ❑ Side Yard ❑ Other WIDTH OF SlL I`WALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF/SIDEWALK bj 4 inches ❑ 5 inches ❑ 6 inches AREA T% BE REPAIRED 31 5-0 sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. COD�F - PATCHES ❑ Yes MNo No. of Squares with Patches CODE G - NOTE:Areas marked with an "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)13 '� T9 Date: `1-/7'AY PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Q - (�{, SE`. 8113 - A - yJI - pow PARCEL CODE_ CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes X No See reverse 'de for Defect odes A-F See below for Defect Code G TRIM VEGETATION per'` I ❑ Yes M No 1 1I WATER VALVE ADJUSTMENT REQUIRED ¢\e a�` ❑ Yes ;9 No Lo�ct.k PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No `tom/ Lio — LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet i9 5.3 F t ❑ Other DEPTH OF SIDEWALK a 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE 5S ft. 4 in. sq. ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes lA No No. of Squares with Patches CODE G - 1 NOTE -.Areas marked with an"I"' 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 /U//, 4' S?: 99/3 -26- y5/ - o2a 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4. G ❑ Yes P9 No See reverse side for Defect Codes A-F -- I See below for Defect Code G TRIM VEGETATION I I ❑ Yes .X No Lt WATER VALVE 1° ADJUSTMENT EQUIRED L' N �l Yes ,,� No Vs I b""e- 3•�` I I PARKS DEPARTMENT REVIEW REQUIRED .Yes ❑ No �. A A ?&e kM W ivi%1Cb. tom-#TV-z_ V A L-,j fes`; y V . �. LOCATION OF SIDEWALK P<Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK K4 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 : }T� Date: y 15 PERMIT ISSUED FORMED POURED COMPLETED I i I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /Oxy hl In fh S T / -ZG - 51 / - vl 3(p - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes X No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes XNo _ pJ re /WATER VALVE / ADJUSTMENT REQUIRED _ ❑Yes XlNo PARKS DEPARTMENT �� I / REVIEW REQUIRED ❑Yes .K No Ar �- -141 LOCATION OF SIDEWALK ,IR Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet S�-5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR D 7S, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 1KNo No.of Squares with Patches l CODE G - 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 : ISIS. TU:'­ Date: `�l wc- 7- "/ PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /O`f5" 1 � ' 6T _ 1 e2/3- 24- y51 - 013 37 PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect A L ❑ Yes ,®'No 1 See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes X No WATER VALVE 1 N ADJUSTMENT REQUIRED ❑ Yes Ci�No PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes R No 1 LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet e Oth A� 1 DEPTH OF SIDEWALK A_4ieches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq. ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes 1) `No No. of Squares with Patches 1 CODE G - 1 NOTE : Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORK[ - PROPERTY ADDRESS iC,S3 he n �T PARCEL CODE CONTROL NO. Type of Defect F `` CLEAN SIDEWALK — t See reverse side for Defect Codes A-F 1 See below for Defect Code G �'� W ❑Yes No L� TRIM VEGETATION ❑ Yes CR No <* WATER VALVE ADJUSTMENT REQ'D ❑Yes kNo PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes &No LOCATION OF SIDEWALK ❑ Front Yard XSide Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet k5.3 Feet ❑ Other DEPTH OF SIDEWALK )R4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. s /6 in. CODE F - PATCHES , Yes ❑ No No.of Squares with Pat c es CODE G - NOTE:Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY - Iy 7 Date: j 1ft�� 7-1-& PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 44 — get I -2Z6 - q>`s - ola 40 PARCEL CODE f 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 TRIM VEGETATION i ❑ Yes N No WATER VALVE ADJUSTMENT REQUIRED El Yes [9 No k } I 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes CK No W t LOCATION OF SIDEWALK �Front Yard ❑ Side Yard ❑ Other SIDEWALK ❑ 4 Feet ❑ 5 Feet El5.3 Feet [� Other '\ — WIDTH OF �—_ DEPTH OF SIDEWALK es ❑ 5 inches ❑ 6 inches / 8. 1 sq.ft. 6 in. AREA TO BE REPAIRS s ft./q� 4 in. sq.ft. 5 in. _ CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - 1 1 NOTE:Areas marked with an"F may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Dl� i- TF Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` (�13� �� co-, PARCEL CODE % CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes K No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes E No WATER VALVE ADJUSTMENT REQUIRED [d ❑Yes No — io a' PARKS DEPARTMENT REVIEW REQUIRED -- ��� Yes ❑ No LOCATION OF SIDEWALK VLFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet C�Fe ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED .20 s q.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"I"' may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 'O t TF Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORK( PROPERTY ADDRESS 1221 PARCEL CODE' CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes I9 No See reverse side for Defect Codes A-F _ See below for Defect Code G TRIM VEGETATION ❑ Yes Jg No WATER VALVE ADJUSTMENT REQUIRED ❑Yes �4 No PARKS DEPARTMENT _! REVIEW REQUIRED ❑Yes f� No Wyk.�- \ _ �•i� _ _ � _ _ - LA LOCATION OF SIDEWALK �K Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet eet ❑ 5.3 Feet -Oth y y DEPTH OF SIDEWALK 04 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. J, CODE F - PATCHES ❑ Yes K No No. of Squares with Patches CODE L_G�r =1/� 514„JA��C baL)C�a/)S 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 Tf Date: _ yvIN// PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS LISf - 023 v� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes PI No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes No LVE 1 ADJUSTM NT REQUIRED 0 JI Yes ❑ No — I PARKS DEPARTMENT — REVIEW REQUIRED 4-1 ❑ Yes Dd No W•V (�) 1A LOCATION OF SIDEWALK fA Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet e ❑ 5.3 Feet *D Oth r E� DEPTH OF SIDEWALK -i ches ❑ 5 inches ❑ 6 inches — 3�.5 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 - i I — NOTE :Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. iii FIRST INSPECTION AND FORM MADE BY r� Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2!a W. -T 4� S 91 3 -Zs-Is(. -ooy ✓ 45 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ) 0 C_ ❑ 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 v PARKS DEPARTMENT -- REVIEW REQUIRED ❑Yes ?�No a LOCATION OF SIDEWALK -K Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet JR[5.3 Feet ❑ Other DEPTH OF SIDEWALK X-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 : (ZS Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTYADDRESS 32`f • 3Z mil` Ste• f,-)9/3 -.2 b3 ea5 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F a See below for Defect Code G ❑Yes No OJ TRIM VEGETATION `,') ' V} ❑Yes &No A;z WATER VALVE ADJUSTMENT REQ'D ❑ Yes ®'NO PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes ,�No - ;Dj LOCATION OF SIDEWALK XT-rontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Fee(in . (e ❑ Other DEPTH OF SIDEWALK es ❑ es ❑ 6 inches AREA TO BE REPAIRS !v sq. . 4 in. sq.ft. 5 in, sq.ff. 6 in.. CODE F - PATCHES ❑Yes XNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F`may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY '�S � Date: 141'` '1 PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f(j 13 -� - K)4 - ao Zi 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 I ❑ Yes No �arki ,!) WATER VALVE ADJUSTMENT REQUIRED U+' ❑ Yes 0-No I I I ( PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Q No ' at-G' {o•ti W, LOCATION OF SIDEWALK Jg Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -Feet Othgr � L/ DEPTH OF SIDEWALK 4 inches ❑ 5 inches 6_inches AREA TO BE REPAIRED 4 — sq.ft. 4 in. sq.ft. 5 in.--tea 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 Te Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOG - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 61 1 PARCEL CODE ' CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes J7 No See reverse side for Defect Codes A-F e� See below for Defect Code G TRIM VEGETATION \� El Yes No ` WATER VALVE ADJUSTMENT REQUIRED _ ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED a. ka4t ❑ Yes XNo LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ Other DEPTH OF SIDEWALK (;4-inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 9No No.of Squares with Patches - CODE G - NOTE :Areas marked with an"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: If--fy _ PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 017 PARCEL CODE CONTROL NO. Type of Defect A L �/ / v CLEAN SIDEWALK See reverse side for Defect Codes A-F -" See below for Defect Code G I [I Yes ( No �e TRIM VEGETATION ❑ Yes XNo N WATER VALVE ADJUSTMENT REQ'D I ' ❑ Yes No I PARKS DEPARTMENT REVIEW REQUIRED (9.0 ❑ Yes )j No $�9 LOCATION OF SIDEWALK Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0,&:3Feet -0<'Oth 1 � 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 No No. of Squares with Patches CODE G - NOTE:Areas marked with an"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- G Date: PERMIT ISSUED 1 FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ` 7C 9 0 . 7"' olo PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes jW No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑ Yes �� No 4 WATER VALVE 'e/ ADJUSTMENT REQUIRED _ ❑ Yes l9 No PARKS DEPARTMENT REVIEW REQUIRED ja k ❑ Yes No LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Fe ElOther DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR D a I'7 ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes )Zl No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS= -712 7th 5� I A L,fo - C)t( PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect A ❑ Yes C4 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes )XI No WATER VALVE ADJUSTMENT REQUIRED f -4tes No Is-," "ems PARKS DEPARTMENT i REVIEW REQUIRED S ❑ Yes No 7t h 1 I,J LOCATION OF SIDEWALK r%Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet A_5:3-Feet [Other l 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 P6 No No. of Squares with Patches _ 1 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 r TF, Date: `1/7 1Y 1 PERMIT ISSUED i FORMED POURED COMPLETED I i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - 714 U- 7t" S�. 5113 - �6 - q3o - d/2 ;7 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 0 No — WATER VALVE ADJUSTMENT REQUIRED — N ❑ Yes �1 No `'„� I PARKS DEPARTMENT REVIEW REQUIRED 6 ` ' ElYes j9 No W 1 k 5 LOCATION OF SIDEWALK O Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K § -Feet 11 Other 7 Z DEPTH OF SIDEWALK K4 inches ❑ 5 inches El6 inches . AREA TO BE REPAIRED q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes �Z No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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: PERMIT ISSUED FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS`- 711 Li. 7"h S1 _ -26 - q3` - 0,21 � PARCEL CODE CONTROL NO. — CLEAN SIDEWALK Type of Defect I Yes ❑ No See reverse side for Defect Codes A- See below for Defect Code G e� `� TRIM VEGETATION ❑ Yes No 1 u { WATER VALVE ADJUSTMENT REQUIRED — e N ❑ Yes ( No I I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No (J. 7"' f� LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet i!55 3 F ❑ 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 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 DN Date: 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS -7 Z 1 �� • -7 S'z: `434 5YA PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect D Yes T<No `See reverse side for Defect Codes A-F S6e,below for Defect Code G I TRIM VEGETATION ` I ` ❑Yes K No WATER VALVE ADJUSTMENT REQUIRED _ ❑Yes JX(No I 3 ' I ti PARKS DEPARTMENT I I — i REVIEW REQUIRED i r 4 t' ❑Yes J(No =e � � ..t LOCATION OF SIDEWALK N Front Yard/ ❑ Side Yard `.❑ Other — 1 =t WIDTH OF SIDEWALK ❑ 4 Fee ❑ 5 Feet 1r5.3 Feet` ❑ Other DEPTH OF SIDEWALK ❑ 4 in;�hes 5 inches ❑ 6 inches i _ AREA TO BE REPAIRED �� sq.ft. 4 in. bo.7 sq.ft. 5 in. `. sq.ft. 6 in. — CODE F - PATCHES P Yes XNo No. of Squares with Patches 1*7 6- r rf a V ts.V ,,�r- a vu rr x- � s✓Nc;�'��� �>` i`��.t�� �413v?J'c-' ficzt� llc�i4'�- �jyn�® �>'%��,� all 7tn7' i NOTE:Areas marked with an"F" may be repaired by patching. All other areas shall be repaired by reconstruction bf full sidewalk panels. FIRST INSPECTION AND FORM MADE BY D,5 79- Date: — l'tjL PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ZZ--1 1V 7-//' -5r PARCEL CODE CONTROL NO. Type ofDefect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G 0 Yes �NO TRIM VEGETATION 0 Yes P(NO WATER VALVE X Z ADJUSTMENT REQ'D XYes ONO PARKS DEPARTMENT T Z REVIEW REQUIRED El Yes �No 4 ---------------- LOGATI'ON OF SIDEWALK krFront I Yard JR Side Yard El Other WIDTH OF SIDEWALK U4 Feet 05 Feet Y,-5.3 Feet El Other DEPTH OF SIDEWALK 'X4 inches ;W5 inches El 6 inches AREA TO BE REPAIRED -57 sq.ft. 4 in. 3,0.7 sq.ft. 5 in, sq-,ft. 6 in_ CODEF - PATCHES El Yes XNo No.of Squares with Patches CODE G 7?7 LAJ--7-ice 73-14J NOTE:Areas marked with an"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: Y'-171Y (/-, -/7-AY PERMIT ISSUED 7 3-1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d C W'• 7" 5I 5117 -,?G - q0 f - 4yy 1/�r cat PARCEL CODE J 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 N ER VA E DJUSTM T REQ'D �I �Y NO PARKS DEPARTMENT r REVIEW REQUIRED Yes Z No WV G4P 51w LOCATION OF SIDEWALK P Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet �I 5.3 Feet ❑ Other DEPTH OF SIDEWALK ( ches - c es ❑ 6 inches AREA TO BE REPAIRE a3.3 q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Yes [ �No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED i 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS go 7 1 -- 89t3 PARCEL CODE CONTROL NO. 1 Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK 1 See below for Defect Code G C ❑ Yes RNo TRIM VEGETATION ❑ Yes g No WATER VALVE Yzt ADJUSTMENT REQ`D 1 ❑ Yes k No PARKS DEPARTMENT REVIEW REQUIRED .A ❑ Yes Pq No 1 } L2 LOCATION OF SIDEWALK Front Yard Dd Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet M 5.3 Feet ❑ Other _ 1 DEPTH OF SIDEWALK X4 inches 95 inches ❑ 6 inches AREATO BE REPAIRED sq.ft. 4 in. 7Y S sq.ft. 5 in. sq.ft. 6 in. ` CODE F - PATCHES ❑ Yes 1�1 No No.of Squares with Patches I C3BE G - /� l�I €j?✓li r�� 'EGl cid 7�G/� s'�OstJ D Z7 W.7-+" S%. 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 72—r- Date: //-17--/�/ PERMIT ISSUED 1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L1� Tth 57 �'ql3 -.ZG films PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK Type of Defect El Yes X No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION \� Z ❑Yes XNo WATER VALVE ADJUSTMENT REQUIRED 4 Yes .�No -- 0 1 � I PARKS DEPARTMENT REVIEW REQUIRED ❑Yeso 5 2 ' l -7 LOCATION OF SIDEWALK Front Yard ❑ SideLard, Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 3 F El Other 5 inches El inches DEPTH OF SIDEWALK �4 inche3 ❑ ft. 5 in. q AREA TO BE REPAIRED sq.ft. 4 in. s q 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: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS- q;O 1,1. 74h Ste. PARCEL CODE' CONTROL NO. CLEAN SIDEWALK Type of Defect [I Yes � No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION Z�,A ( � El Yes � No Q u r e, WATER VALVE 42 o N ADJUSTMENT REQUIRED ❑ Yes fg(No _ J PARKS DEPARTMENT ." REVIEW REQUIRED ❑ Yes M No W -7 S . LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ Other — DEPTH OF SIDEWALK 94 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq. ft. 4 in. sq. ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes AND No. of Squares with Patches _ CODE G - NOTE :Areas marked with an"F may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED L FORMED POURED COMPLETED A CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS — g�,3 -a6 - qyl - od3 70 PARCEL CODE CONTROL NO. Type of Defect G CLEAN SIDEWALK _ See reverse side for Defect Codes A F +®_ ❑ Yes Ya No tQ� See below for Defect Code G I TRIM VEGETATION �pn e ❑ Yes No N V\ WATER VALVE ADJUSTMENT REQ'D ❑ Yes 9 No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No IA). . 7-"* LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK 0_4Eeet et ❑ 5.3 Feet �1 Ot �r ) DEPTH OF SIDEWALK ff 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 Fj No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 4- T Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS is 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 I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ,s N El Yes �No � I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes JK No 'Ise �t LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard ❑ Other =�1 WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 0-5.Feet 0 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 - 1 NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f Date: Y-f 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS--' 117- iA s1' CONTROL NO. PARCEL CODE CLEAN SIDEWALK ❑Yes No Type of Defect See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G � ❑Yes �Z No WATER VALVE ADJUSTMENT REQUIRED ❑Yes W No Z PARKS DEPARTMENT — �<�` - F` REVIEW REQUIRED Yes ❑ No il.2 1 ;J, — — — — 6AZ LOCATION OF SIDEWALK (Front Yard ❑ Side Yard [I Other WIDTH OF SIDEWALK El Feet ❑ 5 Feet 5.3 F ❑ Other DEPTH OF SIDEWALK 4 inc'hes El inches ❑ 6 inches AREA TO BE REPAIRED sq.fit. 4 in. sq.ft. 5 in. sq. 6 in. ft. 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_ D3 r Date: -� FIRST INSPECTION AND FORM MADE BY — PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS .L �q/3 -2� -f`� -o�G •�-c��� 73 PARCEL CODE CONTROL NO. 1 Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes ,[�'No See below for Defect Code G �j `�. I TRIM VEGETATION 1 %'o;` � �(�,-I`� � El Yes XNO duc TER VALE N ADJUSTMENT REQUIRED Yes / ❑ No �--PARKS DEPARTMENT REVIEW REQUIRED 1 — — 'Q �--��" Yes ❑ No 1 js-:D 4 der 1 P1 7t`' ST LOCATION OF SIDEWALK eFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 114 Feet ❑ 5 Feet �5_ F ❑ Other 1 DEPTH OF SIDEWALK j'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR %ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. 1 CODE F - PATCHES Yes D?'No No.of Squares with Patches IV& 65- GODE--G - LJ6fTS Vr9Li1C /'°;;J Ub'`S�tr� �-/tc� t,�,y�L oil NOTE :Areas marked with an"F" may re b--' Y be aired p y patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY TC Date: PERMIT ISSUED 1 FORMED POURED COMPLETED I i CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' //,go 13 SOS CONTROL NO. PARCEL CODE ' CLEAN SIDEWALK ❑Yes No Type of Defect See reverse side for Defect Codes A-F I TRIM VEGETATION I See below for Defect Code G � El Yes �.No I WATER VALVE ADJUSTMENT REQUIRED _ �,Z(o ❑Yes I�No r� ` �v I I PARKS DEPARTMENT REVIEW REQUIRED !l_ p4 Yes ❑ No — — — J Q� LOCATION OF SIDEWALK Front Yard ❑ Side Yard [I Other WIDTH OF SIDEWALK El Feet ❑ 5 Feet CX5 FF t El Other nches El inches El inches DEPTH OF SIDEWALK i, AREA TO BE REPAIRED 7 d s 4 in. sq.ft. 5,in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No. of Squares with Patches CODE G - ed with an"F"may be repaired by patching.All other areas shall be repaired by _ NOTE:Areas tion of full sidewalk anels 3 Date: FIRST INSPECTI ON AND FORM MADE BY 1�1 T� PERMIT ISSUED COMPLETED FORMED POURED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' 11.2g tJ• 7fh �. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes Vi No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION F 2.0, A I I ❑ Yes kI No WATER VALVE ADJUSTMENT REQUIRED i ❑Yes fX No PARKS DEPARTMENT -U REVIEW REQUIRED 5 5 ❑ Yes J�; No G LOCATION OF SIDEWALK V Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet iX-5.-3-F-eet 010the S. 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. y CODE F - PATCHES ❑ Yes I�J No No. of Squares with Patches CODE G - 1 1 NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ...-TOP 4- Tr Date: il-/S-/ 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` /a � �'7�� S — CONTROL NO. PARCEL CODE- a CLEAN SIDEWALK 0., A ❑Yes No Type of Defect See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes JA No r23 e�� WATER VALVE ADJUSTMENT REQUIRED — �,e ❑Yes P No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes [ No o V) — �ct5 Side Yard Other LOCATION OF SIDEWALK I Front Yard ❑ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 F et ❑ Other _-- DEPTH OF SIDEWALK ME es ❑ 5 inches ❑ 6 inches — . .--- sq.fL 5 in. —sq•ft. 6 in. AREA TO BE REPAIRE J'7.D s 4 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches _— CODE G - aired b NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be rep y reconstruction of full sidewalk panels. Date: — FIRST INSPECTION AND FORM MADE BY . — -- PERMIT ISSUED COMPLETED FORMED POURED 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5210 Jr PARCEL CODE CONTROL NO. Type of Defect 146 See reverse side for Defect Codes A-F CLEAN SIDEWALK e� a See below for Defect Code G m � ❑ Yes ❑ No TRIM VEGETATION m ❑ Yes ❑ No l WATER VALVE ADJUSTMENT REQ'D l ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No SouTM S,. 1 _ LOCATION OF SIDEWALK Wront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet JR5.3 Feet ❑ Other _ j DEPTH OF SIDEWALK IX4 inche'§ ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. ft. 6 in. 1 -sq. F - PATCHES ❑ Yes fZNo No. of Squares with Patches 1 CODE G - y 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(_Z/-ycs/ VVL (o -17-1c( PERMIT ISSUED 1 FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ Go� � - {h PROPERTY ADDRESS _ ff 5113 b - 9 V - 00 CONTROL NO. PARCEL CODE CLEAN SIDEWALK ❑Yes �4No Type of Defect See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G ❑Yes 14 No WATER VALVE ADJUSTMENT REQUIRED _ ❑Yes fKNo PARKS DEPARTMENT _ REVIEW REQUIRED t,.Sad� ❑Yes %No to.z � Other LOCATION OF SIDEWALK .Front Yard ❑ Side Yard _ ❑4 Feet El Feet 5.3 et ❑ Other _— WIDTH OF SIDEWALK ' DEPTH OF SIDEWALK 4 inc [) 5 inches El 6 inches — �fsq.ft4 in. sq.ft. 5 in. —sq.ft• 6 in. AREA TO BE REPAIRED . - ❑ [�.No No. of Squares with Patches CODE F PATCHES Yes CODE G - NOTE:Areas marked with an"I"' may be repaired by patching. All other areas shall be repaired by — reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ` 616 GJ. rh 5� . -,�(Q - L131 - 00 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 TRIM VEGETATION ❑ Yes N No WATER VALVE ADJUSTMENT REQUIRED No PARKS DEPARTMENT rQ REVIEW REQUIRED ❑ Yes No �P A)_ LOCATION OF SIDEWALK 5dFront Yard ❑ Side Yard �❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet El Other DEPTH OF SIDEWALK �)4 inch:.q. s El inches ❑ 6 inches ` AREA TO BE REPAIRED( .L, ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES �❑ Yes L No No. of Squares with Patches _ CODE G - y. NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY g 4 T Date: 1 PERMIT ISSUED 1 FORMED POURED COMPLETED i CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5 t o -��- S ` _ 0 1© - CONTROL NO. PARCEL CODE-' CLEAN SIDEWALK 7 El Yes I�(No Type of Defect See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I ❑Yes 4 No WATER VALVE o ADJUSTMENT REQUIRED c� 1 ❑Yes 9 No PARKS DEPARTMENT 4,. REVIEW REQUIRED ti ElYes [ No y 1J • }� A i ' ❑ Side Yard Other LOCATION OF SIDEWALK %Front Yard [� 5 Feet ❑ Other WIDTH OF SIDEWALK El me .3 e El 6 inches 4 Feet ❑ ----- DEPTH OF SIDEWALK El inches s . ��}5 .ft. 5 in. --sq.ft. 6 in. AREA TO BE REPAIRED _--- q ft. 4 in CODE F - PATCHES ❑Yes � No No.of Squares with Patches _-- CODE G - Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by NOTE reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY � yr PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS e- M3 - - 1132, -020 �y 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 TRIM VEGETATION ❑ Yes A No WATER VALVE �CkCrty1 T ADJUSTMENT REQUIRED N ❑ Yes No LA PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ANo ?.G P', LOCATION OF SIDEWALK [A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 ee`{ - -Othe Y 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 [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 Date: -1-0-Al ISSUED FORMED POURED COMPLETED r— I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes K No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes KNo — o' WATER VALVE ADJUSTMENT REQUIRED — N ❑Yes No PARKS DEPARTMENT = REVIEW REQUIRED ❑Yes No Z Can(- -LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _. WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 F ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED q• —• CODE F - PATCHES ❑Yes $No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY `� -F- Date: PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS £` 71,�, i,f. g�`` -5 ft3 -.20 - `1y - 0$) PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A , 17 [I Yes [�No See reverse side for Defect Codes A-F _ See below for Defect Code G TRIM VEGETATION ❑ Yes No o << WATER VALVE dam^e i a'z ADJUSTMENT REQUIRED ❑ Yes $x No PARKS DEPARTMENT w au REVIEW REQUIRED El �No A I.s W V LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet5.3 Fee ❑ Other — DEPTH OF SIDEWALK ches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR, Id3 � _ 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-'F Date: q/7/y PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS °' 7�!�- 0. � 8�13 -J4 - 11�� - a,K C� PARCEL CODE= CONTROL NO. CLEAN SIDEWALK Type of Defect A. El Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 4}r` ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes XNo PARKS DEPARTMENT 14" REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK IK Front Yard ❑ Side Yard n Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I 5.3 F et ❑ Other DEPTH OF SIDEWALK 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. FIRST INSPECTION AND FORM MADE BY �y Date: — PERMIT ISSUED -- FORMED POURED COMPLETED 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS "` 610 (Ut. 01" S 1 PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect A ❑ Yes Bl No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes j$1 No � I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes [ No A� G LOCATION OF SIDEWALK K Front Yard ❑ Side Yard ❑ Other WIDTH.OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 F- �t ❑ Other DEPTH OF SIDEWALK l l 4 ni che�s� ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 70'S sq,,4. 4 in. sq. ft. 5 in. sq.ft. 6 in. L CODE F - PATCHES ❑ Yes C2;1 No No. of Squares with Patches CODE G - 1 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 : l7 + Date: y-17,/ PERMIT ISSUED 1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL N(h. CLEAN SIDEWALK Typ of Defect ❑Yes No See re rse side for Defect Codes A-F See belo for Defect Code G TRIM VEGETATION ❑Yes �No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes NrNo I PARKS DEPARTMENT REVIEW REQUIRED J ❑Yes J"o _3 _ so j A LOCATION OF SIDE ALK ,R Front Yard ❑ Side Yard El Other WIDTH OF SID LK ❑ 4 Feet 8I-5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF Sl EWALK N'4 inches 3 5 inches \h;L7 6 inches AREA TO E REPAIRED �z o sq.ft. 4 in. 25-G sq.ft. 5 in.' sq.ft. 6 in. — CODE - PATCHES 5�Y es ❑ No No. of Squares with tches /I/U7 Re V/Se:-d y re NOTE Areas marked with an "F" may be aired by patching.All other areas shae repaired by : P ll b reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 1�� Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS k c (,J 5-� _' i►3 -,.6 - �`�- O� ioZ 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 I ❑ Yes X No WATER VALVE ADJUSTMENT REQUIRED j)c 4 PARKS DEPARTMENT -- � c REVIEW REQUIRED 2 (.9., e� ❑ Yes No \�`EF LOCATION OF SIDEWALK ®,Front Yard ❑ Side Yard_;❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet "t ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED l�q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IMNo No. of Squares with Patches 1 CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 1 FIRST INSPECTION AND FORM MADE BY : !� -r Date: PERMIT ISSUED 1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORK[ PROPERTY ADDRESS/ q,;Z3 105 8-1 f3 971 - '�Jq CONTROL NO. PARCEL CODE CLEAN SIDEWALK Yes ❑ No k Type of Defect See reverse side for Defect Codes A-F TRIM VEGETATION w, See below for Defect Code G � ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No G t°�2 �� else®� PARKS DEPARTMENT REVIEW REQUIRED — i 3' 1 ❑ Yes 14 No C� W p.f4 Front Yard El Side Yard � Other ---- -LOCATION OF SIDEWALK — WIDTH OF SIDEWALK ❑4 { (�5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches 5 inches El 6 inches ---- sq.ft. 5 in. —sq.ft. 6 in. AREA TO BE REPAIRED vwor sq.ft. 4 in. CODE F - PATCHES ❑Yes 9 No No.of Squares with Patches CODE G - NOTE:Areas marked with an"I"' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. D i T� Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SU Y FORM PROPERTY ADDRESS' $ 1 13 —o�G _ `(7� — D lj x )0 5 0 PARCEL CODE' rt e4 \CONTROL NO. Type of Defect -19 CLEAN SIDEWALK See reverse side for Defect Codes A-F M , No See below for Defect Code G 3 TRIM VEGETATION A - es No �ou iD 14 k� � 10_ st� N � WATER VALVE —� ADJUSTMENT REQ'D ❑ Yes ICI No j ' PARKS DEPARTMENT REVIEW REQUIRED )c q o Yes El No —� — — s LOCATION OF SIDEWALK Front Yard gSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet (31 5 Feet ❑ 5.3 Feet )(Other -- _ —I DEPTH OF SIDEWALK 4 inches '13 5 inches ❑ 6 inches ,4 AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. CODE F - PATCHES [)(Yes ❑ No No. of Squares with Patc es CODE G - _ NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by ! reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 7-1 Date: --��='- - P5- PERMIT ISSUED — ( FORMED POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS //U 5 W. s '— i3 -2- - q c.Z. - 6)01 °ch I�J7 PARCEL CODE Ct NTROL NO. Type of Defect fa-\ CLEAN SIDEWALK — .Z ,, See reverse side for Defect Codes A-F El Yes El No See below for Defect Code G TRIM VEGETATION ❑ Yes ❑ No N WATER VALVE — ADJUSTMENT REQ'D ❑ Yes ❑ No '7< PARKS DEPARTMENT \Nj � REVIEW REQUIRED — _ _ A ❑ Yes ❑ No cD LOCATION OF SIDEWALK 9 Front Yard R Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet --R, Gt (W-5_3�Feet ❑ Other DEPTH OF SIDEWALK '( 4 incites ❑ 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 - — 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 : Tom' Date: PERMIT ISSUED — FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -' 11`10 t)- 4 mks - ;6 - e47 ! PARCEL CODE CONTROL NO. CLEAN SIDEWALK ? Type of Defect f El Yes M No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes g No `3 1 WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes 56 No PARKS DEPARTMENT REVIEW REQUIRED -- Yes ❑ No W�• `; LOCATION OF SIDEWALK X Front Yard ❑ Side Yard 0 Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet s[% 5.3 Fee ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches 1 -7-7.y s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED q 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 - 5o ) 61�k Vt, -)FA �T 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 TRIM VEGETATION rtti ❑ Yes I No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes &I No V utt \�,L PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0,' No LOCATION OF SIDEWALK [A-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LTA-5 Feet -®"Oth r�' L4 DEPTH OF SIDEWALK ❑ 4 inches �t 5 inches '=< ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. -I sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Q No No. of Squares with Patches CODE G -NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. � FIRST INSPECTION AND FORM MADE BY ���I4 I:' L- Date: 9 �e i PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes 2 No \ WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [Z No 1 PARKS DEPARTMENT REVIEW REQUIRED 5 t� t �U� 1 ❑ Yes IM No AA LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet � 5 3E.eet- "�R7 Ot er5, S 1 DEPTH OF SIDEWALK fl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes LI No No. of Squares with Patches 1 CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY )1y •j Date: PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS �1 01 t3 -25- 36 t PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes N-No See reverse side for Defect Codes A-F I — See below for Defect Code G TRIM VEGETATION ❑ Yes X No WATER VALVE ADJUSTMENT REQUIRED \� d Yes ONO — ,� N Ae I I PARKS DEPARTMENT REVIEW REQUIRED t) s ElYes N-No LOCATION OF SIDEWALK Wront Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet / R5.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAI D 2 _ q•ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes XNo No. of Squares with Patches — CODE4e & GdZ�U,�✓2S 7a P1.��Yr 7, /'P/>6-,�-CAIc �YL-tZ �x1�i'�/J� oi/rr A107 NOTE :Areas marked with an"F" may be repaired by patching. All other areas shall be repaired by — reconstruction of full sidewalk panels- FIRST j� tY'VL- Date: I FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO J SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' I PARCEL CODE- CONTROL NO. CLEAN SIDEWALK esk Type of Defect ❑ Yes © No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes 0 No A WATER VALVE �� N ��� NTREQUIRED / ❑ Yes 7_SqjSb_ I I � RKS DEPARTMENT o sx L1 VI E�9R 13 12)'� IL es [S'No LOCATION OF SIDEWALK jZ Front Yard ❑ Side Yard ❑ Other WIDTH.OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5. eet ❑ Other DEPTH OF SIDEWALK 4inche ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES ❑ Yes ® No No. of Squares with Patches CODE G - _I 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 : 4 ��� Date: l� �� ✓r� PERMIT ISSUED -'I FORMED POURED COMPLETED 1 i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 00$ PARCEL CODE CONTROL NO. -- CLEAN SIDEWALK = Type of Defect ❑ Yes O No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes No — o J; WATER VALVE �v^c ADJUSTMENT REQUIRED — ❑ Yes No I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK r%Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet �A'5.3 Feet ❑ Other DEPTH OF SIDEWALK 1[4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes KNo No. of Squares with Patches CODE G -NOTE :Areas marked with an"P'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY E 4- -n� Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO a SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Gly J r >E j PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes X No See reverse side for Defect Codes A-F - I See below for Defect Code G I TRIM,VEGETtDN I I ❑-Yes� No WA ' VALVE-` ADJUSTMENT REQUIRED N ❑ Yes K No I I u I PARKS DEPARTMENT REVIEW REQUIRED -) [I Yes V) No k) g+" LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other _I WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet 4 Other s�_ r 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. —I CODE F - PATCHES ❑ Yes 1KNo No. of Squares with Patches _ CODE G - NOTE :Areas marked with an"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�I� + T G Date: _1 PERMIT ISSUED FORMED POURED COMPLETED I I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2- S D l -ZL - 0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ) Yes ❑ No yl See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION l� i\e I I ❑ Yes M No WATER VALVE L ADJUSTMENT REQUIRED �A eo,s �� ❑ Yes [Fl No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes [ No LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK M4 inches 5 incches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. '3 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 19 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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 716 0 - Tl"` 5f-- _ f a13 - (�4 - u3k -©off , PARCEL CODE CONTROL NO. ,J 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 V o WATER VALVE ADJUSTMENT REQUIRED N ❑Yes j[ No PARKS DEPARTMENT �1 REVIEW REQUIRED _ Yes ❑ No 1 LOCATION OF SIDEWALK �4 Front Yard ❑ Side Yard ❑ Other _ WIDTH-OF-SIDEWP't K ( ❑4 Feet ❑ 5 Feet Feet QOthe � 't i►t o aEPT'H-OF SIDEWALK [ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPA.RED sq. ft- 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F, - PATCHES ❑ Yes J�'j\No No. of Squares with Patches _ CODE G f ` J `NOTE :Areas marked with an "F"may be repaired by patching-All other areas shall be repaired by reconstruction of full sidewalk panels. FIRSTINSPECTION AND FORM MADE BY T Date: 4-/�'/u PERMIT ISSUED —I FORMED POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 712 I� TA .5� PARCEL CODE CONTROL NO. CLEAN SIDEWALK y 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 JI No PARKS DEPARTMENT — \� REVIEW REQUIRED ❑ Yes ; ] No 1 LOCATION OF SIDEWALK i9 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 53 Feet Mth�+r DEPTH OF SIDEWALK, 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 E4 No No. of Squares with Patches CODE G - i NOTE:Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by — i reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY TF, Date: '���� PERMIT ISSUED _ FORMED POURED COMPLETED I 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPER ADDRESS' 7,.d 0 . �`` ji-. _ PARCEL CODE CONTROL NO. //CLEAN SIDEWALK Type of fect ❑ Yes X No See revers side for Defect Codes A-F —� See below f Defect Code G ( TRIM VEGETATION ' ❑ Yes R No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes ZK No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No Ld e % / a�K LOCATION OF SIDEWALK j IXFront Yard ❑ Side Yar� ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 65�Feet ❑ Other f � DEPTH OF SIDEWPXK V4 inches X 5 inches ❑ 6 inches AREA TO BE R AIRED 1. 7 sq.ft. 4 in. °a sq.ft. 5`in. sq.ft. 6 in. _I CODE F - ATCHES ❑Yes <`71 No No. of Squares with Patches 1 CODE G%- \ NOTE :Areas marked with an "F"may be repaired by patching.All other areas hall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED —I FORMED POURED COMPLETED I► - I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 7,0 Lj q41' 5�- Zr ,, -dfQ - q77 - 002 PARCEL CODE F CONTROL NO. CLEAN SIDEWALK - Type of Defect ❑ Yes IK No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes CX No — ` rl }= WATER VALVE ADJUSTMENT REQUIRED — (i n] ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED i•e f"kk ❑ Yes Cd No S�f U'�ooF T�G� LCa�i — W. afh s� — LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �_3ee ❑ Other DEPTH OF SIDEWALK [9 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED �"dsq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. — CODE F - PATCHES ❑ Yes IX No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY D 7'L' Date: Z/.a2 v�y PERMIT ISSUED — FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS q I S l� q+h _ tN13 -)-6 - j7j - dd5 ? PARCEL CODE: CONTROL NO. CLEAN SIDEWALK Type of Defect G ❑Yes K No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION D L I ❑Yes l; No 1 � WATER VALVE ADJUSTMENT REQUIRED ❑Yes �gNo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet 4 'Feet5.3 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. JCODE 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 �I reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM-MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED — i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS PARCEL CODE ' CONTROL NO_.-' CLEAN SIDEWALK Type of Defect CpYes. ❑ No See reverse side for Defect Codes A-F See below for Defect Code G _.TRIM VEGETATION ❑ Yes No _ t o`q. WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes Cam_ No PARKS DEPARTMENT REVIEW REQUIRED —�� Yes X No — -- LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C 5.F ❑ Other DEPTH OF SIDEWALK IJ 4 inches 5 inches ❑ 6 inches - AREA TO BE REPAIRED -VW4*'-sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CB�No No. of Squares with Patches CODE 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: `� Z � c PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS g),,, L) q+�, 5+ . _,z - Lj-?q _ i4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes A No See reverse side for Defect Codes A See below for Defect Code G TRIM VEGETATION ❑ Yes �j No WATER VALVE ADJUSTMENT REQUIRED r� El Yes No PARKS DEPARTMENT REVIEW REQUIRED Yes ANo LOCATION OF SIDEWALK )�-FrontYard ❑ Sid7E[:�] Yard___ ther - WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet 5.3 F ❑ Other DEPTH OF SIDEWALK; C 4 inches ❑ 5 inches ❑ 6 inches 1 AREA TO BE REPAIRED"---It sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. J 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 -�I 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 SgI3 - ZL_ -4`'ot 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 ❑ Yes I"No WATER VALVE ADJUSTMENT REQUIRED _ ❑ Yes 0 No �.a ,b• I I PARKS DEPARTMENT rn� REVIEW REQUIRED i ❑ Yes W No yi1 9"V` LOCATION OF SIDEWALK ,L7 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 0 4 Feet ❑ 5 Feet ❑ 5.3 Feet Rr ther y , DEPTH OF SIDEWALK IN 4 inches 5 inches ❑ 6 inches — L AREA TO BE REPAIRED sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes "o No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1SI3 r3.5 Date: '�� — we-, PERMIT ISSUED — FORMED POURED COMPLETED i CITY OF WATERLOO i SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9 Z 7 W. 9' S;T. .1 - b27 PARCEL CODE CONTROL NO. Type of Defect 14 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes �(No TRIM VEGETATION .) ❑ Yes ?�f No N WATER VALVE ADJUSTMENT REQ'D El Yes KNo PARKS DEPARTMENT 1 ( REVIEW REQUIRED I may` _ El Yes XINo G qfh SI LOCATION OF SIDEWALK 9 Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet er 1 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 eNo No.of Squares with Patches _ CODE 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 Date: 1�1-ZZ JY PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS a to PARCEL CODE- CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F -i See below for Defect Code G ( ❑Yes ] No TRIM VEGETATION — o�-` -4L ❑ Yes N'No 4 WATER VALVE ADJUSTMENT REQ'D ❑Yes 1 No — PARKS DEPARTMENT REVIEW REQUIRED _ _ Gr1 Yes ❑ No !id LOCATION OF SIDEWALK ❑ Front Yard Ed Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet [ 5 Fe ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK #Tes ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE q. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes �9 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching. All other areas shall be repaired by . reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 13 + 7-� Date: PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS- PARCEL CODE= CONTROL NO. CLEAN SIDEWALK s?S k Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 111 No TER VALV ADJUSTMEN7REQUIRED Yes ❑ No (1 -15ARKS DEPARTMENT REVIEW REQUIRED ❑Yes (No t3tQ�k R��t�•y 31ru� 444'"� - - LOCATION OF SIDEWALK �4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 3 Feet 23�'Ot4 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 - . 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: y�s PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS ', DDRESS " /(fL6113 00- 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 K No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes JK No PARKS DEPARTMENT _ �A REVIEW REQUIRED .��".� [I Yes No LOCATION OF SIDEWALK iV,Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -- -Feet =-I] Other DEPTH OF SIDEWALK ll 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED — s . 4 in. sq.ft. 5 in. sq.ft. 6 in. � q•ft. CODE F - PATCHES ❑ Yes [ 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. y�,s Date: FIRST INSPECTION AND FORM MADE BY Da — PERMIT ISSUED _ FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE` CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes 10 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION y ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED �tet� x ❑Yes XI No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No �j . qt1 . LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet LRz_Oth r -S 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 - i i j NOTE :Areas marked with an "I"' 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 18(2, -1 gg W . 1 U},� St-reei- &q t 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect U`Yes KNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes [ No VAT _R LVE STM NT REQUIRED Lk�Yes ❑ No — ' �\ KS DEPARTMENT — �b � x�� Pic" � REVIEW REQUIRED ❑ Yes A No LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 195.3 Fe ❑ Other DEPTH OF SIDEWALK Vinci El inches El inches AREA TO BE REPAIRE 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"P' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY : —R 4 L c--- Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS °' Zoo )K ), 10+� _ i 6913 -z5 - 3Z8 -(90z PARCEL CODE CONTROL NO. CLEAN SIDEWALK T e of Defect ❑ Yes b�No See verse side for Defect Codes A-F See b w for Defect Code G I TRIM VEGETATION I ❑Yes X No �.l - ey WATER VALVE ADJUSTMENT REQUIRED -1 ® Yes ❑ No Z - W1V I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes J9 No J � Z � LOCATION OF SIDEWALK Front Yard ❑ de Yard ❑ Other J WIDTH OF SIDEWAL ❑ 4 Feet ❑ 5 Feet [0 5.3 Feet ❑ Other DEPTH OF SIDE LK �J 4 inches ❑ 5 inch ❑ 6 inches AREA TO BE PAIRED _ sq.ft. 4 in. sq.ft. 5 in. _ sq.ft. 6 in. —� CODE F PATCHES ❑ Yes 14 No No.of Squares with Patches COD - NOTE:Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : MG k V�G Date: ) PERMIT ISSUED —I FORMED POURED COMPLETED I r- I CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. ... Type of Defect GLEAN SIDEWALK _- See reverse side for Defect Codes A-F ❑ Yes ® No See be w for Defect Code G I TRIM VEGETATION _ i ❑ Yes No WATER VALVE ADJUSTMENT REQ`D El Yes I`,No S, k - �)..� � PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes ;R No I L) LOCATION OF SIDEWALK R Front Yard j' ❑ Side Yard \E] Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet N Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches I9 inches AREA TO BE REPAIRED _Lsq.ft. 4 in. sq.ft. 5 in. I Ts' q.ft. 6 in. CODE F - PATCHES ❑ es No No.of Squares with Patch s CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION' D FORM MADE BY : ����' �ti� Date: PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS IE-5- 189 / tti Sfireof PARCEL CODE CONTROL NO_ I - Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G � ❑ Yes No ....I �1 TRIM VEGETATION d ❑ Yes "15 No a WATER VALVE ADJUSTMENT REQ'D ° ❑ Yes No PARKS DEPARTMENT —I y okol-• � REVIEW REQUIRED ❑Yes 1(No IL) LOCATION OF SIDEWALK K Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet �g5Fee ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK K4 in es ❑5 inches ❑ 6 inches AREA TO BE REPAIR sq.ft. 4 in. sq.ft. 5 in. s 6 in. J CODE F - PATCHES XYes 49No No.of Squares with P hes '/ CODE G - I I 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 : 5 Date: j PERMIT ISSUED —{ FORMED POURED COMPLETED I " CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 326 iy. /) th S4,,ee-}- ✓ "13 - 25- 333 -01k ✓ 1�7,, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C—, ❑ Yes 7 No 1 e See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes 4 No Too 1 c WATER VALVE ADJUSTMENT REQUIRED — (� ❑ Yes No I I \ PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes ,Q No - \� fI l � ►1 0, e� LOCATION OF SIDEWALK k Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK /�in ❑ 5 inches /� 6 inches AREA TO BE REPAIRED sq.jt--. 4 in. sq. 5 in. CODE F - PATCHES"----Styes I<No No.of Square�Patche� �� ; CODE G - — NOTE :Areas marked with an"I"' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : K S Date: PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - L�- 3s3- o0'?, c73 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes [e No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes [M No WATER VALVE E \.5 ADJUSTMENT REQUIRED per ❑Yes LN-No I I I PARKS DEPARTMENT ._ REVIEW REQUIRED ❑Yes U No /ak� Vj LOCATION OF SIDEWALK N Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet meet -KOt r LD 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 J Date: t¢ —I — 'j PERMIT ISSUED FORMED POURED COMPLETED ='I F -- f CITY OF WATERLOO i SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS' z l l l — 43-13 PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type\Of Defect El Yes No — See revoise side for Defect Codes A-F See below,for Defect Code G I TRIM VEGETATION ❑ Yes 0 No — WATER VALVE -� ADJUSTMENT REQUIRED — N ❑Yes No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No , LOCATION OF SIDEWALK M Front Yard ElSide'Yard 0 Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches I AREA TO BE REPAIRED I�, 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. 3.� l�D FIRST INSPECTION AND FORM MADE BY Date: — PERMIT ISSUED — FORMED POURED COMPLETED �- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS° � t� - z�- 3�3 -bcc f PARCEL CODE' CONTROL NO. CLEAN SIDEWALK r, Type of Defect ❑Yes 9 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 2�No t3-!u WATER VALVE ADJUSTMENT REQUIRED 2 ❑Yes ["o I PARKS DEPARTMENT .� REVIEW REQUIRED i LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK -' 4 inches ` ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 22,_S 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 - `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 : )tL i69 Date: "t� - !Zf PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS C�315 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 2 No — WATER VALVE ADJUSTMENT REQUIRED — �'�� ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes P No — LOCATION OF SIDEWALK [�l Front Yard ❑ Side Yard 0 Other ! WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®-5-.3-Feet �40th r DEPTH OF SIDEWALK 1214 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 7" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY = P% Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS" (34 t s � -Z�- 3s3- a13 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ri�No See reverse side for Defect Codes A-F -- See below for Defect Code G TRIM VEGETATION ❑ Yes N6 WATER VALVE_-- - `o c3 -f'{ N ADJUSTMENT REQUIRED D ❑ Yes IN No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes L No C LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I9 5.3 Feet P-_Oth 1 DEPTH OF SIDEWALK 5�4 inches N ❑ 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 - �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 : 31 0 5 Date: -( 4- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS W, l \TA PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect P ❑ Yes P.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 I?No I PARKS DEPARTMENT REVIEW REQUIRED \V ❑ Yes ( No LOCATION OF SIDEWALK SJ Front Yard ElSide Yard Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK r 4 inches ❑ 5 inches ❑ 6 inches s ft. 5 in. ft. 6 in', AREA TO BE REPAIRED sq.ft. 4 in. q s — f CODE F - PATCHES [ Yes ElNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"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 t 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 ❑ Yes [j�No P_j.,J c2 WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT ... REVIEW REQUIRED ❑ Yes C No �C VA LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �5_ Fee ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Le, q.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES ❑ Yes [9,No No.of Squares with Patches CODE 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 : 3� Date: PERMIT ISSUED FORMED POURED COMPLETED I i CITY OF WATERLOO I _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' LA-) \,14� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes E?a No _ See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes No —' 25 WATER VALVE ADJUSTMENT REQUIRED ❑Yes {�4 No 4, PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No — LOCATION OF SIDEWALK S'Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®'5.3 Feet ❑ Other — DEPTH OF SIDEWALK C,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. ,�!s ft. 6 in. — CODE F - PATCHES I Yes El No No. of Squares with Pches z CODE G - NOTE :Areas marked with an"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� Date: PERMIT ISSUED s FORMED POURED COMPLETED i CITY OF WATERLOO I' SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS''" PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑1 Yes D No l WATER VALVE I �.1 ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ® No LOCATION OF SIDEWALK N�Front Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet La5::3�Fe ❑ Other 1 DEPTH OF SIDEWALK IN 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. I -` CODE F - PATCHES ❑ Yes M No No.of Squares with Patches j CODE G - ..L j NOTE:Areas marked with an "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 - t e- t - - PERMIT ISSUED 1 FORMED POURED COMPLETED I. i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS' -2� 3�3= �3 - PARCEL CODE CONTROL NO. ' CLEAN SIDEWALK '— Type of Defect ❑ Yes p No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G j ❑Yes N No \0 J WATER VALVE ADJUSTMENT REQUIRED ❑Yes 11�No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 13�No LOCATION OF SIDEWALK C�j Front Yard ❑ Side Yard ❑ Other , WIDTH OF SIDEWALK El Feet El Feet �-S Feet E106 r DEPTH OF SIDEWALK - inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED` sq.ft. 4 in. s q.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes Q No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching. All other areas shall be repaired by _ reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` 700 bl_ I l --3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 5_1"No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes [S�No WATER VALVE ADJUSTMENT REQUIRED -1 ❑ Yes [I No 4u I I V S� I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes PP No _ 11 as LOCATION OF SIDEWALK 9 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (!a5.3 Fee ❑ Other DEPTH OF SIDEWAL 4 inc ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Ep No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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�5 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS- 00 — „t,� ,3 - 373 - , CONTROL NO. PARCEL CODE - CLEAN SIDEWALK ❑Yes i�5 No Type of Defect — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes IPNo WATER VALVE ADJUSTMENT REQUIRED ❑Yes [�-No PARKS DEPARTMENT REVIEW REQUIRED t ? ❑Yes C� No LOCATION OF SIDEWALK Cffront Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet / L 5.3 Fee'f ❑ Other �;� ��� DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches -- s f}. 6 in. AREA TO BE REPAIRE �� � �q•�• 4 in. sq.ft. 5 in. q• CODE F - PATCHES ElYes [)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 ` Date: T PERMIT ISSUED COMPLETED FORMED POURED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS- PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect ❑ Yes ® No 1 See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes [�P No WATER VALVE ADJUSTMENT REQUIRED -J- Yes ❑ No 1 Dar� PARKS DEPARTMENT REVIEW REQUIRED i ❑ Yes C�No LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet f 5.3 Fe ❑ Other 1 DEPTH OF SIDEWALK 4 inches '' ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE© t-13..V sq.ft. 4 in. sq.ft. 5 in. 6 in. 1 CODE F - PATCHES `10 Yes -❑ No No.of Squares wit atches �> CODE G - NOTE :Areas marked with an "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�( �j Date: PERMIT ISSUED 1 FORMED POURED COMPLETED I CITY OF WATERLOO I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2? �n1`-? -25- 35 P CONTROL NO. PARCEL CODE CLEAN SIDEWALK Type of Defect ❑Yes © No See reverse side for Defect Codes A-F I _ See below for Defect Code G TRIM VEGETATION ❑Yes C No WATER VALVE ADJUSTMENT REQUIRED �''� ❑Yes �No W r f JJ, i' PARKS DEPARTMENT REVIEW REQUIRED "- ❑ Yes ;ft No A LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (:M:5.3 Flt ❑ Other DEPTH OF SIDEWALK 4:L94 inches El 5 inches El 6 inches _ Z T O sq AREA TO BE REPAIRE 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. 43�S FIRST INSPECTION AND FORM MADE BY : 3� 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 E6 No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 9 No r PARKS DEPARTMENT REVIEW REQUIRED e ld � ❑ Yes ZNo LOCATION OF SIDEWALK P FrontYard ❑ Side Yard ❑ Other j r J WIDTH OF SIDEWALK El4 Feet El5 Feet 6. eet 1 O ers q DEPTH OF SIDEWALK _� 4 inches C5 inches_ El6 inches AREA TO BE REPAIRED l sq.ft. 4 in. Z l sq.ft. 5 in. sq.ft. 6 in. --I CODE F - PATCHES ❑Yes [2 No No.of Squares with Patches CODE G - NOTE :Areas marked with an "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 ' CONTROL NO. PARCEL CODE CLEAN SIDEWALK ❑Yes [�T No Type of Defect See reverse side for Defect Codes A-F — I See below for Defect Code G I TRIM VEGETATION I ❑Yes i-No I _ WATER VALVE ADJUSTMENT REQUIRED N ❑Yes y No �c. i PARKS DEPARTMENT REVIEW REQUIRED — �`s` El Yes RPNo LOCATION OF SIDEWALK "Front Yard ❑ Side Yard C❑ Other — WIDTH OF SIDEWALK El4 Feet ❑ 5 Feet (ff 513 Feet) ❑ Other DEPTH OF SIDEWALK inches El5 inches El6 inches _ ft. 5 in. q s ft. 6 in. AREA TO BE REPAIRE ` ft. 4 in. sq- _!!:� CODE F - PATCHES ❑ Yes ff] No No.of Squares with Patches CODE 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 _(s - (4- 1> Date: ' FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 1 PROPERTY ADDRESS 300 N o c K W . 5�ree4- f13 -25 - 333 - 00-1 ✓ �� PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect A. C, F ❑Yes �No x See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes K No 0710 � WATER VALVE J f✓, ADJUSTMENT REQUIRED `) -A ❑Yes 4�,No DARKS DEPARTMENT �h•2 Z'�85 REVIEW REQUIRED �k ❑ Yes -9l No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K-5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I sq. ft. 4 in. sq.ft. 5 in. J CODE F - PATCHES Yes g No No.of Squares with Patc es 1 '� l CODE G - NOTE :Areas marked with an"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 c-c— Date: t1-23-1�1_ PERMIT ISSUED FORMED POURED COMPLETED I i — GI-TY OF WATERLOO { SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS '--7,2- YV )Z."v" ST. 'ARCEL CODE CONTROL NO. - Type of Defect CLEAN SIDEWALK _ } F See reverse side for Defect Codes A- ey _ ❑Yes ❑ No See below for Defect Code G TRIM VEGETATION L� ` ❑Yes ❑ No '1 WATER VALVE o� ADJUSTMENT READ f ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED - ---- G A ❑ Yes ❑No p ' r 3.9 yt/, /Z' ST. LOCATION OF SIDFWALK X FrontYard ❑ SideYa,=' ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ,®'Other DEPTH OF SIDEWALK X41 inches ❑ 5 inches ❑ 6 1 — ARE('TO BE REPAIRED 6.3�5sq."in. sq.ft. 5 in. sq.fE. 6 in. — CODE F - PATCHES ❑Yes JXl No No.of Squares with matches CODE G - — NOTE:Areas marked with an"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 L-G Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS ,top p,�a�k LU • f3tk Stree�'� �' S13 -2S-337 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C- ❑Yes No Sedreverse side for Defect Codes A-F l I See below for Defect Code G \` I ;PRIM VEGETATION ❑Yes a No 1 _ WATER VALVE ADJUSTMENT REQUIRED C �RO / El Yes '� No ` L I =� � I C PARKS DEPARTMENT REVIEW REQUIRED '4 ❑Yes CYNo i LOCATION OF SIDEWALK Z.Front Yard ❑ Side Yard �Other WIDTH OF SIDEWALK El Feet ❑ 5 Feet X5.3 Feet ``p,_Other DEPTH OF SIDEWALK R4-nches ❑ 5 inches ❑ 6 inches_ AREA TO BE REPAIRED e7,�n L sq. ft. 4 in. sq.ft. 5 in. —sq.ft_, 6 in. CODE F - PATCHES ❑Yes X No No. of Squares with Patches _ i CODE G - 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 : S Date: q-Zs'- Iq PERMIT ISSUED FORMED POURED COMPLETED r— CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3Z 5 lA) S 9 1 -ZS - S7 - aIiYt' 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 _ ❑Yes ❑ No PARKS DEPARTMENT `l REVIEW REQUIRED ❑Yes ❑ No _ LOCATION OF SIDEWALK �ront 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 Z43•$ 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 L c_._ Date: �� ��y -- PERMIT ISSUED FORMED POURED COMPLETED r _ I CITY OF WATERLOO _{ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -25 PARCEL CODE CONTROL NO. CLEAN SIDEWALK X Type of Defect El Yes XNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION j ❑ Yes X No WATER VALVE G ADJUSTMENT REQUIRED ❑ Yes XNo —I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes X No c i L .q, LOCATION OF SIDEWALK kFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet �therS J DEPTH OF SIDEWALK 4 inches inches ❑ 6 inches AREA TO BE REPAIRED !Hm�g sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes XNo No. of Squares with Patches j CODE G - NOTE:Areas marked with an "F"may be repaired by patching_ All other areas shall be repaired by reconstruction of full sidewalk panels. _I FIRST INSPECTION AND FORM MADE BY : S LL Date: 7"ZS�I7 PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 Z(�- 1/j l g f k Sfreef' '� 8 q►3 -26' -377 -oo-1 ✓ PARCEL CODE CONTROL NO. 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 I ❑Yes 1�0No -- WATER VALVE ADJUSTMENT REQUIRED N ❑Yes K No I ( kea I PARKS DEPARTMENT REVIEW REQUIRED P , Zo.o l ❑Yes 1 No _ �•3 LOCATION OF SIDEWALK [N Front Yard ❑ Side Yard El Other — WIDTH OF SIDEWALK ❑ 4`Feet ❑ 5 Feet .3 Feet ❑ Other DEPTH OF SIDEWALK _1<4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED J_2id q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes [9No No. of Squares with Patches CODE G - NOTE:Areas marked with an"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 L Date: PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3Z8 ty, ( q fk �-re-ef gcr 13 -2S-317 - 008 ►/ 1. I PARCEL CODE CONTROL NO. �!\ Type of Defect \ � C CLEAN SIDEWALK JSee reverse side for Defect Codes A-F t See below for Defect Code G ( ❑ YesNo TRIM VEGETATION ❑ Yes No v1 N WATER VALVE ADJUSTMENT REQ'D ❑ Yes rXjNO PARKS DEPARTMENT ' REVIEW REQUIRED ❑ Yes K No J (3(u S- r'e of LOCATION OF SIDEWALK XZ Front Yard ❑ Side Yard O Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �5.3 Fee ❑ Other — DEPTH OF SIDEWALK <l 4 inches' ❑ 5 inches El inches _. ,; ✓ AREA TO BE REPAIRED'-- t sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes C(No No.of Squares with Patches CODE G - JNOTE: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 Date: -i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS IV_ It T� 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 N'No TRIM VEGETATION ❑ Yes �(No a WATER VALVE — ADJUSTMENT REQ D ❑Yes 1X/No — PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes VNo Aro LOCATION OF SIDEWALK ❑ Front Yard XSide Yard —t-Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Fee ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ,`"")Z 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft.,5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes XNo No. of Squares with Patches I CODE G -NOTE:Areas marked with an"P'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � Date: PERMIT ISSUED — FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 186 W I S 4 1, S4,ree-F 1 99 13 -25 -y63 -Olt �� "—I PARCEL CODE CONTROL NO_ Type of Defect A CLEAN SIDEWALK 1 See reverse side for Defect Codes A-F El Yes -'l� No 17Gt�f�` � See below for Defect Code G TRIM VEGETATION ❑Yes 4�No 1 WATER VALVE ADJUSTMENT REQ'D C]Yes T No 190 �"' 150% PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ] No 1 � oM�e,rc` al 5}reel LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet El Other 1 DEPTH OF SIDEWALK Z4 inches ❑ 5 inc ❑ 6 inches AREA TO BE REPAIR D ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes -4<,No No.of Squares with Patches CODE G - r NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED I i I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /8 i'. 1 "''h .57. 2©7 PARCEL CODE CONTROL NO_ I' Type of Defect 14 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes ❑ No h TRIM VEGETATION ❑ Yes ❑ No WATER VALVE _ ADJUSTMENT REQ'D ❑ Yes ❑ No _ J , PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 11 ,�-e may . LOCATION OF SIDEWALK FJ Front Yard 9Side Yar ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Fe t ,l_R/5.3�F� t ElOther DEPTH OF SIDEWALK �Xr4inche�s ❑ Prrs ❑ 6 inches AREA TO BE REPAI �ED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑ Yes J�a'No No.of Squares with Patches CODE G NOTE:Areas marked with an "F"may be repaired by patching.All other areas#all be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY S L Date: J�y PERMIT ISSUED _ FORMED POURED COMPLETED `` CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I`t0 W 5 +k -}reed C113 -ZS -463 - OiZ'l PARCEL CODE CONTROLNO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F [I Yes No See below for Defect Code G TRIM VEGETATION ❑Yes No ,l WATER VALVE 6� vl ADJUSTMENT REQ'D - ❑Yes KNo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Xhlo —I —I - LOCATION OF SIDEWALK ❑ Front Yard e Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet - ] 5 F t ❑ 5.3 Feet El Other — —� DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE 2— q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No. of Squares with Patches _ CODE G - NOTE:Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : `� �-� Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS ! 'v�i . 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 fl No WATER VALVE Nt ADJUSTMENT REQUIRED — �,,"i� ❑Yes ® No f � PARKS DEPARTMENT — f REVIEW REQUIRED K Yes iX No �` A r — —� — LOCATION OF SIDEWALK )R Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet J95 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 9 4 inch/es ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq. ft. 4 in. sq. ft. 5 in. sq.ft. 6 in, CODE F - PATCHES ❑ Yes 0 No No. of Squares with Patches CODE G - — - 1 NOTE :Areas marked with an "F" may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY E V/> Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect F ❑ Yes RNo See below for Defect Co TRIM VEGETATION . Y�, ❑ Yes No WATER VALVE ' ADJUSTMENT REQ'D ❑ Yes No PARKS DEPARTMENT r7 ' REVIEW REQUIRED ;Yes ❑ No 5� LOCATION OF SIDEWALK ❑ Front Yard XSide Yard ❑ Other y WIDTH OF SIDEWALK ❑ 4 Feet -Feet ❑ 5.3 Feet Other s•�/ DEPTH OF SIDEWALK i� ;<4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED - sq. ft. 4 in. sq. ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes j<No No. of Squares with Patches CODE G O-"-- IWA/L=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 0Y Date: h/IL_11 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM �- PROPERTY ADDRESS 170 W 1 ST. 25- - Y.Stb - 004 213 PARCEL CODE CONTROL NO. Type of Defect G CLEAN SIDEWALK .r See reverse side for Defect Codes A-F See below for Defect Code G i I] Yes I?(No � J TRIM VEGETATION ❑ Yes I No Q _ WATER VALVE ADJUSTMENT REQ'D ❑ Yes No Oil - i PARKS DEPARTMENT — REVIEW REQUIRED _ ❑ Yes ,<No LOCATION OF SIDEWALK ❑ Front Yard X Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet P Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches J<6 inches AREATO 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 NOTE Areas marked with an "F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST)NSPECTION AND FORM MADE BY : 8-4/ Date: 1-1-zg-11f- — PERMIT ISSUED _ FORMED POURED COMPLETED f CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zle &j'. PARCEL CODE CONTROL NO. Type of Defect A \\�sl CLEAN SIDEWALK 4:\�See reverse side for Defect Codes A-F ❑ Yes N0 i\� J See below for Defect Code G TRIM VEGETATION \`- 5 ❑ Yes gNo 17���� WATER VALVE `u 0 ADJUSTMENT REQ'D❑Yes iNNo V PARKS DEPARTMENT REVIEW REQARED ❑ Yes [PWO 6Lo1u6 _ A.r�t?JT Cf,E�FiJVI�t/C•- �l.+J LOCATION OF SIDEWALK tdF and ❑ Side Yard ❑ Other WIDTH OF SIDEWAL D`4 Fe ❑ 5 Feet ❑ 5.3 Feet ❑ Other J DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches 6 inc s AREA TO BE REPAIRED sq.ft. 4 in. sq. 5 in. -3 sq.ft. 6 in. CODE F - PATCHES El Yes No No. of Squares es CODE G - NOTE:Areas marked with an"P`may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' $!t /41/ � PARCEL CODE= CONTROL NO_ CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A-F A • � See below for Defect Code G TRIM VEGETATION ❑ Yes E�j No — a ;c' WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ($ No I PARKS DEPARTMENT REVIEW REQUIRED —�� ❑ Yes No 10.6 — LOCATION OF SIDEWALK C4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet Other DEPTH OF SIDEWALK 4 in heC s ❑ 5 inches ❑ 6 inches - AREA TO BE REPAIRE�� 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 : �If T� Date: y-17'11Y PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' " it-I �}fl-t4 S� . CONTROL NO. PARCEL CODE- CLEAN SIDEWALK ! El Yes No Type of Defect � A See reverse side for Defect Codes -F See below for Defect Code G TRIM VEGETATION 7s 1 No WATER VALVE a ADJUSTMENT REQUIRED ❑Yes �9 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes A No i Cad -AlIL4 y� LOCATION OF SIDEWALK )6 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet (�g�53ee ❑ Other DEPTH OF SIDEWALK 4 inches El5 inches El 6 inches 5, AREA TO BE REPAIRED sq•ft. 4 in. s qft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No.of Squares with Patches _ CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by �. reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY � j- T" Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ I PROPERTY ADDRESS � iS A1Icy 5 r. PARCEL CODE 3 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 �4 No _ WATER VALVE �a� N ADJUSTMENT REQUIRED r ❑ Yes I No SPARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No T — A 1a 5b _ LOCATION OF SIDEWALK CAS( Front Yard ❑ Side Yard ❑ Other �--� 5 s ' WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other DEPTH OF SIDEWALK �9 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 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : T-5 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - dal 4!lc,4 5} PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Q 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 19 No ' PARKS DEPARTMENT J REVIEW REQUIRED ❑ Yes No 0 J A161 5� LOCATION OF SIDEWALK P Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0 Other 6_ I DEPTH OF SIDEWALK t 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 12S-3 2q-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: y/1"& PERMIT ISSUED —� FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS,- ql f A11r 4 . PARCEL CODE.,, CONTROL NO. Type of Defect G _ I CLEAN SIDEWALK See reverse side for Defect Codes A-F e `� See below for Defect Code G °" El Yes No TRIM VEGETATION -- 1 ? ❑ Yes K No re, WATER VALVE ADJUSTMENT REQ'D (her ❑ Yes X No PARKS DEPARTMENT REVIEW REQUIRED 10.2 Y ❑ Yes (No Allm LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other �y DEPTH OF SIDEWALK 'L_(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED q:ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - 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 T_F Date: ��-�� — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ? PROPERTY ADDRESS 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 0 No WATER VALVE to Grape Lµ��L�aM ADJUSTMENT REQUIRED ❑ Yes No l �° I I PARKS DEPARTMENT e= REVIEW REQUIRED ❑Yes No 1u��son �'• �. LOCATION OF SIDEWALK D� Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet .0 DEPTH OF SIDEWALK El4 inches ❑ 5 inches 6 inches y AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in.' sq.ft. 6 in. CODE F - PATCHES ❑ Yes 56.No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. I -\)Q 4- T Date: 1 FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 11 1411e r S4 — �� _q6 - q5_ - 011 PARCEL CODE,- x j t e� CONTROL NO. — Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes Cu] No See below for Defect Code G TRIM VEGETATION ❑ Yes [RI No G WATER VALVE ADJUSTMENT REQ'D ❑ Yes No �I — �� PARKS DEPARTMENT REVIEW REQUIRED ❑Yes [Q No Ej Oft Q 16' 1-\� -ld hoo a sa — LOCATION OF SIDEWALK ❑ Front Yard Side Yard [XOther WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet . Feet 90ther� _J DEPTH OF SIDEWALK 14`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 77 Yes qo-- No. of Squares with Patchd.s CODE G - — NOTE :Areas marked with an"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� } ]✓ Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS X_- _ 7 t or f pp � PARCEL CODE CONTROL NO. ar�(¢P )0,27 ICJ 1 CLEAN SIDEWALK Type of Defect A C_ )(No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION J I ❑ Yes P No 1 1-0 I a j WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Q'No PARKS DEPARTMENT 1 I REVIEW REQUIRED - t / a ❑ Yes W No 4-+n — 1 f' LOCATION OF SIDEWALK IQ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 4* -Feet �_ ��eet ❑ Other DEPTH OF SIDEWALK Q 4 inches C 5 inches ❑ 6 inches ;= AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes to No No. of Squares with Patches CODE G - NOTE:Areas marked with an "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 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS �q 13 -2.5 - qDl -DOS ✓ 2 PARCEL CODE CONTROL NO_ Type of Defect G t A CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G ❑ Yes No \ V) TRIM VEGETATION 3 ❑Yes M No — M E% WATER VALVE ADJUSTMENT REQ'D a 3 ❑Yes K No .... PARKS DEPARTMENT q. q.z 4.4; REVIEW REQUIRED 9.3 4.8 ❑Yes ] No LOCATION OF SIDEWALK K ront Yard ❑ Side Yard `., ❑ Other WIDTH OF SIDEWALK K4 Feet ❑ 5 Feet ❑ 5.3 Feet`, ❑ Other DEPTH OF SIDEWALK ' J4 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 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 : r2 5 L�— Date: PERMIT ISSUED ..- FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS 15762 B l��Kl���,K Street` �q 13 -25 -335 -lJ0( � -7 PARCEL CODE CONTROL NO. nn Type of Defect P) See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G 4- El Yes No �f '3 � TRIM VEGETATION ' 3 ❑ Yes t� No WATER VALVE ADJUSTMENT REQ'D a I 3 ❑Yes [9 No PARKS DEPARTMENT .6 1 REVIEW REQUIRED _ — ❑ Yes 9 No .J LOCATION OF SIDEWALK INf FrontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [15.3 Feet her �• , -.l DEPTH OF SIDEWALK 4 i hes ❑ 5 inches ❑ 6 inches AREATO BE REPAIRED 2-7�© sir A 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes �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 : R­'� `c- Date: L('Z S-'L( PERMIT ISSUED .I FORMED POURED COMPLETED ;I , I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 7 PROPERTY ADDRESS /526 -aoS PARCELCODE CONTROLNO. T Type of Defect A., CLEAN SIDEWALK .— See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes C"No .F vim+, TRIM VEGETATION -" ❑ Yes ONo N WATER VALVE ADJUSTMENT REQ`D l ❑ Yes [$'No PARKS DEPARTMENT REVIEW REQUIRED -- ❑ Yes j11"No 1l/. IVY"' ST. LOCATION OF SIDEWALK ❑ Front Yard X Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet X11 Other DEPTH OF SIDEWALK ❑ 4 inches 5 inches; ❑ 6 insles-f' AREA TO BE REPAIRED sq.ft. 4 tn.= `r sq.ft. 5 in. sq.ft-6-in. _ CODE F - PATCHES [ (Yes ❑ No No.of Squares with Pat/c/ es / S!9>NT. I NOTE:Areas marked with an 7"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 `fy_ PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO i SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1760 61k . PARCEL CODE CONTROL NO_ Typ f Defect CLEAN SIDEWALK y See rev e side for Defect Codes A-F See below Defect Code G [ Yes ❑ No TRIM VEGETATION f ❑ Yes P�No. QL5 V1 \\\ WATER VALVE pe'-a 1 ADJUSTMENT REQ'D s y El Yes [ No PARKS DEPARTMENT REVIEW REQUIRED — — ❑ Yes [2 No 41 ° LOCATION OF S EWALK N Front Yard ❑ Side Yard ❑ Qther WIDTH OF S EWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet q Other _ 1 DEPTH 0 SIDEWALK 914 inches ❑ 5 inches 06 inches AR 0 BE REPAIRED 55 sq.ft. 4 in. sq.ft. 5 in. 9 sq.ft. 6 in. ODE F - PATCHES ❑ Yes [P No No.of Squares with Patches CODE G - ..1 NOTE:Areas marked with an"I"'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY �'� Date: PERMIT ISSUED FORMED POURED COMPLETED I I - i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS /7a5— /707 zs- Yo e/ - 40& 233 PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect 1,4 Z, El Yes C No See reverse side for Defect Codes A-F �Sk See below for Defect Code G I TRIM VEGETATION ( I ❑ Yes [�'No WATER VALVE Z` ADJUSTMENT REQUIRED -- '� tj✓ _ N ❑ Yes ONO V C2 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes J"O Al L! , LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet meet E 10th�e - DEPTH OF SIDEWALK Z4 inches J�'5 inches ❑ 6 inches T z . AREA TO BE REPAIRED sq.ft. 4 in. 3% sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑Yes I-xr No No_ of Squares with Patches CODE G - f7 tz N-, t q-r-r. r,o 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 : 6AI 135 Date: 5-15� PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 171Z 973 -zs- zlo6 - PARCEL CODE CONTROL NO_ I CLEAN SIDEWALK Type of Defect ❑ Yes ONO See reverse side for Defect Codes A-F See below for Defect Code G ��X '`� TRIM VEGETATION ❑ Yes J9 No p W WATER VALVE ADJUSTMENT REQUIRED ❑Yes I9No I I I PARKS DEPARTMENT J REVIEW REQUIRED ❑ Yes N No i LOCATION OF SIDEWALK RrFrontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ee 'Ot r `� DEPTH OF SIDEWALK ;K 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 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 Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS /713 g9I3 -25- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ;i No See reverse side for Defect Codes A-F "- k See below for Defect Code G TRIM VEGETATION �S ❑Yes XNo — �r�, lit WATER VALVE ADJUSTMENT REQUIRED N ❑Yes NINO PARKS DEPARTMENT i REVIEW REQUIRED ❑ Yes ;�r'No LOCATION OF SIDEWALK ZFront Yard ❑ Side Y ❑ Other _ WIDTH OF SIDEWALK 0 4 Feet ❑ 5 Feet 5.3 F ❑ Other DEPTH OF SIDEWALK 4 cin hes ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR D 6.4 q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes XNo No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1_2,1V Date: — t�r PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1729 Z--A-LAz-KkW1C Acto - 005 237 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes XNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes X No p �S� WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ® No CI a S L I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No ; A LOCATION OF SIDEWALK LYFront Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet � 5.3 F ❑ Other DEPTH OF SIDEWALK ches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR D 27-b sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. ._I CODE F - PATCHES ❑ Yes D'No No. of Squares with Patches _— CODE G - 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 t- Date: 'ZS'1x} PERMIT ISSUED FORMED POURED COMPLETED I - J CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 172 5 '6LAt1C 44xw tot, .^ 09t?3 - 25-404 - OOcr 2-"bs PARCEL CODE CONTROL NO. 1 Type of Defect A,� CLEAN SIDEWALK \A See reverse side for Defect Codes A-F U� t ❑ Yes XNo See below for Defect Code G y f x t TRIM VEGETATION ❑ Yes D;KNo WATER VALVE ADJUSTMENT REQ'D ❑Yes xlklo _ f PARKS DEPARTMENT j -� REVIEW REQUIRED — ❑Yes A No NO sib�cvAc.�t LOCATION OF SIDEWALK gFront Yard ❑ Side Yard ,., (7 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet f 5.3 Fe ❑ Other DEPTH OF SIDEWALK �5 4 inc es ❑ 5 inches ❑ 6 inches 3 AREA TO BE REPAIRED - sq.ft. 4 in. sq.ft. Sin. sq_ft. 6 in. — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - X .. 1�,WLZ.-c-, �C /GL[st� .riot:*✓" ol= /'iA// -S _ 70 — btsT�i�l�1>,�'�A. t.41ti5',U 71�$�s._ f�o7'� ���� �C-�r1.t 3✓t'8. NOTE:Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels- FIRST`-INSPECTION AND FORM MADE BY : ' �-� Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM i PROPERTY ADDRESS —1-/,u f31 S7, � . PARCEL CODE- CONTROL NO. Type of Defect J See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes R No TRIM VEGETATION y J. ❑Yes IV No L WATER VALVE y ADJUSTMENT REQ'D ❑ Yes D No PARKS DEPARTMENT J T R /IEW REQUIRED — — f ❑ Yes 0 No t E LOCATION OF SIDEWALK ® Front Yard p Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet N 5 Feet ❑ 5.3 Feet ® Other �l DEPTH OF SIDEWALK M 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 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 Date: ? 4— PERMIT ISSUED FORMED POURED COMPLETED - I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS r 3 -25 - ycs - oar} 2L/O PARCEL CODE CONTROL NO. s� Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes IYNo \\'q See below for Defect Code G TRIM VEGETATION — ��- ❑ Yes X No y V' �� �z WATER VALVE ADJUSTMENT REQ'D X ❑ Yes K No v PARKS DEPARTMENT REVIEW REQUIRED S�s .a5 `J — — — — ElR Yes INO ill0 { /L. t_7 57 LOCATION OF SIDEWALK 9 Front Yard`� ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK a4 Fee �1�5 Feet yet ❑ Other DEPTH OF SIDEWALK .' El inch ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED - I sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATGRES— El Yes n No No. of S- q`ri arm-s witbi Patches NOTE:Areas marked w► an ' 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 0 913 - 25' 6 242 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes X No �1 3 See reverse side for Defect Codes A-F ., See below for Defect Code G ( TRIM VEGETATION ❑Yes Ig No WATER VALVE ADJUSTMENT REQUIRED ❑Yes CH/No - PARKS DEPA TMENT REVIEW REQUIR El Yes (9 No 't 5' �5 EI:L vac.,ARw Y— ST. LOCATION OF SIDEWALK XFront Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Other DEPTH OF SIDEWALK IN 4 inches' El 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 : NJ "CS�S Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i L -L`` ``�" 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 allo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ® No � n C— ?�.� LOCATION OF SIDEWALK �R FrontYard ❑ Side Yard El Other ( -- WIDTH OF SIDEWALK El Feet ❑ 5 Feet 5 ��eet '-,ElOther` -�J" y DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. V-4� 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. • (�,� 1� �J FIRST INSPECTION AND FORM MADE BY . !� Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO J SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' �s3� A>✓c�c t�{; PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes f� No See below for Defect Code G TRIM VEGETATION El Yes J Yes Q 0_1 WATER VALVE ADJUSTMENT REQUIRED ❑Yes N No PARKS DEPARTMENT REVIEW REQUIRED El RLNo Al. p. G LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet �_, .J DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE 8E3• q.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. 1 CODE F - PATCHES ❑ Yes 1,2 No No.of Squares with Patches CODE 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 13J� F-) Date: A z 3— [ - PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i i PARCEL CODE CONTROL NO. �. I Type of Defect CLE I —sib�EWALK See reverse side for Defect Codes A-F Yes ❑ No See below for Defect Code G TRIM-VEGETATION -Yes ; ❑ No � C \ ,� AT VALVE �l \ ', c ADJUSTMENT REQ'D El Yes �No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK [N%'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet DEPTH OF SIDEWALK,/��4 inches P-5 inches' ❑ 6 inches AREA TO BE REPAIRED 96 sq.ft. 4 in sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes D�No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ } �F, f- -- FIRST INSPECTION AND FORM MADE BY I=`�'` Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _j SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 61k- G ,� /, t- d 913 -2 5- y5"3 - �.�� 2 Ll(o PARCEL CODE CONTROL NO_ Type of Defect C. F See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Cade G ❑ Yes Ar No t 1,3'_M TRIM VEGETATION o� �o+)� ❑ Yes X No . I WATER VALVE Ao 0% ADJUSTMENT REQ'D ❑ Yes D"No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes XNo 0 F L cc L F LOCATION OF SIDEWALK ArFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet et ❑ 5.3 Feet K Oth r 5 DEPTH OF SIDEWALK X4 inches ❑ 5 inches R 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 m:— s in. J CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patch s CODE G - JNOTE_Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _I FIRST INSPECTION AND FORM MADE BY Date; `-Z5- 19 we, (o-z5"-1 PERMIT ISSUED FORMED POURED CO MPLETED l CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS b PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes R No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes N No Jill PARKS DEPARTMENT. REVIEW REQUIRED ❑ Yes R No " ^o- c ' 't V\ � c to- r LOCATION OF SIDEWALK N Front Yard ❑ Side Yard 0 Other L WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0 Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 0 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. tvi I,"..� � (�� Date: FIRST INSPECTION AND FORM MADE BY t PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 9 PROPERTY ADDRESS 1411 3-"F-r_ �.-T. PARCEL CODE CONTROL NO_ l ~Type of Defect A t; See reverse side for Defect Co es A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes XNo e ae TRIM VEGETATION \\ El Yes KN.o WATER VALVE I 3 ADJUSTMENT REQ'D j !9 e�� l} ❑ Yes No 5kf I o r PARKS DEPARTMENT Cr � REVIEW REQUIRED — — ❑ Yes IK No O —� W. 12 LOCATION OF SIDEWALK k-Front Yard N Side Yard Other WIDTH OF SIDEWALK ❑4 Feet El5 Feet 0 5.3 Fe —� DEPTH OF SIDEWALK X4 inches El5 inches El6 inches 3 .Z AREATO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in.. CODE F - PATCHES ❑Yes K No No.of Squares with Patches _ �I CODE G - �iVClllZfZ ;%T P �r� A'Ji /VO7& -9(.A5S;,,jU,-ne Ql�'�t S�� �Cl'x!t c -'rv�� �4re- --) 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 : S L Date: PERMIT ISSUED FORMED POURED COMPLETED _,I j CITY OF WATERLOO i SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS M15 B1v�p S�cee-1+ ✓ _ g'?13 -25- 3346 - O PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ( No See reverse side for Defect Codes A-F `aU I See below for Defect Code G I TRIM VEGETATION t I ❑ Yes No � t WATER VALVE ADJUSTMENT REQUIRED _ ❑ Yes K No 1� PARKS DEPARTMENT REVIEW REQUIRED � No ❑Yes p)vg S f ree+ ._ LOCATION OF SIDEWALK )Front Yard ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ('5 DFeet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIREi ✓ .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: ' 23-1y '- PERMIT ISSUED FORMED POURED COMPLETED J CITY OF WATERLOO �( SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z,5 Cad Rr 9713 -26 - 229 - 007 / PARCEL CODE CONTROL NO. ,s, Type of Defect C \�q CLEAN SIDEWALK J See reverse side for Defect Codes A-F See below for Defect Code G C. ❑ Yes XNo .� ,TRIM VEGETATION ❑ Yes En No WATER VALVE d ADJUSTMENT REQ'D - _°- -1 Yes td No 14. 2 �e C ,a - PARKS DEPARTMENT REVIEW REQUIRED y — — ❑ Yes IX No 6„ y. arc LOCATION OF SIDEWALK O<FrontYard Side Yard ❑ Other WIDTH OF SIDEWALK 914 Feet ❑ 5 Feet ❑ 5.3 Feet Other .,I DEPTH OF SIDEWALK _�-Inches ,- ; 0 5 inches 6 inches AREA TO BE REPAIRED-- 2 sq.ft. 4 in. sq. ft. 5 in. 14 6�sq. ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches _I CODEG - Zxposeol a4g. clrs, co.lc„ kcL+ej as re4 �n� y "pcc —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 : RS LC— Date: PERMIT ISSUED i FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS )DO CONTROL NO. PARCEL CODE LEAN SIDEWALK Type of Defect LEAN El No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION El Yes El No WATER VALVE ADJUSTMENT REQUIRED VGL F 1-11-F 11 El Yes D No PARKS DEPARTMENT J REVIEW REQUIRED 36 El Yes 0 No Commerc.,al. 'Sllree�T Q LOCATION OF SIDEWALK KFront Yard El Side Yard Other WIDTH OF SIDEWALK -K4 Fe'et 0 5 Feet El 5.3 Feet '--,-,E_l Other DEPTH OF SIDEWALK X4,.inches F1 5 inches 06 inches jq,q 0 s AREA TO BE REPAIRED q. ft. 4 in. _sq.ft. 5 in. _sq.ft. -6 in. CODE F PATCHES El 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 je,5 cc Date: q PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 10D is 202 -M PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type ofDefect El Yes No See reverse side for-Defect Codes A-F See below for Defect"Code G TRIM VEGETATION El Yes XNO WATER VALVE ADJUSTMENT REQUIRED El Yes NrNo PARKS DEPARTMENT REVIEW REQUIRED \)m El Yes 'it cZn �No 1A x C A A \IN T All, A LOCATION OF SIDEWALK 0 Fro I nt Yard El Side Yard El Other WIDTH OF SIDEWALK Feet 0 5 Feet X5.3 Feet N D,Other DEPTH OF SIDEWALK El 4 inches El 5 inches 46 inchies AREA TO BE REPAIRED, f sq. ft. 4 in. -sq.ft. 5 in. 53 S''s 6 in. CODE F - PATCHES. ^Yes El No No. of Squares with P es CODE G NOTE:Areas marked with an "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? > L_ c' Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPER""' ADDRESS //$ Commercial S91 3 \-\26 -202 - 00 Ll PARCEL CODE CONTROL NO_ - \` CLEAN SIDEWALK Type of Defect y ),Yes ❑ No See reverse side f C Defect Codes A-F See below for Defect ode G TRIM VEGETATION \� ❑ Yes No i' WATER VALVE Pe„a �y g�x /� ADJUSTMENT REQUIRED N gar G ;1\ i ❑ Yes ❑ No I I _ PARKS DEPARTMENT ��rK+wg REVIEW REQUIRED Z5, 85' gyp} ❑ Yes No — C,0MPylErc,�� S rEEI LOCATION OF SIDEWALK Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK 4 Feet El5 Feet El5.3 Feet\ El Other DEPTH OF SIDEWALK ❑ 4 inches El5 inches nches s ft. 4 in. sq.ft. 5 in. Hqo 0 sq.ft. 6 in. AREA TO BE REPAIRED q� — 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 L.c— Date_ PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS AT/3 -2 ©&3 ✓ PARCEL CODE CONTROL NO. I '• i. CLEAN SIDEWALK Type of Defect A <: ' See reverse side for Defect Codes A-F D Yes 9No See below for Defect Code G TRIM VEGETATION ❑Yes -4 No J � WATER VALVE N ADJUSTMENT REQUIRED ❑Yes 'TA No I PARKS DEPARTMENT REVIEW REQUIRED j ❑Yes No COM�erG,Q� 5�-��e-F LOCATION OF SIDEWALK Front Yard D Side Yard ❑ Other WIDTH OF SIDEWALK p 4 Feet ❑ 5 Feet v. Feet -Rothe S 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 Q�XNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY LC_ Date: y-/`�- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 3o o 910 cK 9913 -2r,- 209 -007 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes �K No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes V No - o WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes K No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No Cornmereia\ ee� LOCATION OF SIDEWALK 9,FrontYard ❑ Side Yard 0 Other — WIDTH OF SIDEWALK ❑ 4 Feet El5 Feet ee Othe r DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches X6 inches AREA TO BE REPAIRED -20�� ✓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"I"' may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 1r25 L-e Date: PERMIT ISSUED ' FORMED POURED COMPLETED 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 301- 3oS C.,,,m e c.4 S f-,-eef ✓ 13 C661 ✓ PARCEL CODE CONTROL NO. 1 ;a _ 5.3 Type of Defect See reverse side for Defect Codes A-F ( \oo CLEAN SIDEWALK See below for Defect Code G a ❑ Yes XNo 1 ' I %49tj TRIM VEGETATION ❑Yes -K No d WATER VALVE ADJUSTMENT REQ'D 1 p ❑ Yes X No P RKS DEPARTMENT 1 R EW REQUIRED `C, I 1 es 1 No 1 3�v-;tz d LOCATION OF SIDEWALK (° Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet A5.3 Feet Other s•q l 1 DEPTH OF SIDEWALK (4 inches ❑ 5 inches f 6 inches L. 1q AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in:7—V-0-74'sq. ft. 6 in. CODE F - PATCHES ❑ Yes X1 No No.of Squares with Patches CODE G - NOTE :Areas marked with an"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 5 LL Date: PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3D z C D r C 0.1 S � r-ee-' /'3 g. $9�3 -,�� - Z o g -oat ✓ ��7, Q' �-__-�--" PARCEL CODE CONTROL NO. f CO Type of Defect A 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 ` N ADJUSTMENT REQ'D I . i V ❑ Yes 11 No _ J PARKS DEPARTMENT _ REVIEW REQUIRED a `,�y '° /% {' ❑Yes ] No C o m m d e i ce` S-) E:Le,+ LOCATION OF SIDEWALK Sj Front Yard t4 Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet 9,Other 6 .0 - DEPTH OF SIDEWALK X4 inches ❑ 5 inches 0 6 inches � s ft. 4 in. sq.ft. 5 in. sq.ft. in. t AREA TO BE REPAIRED - q• ✓� — CODE F - PATCHES .Yes ❑ No No. of Squares with Patch �—f CODE G - i NOTE:Areas marked with an"F" may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. E;5 L c- Date: FIRST INSPECTION AND FORM MADE BY : PERMIT ISSUED FORMED POURED COMPLETED J CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 3f� � PROPERTYADDRESS Co�,,�er�:0.l S free J $TI3 -26 - 209 - 003 ✓ �� PARCELCODE CONTROLNO. J CLEAN SIDEWALK Type of Defect C ❑ Yes KNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes 5(No J _ C_jATERLVE TATToo_s NT// EQUIRED /6 No PARKS DEPARTMENT REVIEW REQUIRED �.3 ❑ Yes 1�No �osiyi'� C� 6 JCaMr.�erc;at S+ree-+ LOCATION OF SIDEWALK K Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �5.3 Fe ❑ Other DEPTH OF SIDEWALK �\4 inches ❑ 5 inches ❑ 6 inches_______ AREA TO BE REPAIRED sq.ft. 4 in, sq.ft_ 5 in. Zu./ sq,ft:6 in. CODE F - PATCHES ❑ Yes D�No No. of Squares with Patches CODE G - �I NOTE:Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _I FIRST INSPECTION AND FORM MADE BY f'. 5 Lc Date: `I-!i/ l,-! PERMIT ISSUED —I FORMED POURED COMPLETED _I I I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 3Z5, - 8q►3 -.2(, -2Z7 - 000 r � PARCEL CODE CONTROL NO. Type of Defect A_}C--- CLEAN SIDEWALK _ See reverse side for Defect Codes A-F ❑ Yes KNo See below for Defect Code G I TRIM VEGETATION - -+- ❑ Yes KNo 0 WATER VALVE ADJUSTMENT REQ'D I ' 4 r M ❑ Yes XN0 _ PARKS DEPARTMENT s 0 =�� ,1 / i REVIEW REQUIRED _ ❑ Yes [i No p �l fay ` W.V. S�rv;C6 Co m M2f Gi q� S+reJ — LOCATION OF SIDEWALK 9 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Other DEPTH OF SIDEWALK KJ 4 inches ❑ 5 inches 14 6 inches — J o AREA TO BE REPAIRED �33 ? sq.ft. 4 in. sq.ft. 5 . 2 in. - sq.ft. 6 in. — CODE F - PATCHES ❑ Yes )KI No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED -" FORMED POURED COMPLETED i CITY OF WATERLOO 1�3 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -i 215 -Z.4 - 2 34 ! 244 PARCEL CODE CONTROL NO. Type of Defect A G _I See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes N No —, TRIM VEGETATION 1a� ❑Yes XIND WATER VALVE j'� r ADJUSTMENT REQ'D ❑ Yes k No fy t ` — �:fL� 2" l ,�• 'r PARKS DEPARTMENT rl VAULT4� AIL REVIEW REQUIRED — — - ❑ Yes �'No _ LOCATION OF SIDEWALK X Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet__-__❑ 5 Feet ❑ 5.3 Feet Other _ _I DEPTH OF SIDEWALK ,<4 inches LI 5 inches ❑ 6 inches r-- AREA TO BE REPAIRED-,= sq t} 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes JK No No.of Squares with Patches CODE G - --� NOTE:Areas marked with an"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: - MG 61- PERMIT ISSUED FORMED POURED 1 COMPLETED _I CITY OF %IVATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS GONTROL NO_ PARCELCODE Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes IA No See below for Defect Code G TRIM VEGETATION 10.,5-s 0Yes [�No WATER VALVE CP ADJUSTMENT REQ'D LP El Yes 2f No PARKS DEPARTMENT REVIEW REQUIRED 0 Yes VAO 1-1 tL /491 2.' 0 Wtx-r 4-ef Front Yard Side Yard El Other Z7 x LOCATION OF SIDEWALK 0 \ 24 XOther WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet El 5.3 Feet ,-143- " 0 5 inches 06 inches '7.lr DEPTH OF SIDEWALK 94 inches sq 4 sq-ft- 5 in. s_q-it- 66 1 in.TO BE REPAIRED sq._ft- 4 in-. _sq.it. 5 in. sq.ft. S s with s 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. Date: �/-/�;--/Z/ FIRST INSPECTIONAND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESSZ57a03rn�n� l - PARCEL CODE CONTRDL NO_ •J Type of Defect e 3 �'' + CLEAN SIDEWALK See reverse side for Defect Codes A-F" ❑ Yes 1S'No See below for Defect Codp_-6 TRIM VEGETATION E S COs ,r�a \ ❑Yes J�/No Sf �,r 21 WATER VALVE ADJUSTMENT REQ'D ❑ Yes IP"No PARKS DEPARTMENT g,o REVIEW REQUIRED ❑Yes ONo j LOCATION OF SIDEWALK ❑ Front Yard XSide Yard Id"'Other _I WIDTH OF SIDEWALK ❑"4 Feet__- 70 5 Feet ❑-5.3 Feet .Other _ DEPTH OF SIDEWALK [94 inches ❑ 54nches ;' X6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ff. 5,in. '17 G sq.ft. 6 in. —.� CODE F - PATCHES ❑Yes JK No No.of Squares with Patches CODE G I;bz- ?M 4 5-61MZ �, Z y NOTE:Areas marked with an"I"'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRSTINSPECTION AND FORM MADE BY : S Date: J3-z •)q PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS !(QZZ R7r3 -z(-- 233 - 0103 ✓ 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 \. I ❑Yes 'I No _ WATER VALVE ADJUSTMENT REQUIRED o�s ❑Yes No PARS REVIEW REQU I REDNT �rC7 ❑Yes No C�°s '` VII — LOCATION OF SIDEWALK A Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet .&Other DEPTH OF SIDEWALK zxZ4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAI D Z 8.5 ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 9,No No.of Squares with Patches CODE G - NOTE :.Areas,marked with an"F'may be repaired by patching.All other areas shall be repaired by _I reconstruction of full sidewalk panels. K 5 L.L Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED — — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 728 C o m,-\ercta,l Sfree_ - 9713 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 K No TRIM VEGETATION ❑ Yes -�Q No WATER VALVE ADJUSTMENTREQ'D F ❑ Yes �1 No � v PARKS DEPARTMENT REVIEW REQUIRED _ bNo LOCATION OF SIDEWALK ❑ Front Yard ;Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet _-91 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches — ( i AREA TO BE REPAIRED �1 s 1.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 R-S L C_ Date: -- PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS WO'I- 30G Co,,,r erc,'al S+reel $Q 13 - - .sb -00 t ',, -21"-1 6 PA\EL CONTROL NO. Type of D CLEAN SIDEWALK See reverefect Codes A-FSee belowode G ❑ Yes iNo jTRIM VEGETATION / V� ❑Yes KNO �[ 4- WATER VALVE ADJUSTMENT REQ'D 21Yes ❑ No �RoTN PARKS DEPARTMENT o '� H REVIEW REQUIRED 1 +5, ElYes 1!�No 7 lO ConnpAeC6cxk S +reed /BREPAIRED SIDEW LK Front Yard El Yard Other W LK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other WALK �14 inches ❑ 5 inches .�7 6 Inc es EPAIRED � �• s'q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 1CHES LI Yes ❑ No No.of Squares with Patches ---�- NOTE:Areas marked with an"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 X-C_ Date: q-18 -19 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS TOO Caws m e rc,Q ( S f reei 8 d 3 -25 - )57 - 00 1 -7,7,-1 PARCEL CODE CONTROL NO. - Type Defect /4_G — CLEAN SIDEWALK See reve se side for Defect Codes A-F �G� f j ❑ YesNo See belo for Defect Code G a + v TRIM VEGETATION 33,' � ❑Yes czno Qaz N.AI, -� 4- WATER VALVE — 5D ADJUSTMENT REQ'D I -- aYes ❑ No f I Q n,,ssR A C.I.� a PARKS DEPARTMENT i( o 5•►' g,/p` IS 5,a2 0+25:( i�t;5� REVIEW REQUIRED — f ❑Yes I No g43.6 Cc,r4 +al .S reed _ LOCATION OF SIDEWALK%❑ Front Yard 1 Si e Yard ❑ Other — WID/FHE ❑ 4 Feet ❑ 5 Feet i q5.3 Feet I�Other �_ DEP 1� 4 inches ❑ 5 inch J46 inches — ARE 3�0`J sq.ft. 4 in. s ft. 5 in. 11244.9 sq.ft. 6 in. — COD '/Yes ' No No.of Squ res with Patches CODl�� — NOTE:Areas marked with an"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-(B-I`I ' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `�I l Cc m eAerci cL S Tree f _ F713 -25 153 - 006 ✓ 6:�.." 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 Al I ❑ Yes CW No -} WATER VALVE ADJUSTMENT REQUIRED 1 N ❑ Yes L�No 4 13Z't' 1 i w PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes P�No 1 I 1 c 0 M nne.re%0A Sfcee� LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet Other .y 1 DEPTH OF SIDEWALK �Q 4 inc es ❑ 5 inches ❑ 6 inches AREA TO BE REPAI sq. ft. 4 in. sq. ft. 5 in. sq.ft. 6 in r 1 CODE F - PATCHES ❑Yes 1 1�fNo No. of Squares with Patches i 1 CODE G - J, NOTE :Areas marked with an"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 1 FORMED POURED COMPLETED i i i i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - 1 PROPERTY ADDRESS /000 Qtoc,K Cow merecJ S�re.e_+ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes g No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes l No �i WATER VALVE ADJUSTMENT REQUIRED _ N VaCa � ❑ Yes No I Lo I I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes XNo LOCATION OF SIDEWALK -1 Front Yard ❑ Side Yard ❑ Other - - WIDTH OF SIDEWALK ❑Feet-� ❑ 5 Feet �' C5.3 Feet' El Other DEPTH OF SIDEWALK / �4 inches i ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED �-7-0q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes XNo No. of Squares with Patches CODE G - — NOTE :Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY C Date: If 2 f-1 Y -- PERMIT ISSUED — FORMED POURED COMPLETED -I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /000 61 oGI< Co m merc' Sf reei- i 9113 - ZS'- 15y - 611 ✓ "= ate PARCEL CODE CONTROL NO. CLEAN SIDEWALK k Type of Defect A ❑Yes �4-No See reverse side for Defect Codes A-F r` I See below for Defect Code G \ I TRIM VEGETATION Ji I I ❑Yes �No WATER VALVE ADJUSTMENT REQUIRED Lo4- ❑Yes NNo I PARKS DEPARTMENT REVIEW REQUIRED ci ❑ Yes -dNo J � J C O van van e r c CaA S j-r C e} LOCATION OF SIDEWALK )4 Front Yard ❑ Side Yard ❑ Other J - WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet F!<-fOth r S- DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 6 inc es AREA TO BE REPAIRED sq. ft. 4 in. sq.ft. 5 i 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 : 2g L Date: '4-21-iq PERMIT ISSUED FORMED POURED COMPLETED I r — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS lDns CawlvnP�@1a1 �S� reef '� gq 13 -2S - 10 - 00 8 ✓ f PARCEL CODE CONTROL NO_ Type of Defect C, CLEAN SIDEWALK — See reverse side for Defect Codes A-F -qj ❑ Yes No See below for Defect Code G TRIM VEGETATION El Yes No � l L v WATER VALVE ADJUSTMENT REQ'D ❑ Yes J�No q'11 x ILA a PARKS DEPARTMENT — REVIEW REQUIRED —� ❑ Yes KNO S+fee - LOCATION OF SIDEWALK ❑ Front Yardl Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑ 5.3 Feet 'RLOther z DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches inches J AREA TO BE REPAIRED- sq.ft.14in. sq.�ft. 5 in. -53.2 s 6 in. — CODE F - PATCHES El Yes [(No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. p FIRST INSPECTION AND FORM MADE BY L �— Date: 4-4?I PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS )0Z9 C o m me '6CL, .S1 )sy -Co7 '� Z, PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-FNo -' See below for Defect Code G ❑ Yes 1� l _- .� �I TRIM VEGETATION I ❑Yes No S: WA` - ADJUSTMENT TER E REQ'D ❑ Yes YNo sl I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes _KNo —I —I Co►r►'�w�.e�cf0.� S'�►�e e.� LOCATION OF SIDEWALK 2�-FrontYard ❑ Side Yard ❑Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet metOth r `� DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches �6 inch s AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ff. 6 in. CODE F - PATCHES ❑ Yes IS No No.of Squares with Patches _ CODE G - —I NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. S_ C�) FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTYADDRESS a9ti3 - z 5_ 155 60`l ✓ u PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK '- See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes No TRIM VEGETATION e cam. El Yes NfNo 0.cCkAt s WATER VALVE L c7; ADJUSTMENT REQ'D ❑ Yes X No -- o�a- PARKS DEPARTMENT s,3 ` REVIEW REQUIRED - - — — — ❑Yes No I L) CC)VV\wley-c Iak SFie2} — LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 1�1 ter S y _DEPTH OF SIDEWAL IZ4 inches � 5 inches El inches AREA TO BE REPAIR s 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes 14No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. ,r FIRST INSPECTION AND FORM MADE BY : RS L c Date: 4-2 PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS //DO NOCKC C O M MC-C )MI Sfre e{ PARCEL CODE CONTROL NO. 1 Type of Defect CLEAN SIDEWALK 6 ❑Yes `.� No 1 - See reverse side for Defect Codes A-F See below for Defect Code G � TRIM VEGETATION 1 ❑Yes F<T No WATER VALVE ADJUSTMENT REQUIRED G AghG ❑ Yes 9 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No 1 Co'Amerc1aJ Sfreet LOCATION OF SIDEWALK L'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet /3 Feet)O Other J, DEPTH OF SIDEWALK 'lI 4 inches ❑ 5 inc ❑ 6 inches AREA TO BE REPAIRED 2S y-q. ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - .1 NOTE:Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY L Date: 1 PERMIT ISSUED 1 FORMED POURED COMPLETED i i CITY OF WA T ERLOO I SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 11D3 In' Z`�O PARCEL CODE CON ROL NO_ - Type of Defect G CLEAN SIDEWALK -- M�I� See reverse side for Defect Codes A-F ❑Yes Irmo 4�7ifl,LZ_t See below for Defect Code G — ,� TRIM VEGETATION r` El es Flo L !� WATER VALVE ADJUSTMENT REQ'D ❑Yes IXNo — PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes 91`40 LOCATION OF SIDEWALK XFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet `�5.3 Feet' Other— _ — DEPTH OF SIDEWALK inches El5 inches El 6 inches AREATO BE REPAIRED— sq.ft. 4 in. sq.ft. 5 in. sq.ff. 6 in. — CODE F - PATCHES ❑Yes 20No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Date:L-�- FIRST INSPECTION AND FORM MADE BY : 7 PERMIT ISSUED FORMED POURED COMPLETED J CITY OF WATERLOO J SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ) 1 Z ti $913 -ZS - 165 PARCEL CODE CONTROL NO. —1 CLEAN SIDEWALK Type of Defect A ❑ Yes 9 No See reverse side for Defect Codes A-F ,o " See below for Defect Code G TRIM VEGETATION b � El Yes [5 No WATER VALVE ADJUSTMENT REQUIRED CA2 Gc N El Yes ONO PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No q.5 � They 11ad the w;,,rete I Cannr�terc�a� ,Street- +r,xK dr;ve �re, J. io-zs y LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK El Feet <-El Feet ❑ 5.3 Feet ther �- y DEPTH OF SIDEWALK 1?_(_4 inches ❑ 5 inches ❑ 6 Tinc es AREA TO BE REPAIRED 53.5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. "1 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. n FIRST INSPECTION AND FORM MADE BY : 2s L L Date: N Z f y PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS ��� C'o s,�� rs� f5_ PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK —' See below for Defect Code G ❑ Yes [> to �f1 `' TRIM VEGETATION — �� ❑ Yes XNo WATER VALVE ADJUSTMENT REQ'D ❑ Yes A No — PARKS DEPARTMENT — A REVIEW REQUIRED ❑ Yes , WNO Aso• — T. — LOCATION OF SIDEWALK ❑ Front Yard (Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 3 Fee El Other DEPTH OF SIDEWALK 4in�e ❑ 5 inches El inches AREA TO BE REPAIRED 24•S q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes J! IlNo No. of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 1-6 Date: ` PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS !ZOO COmme(c,'d Z5- 30 - oo 1 PARCEL CODE CONTROL NO. j Type of Defect CLEAN SIDEWALK See reverse a for Defect Codes A-F ❑ Yes [<No See below for feet Code G TRIM VEGETATION J ❑ Yes C4 No 0 N WATER VALVE W jy ADJUSTMENT REQ'D X Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED J _ ❑ Yes 0 No I d rvifv►er LOCATION OF SIDEWALK ❑ Fr t Yard J4 Side Yard ❑ her _ _I WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet A5.3 Feet Other DEPTH OF SIDEWALK ;9.4 inches ❑ 5 inches ❑ 6 inc s 1, AREA TO BE REPAIR sq.ft. 4 in. — sq.ft. 5 in. — s ft. 6 in. CODE F - PATCHE ❑ Yes No No. of Squares with Patches '=9 CODE G - NOTE:Areas marked with an"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: i 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 61k- G'�1t1J�7c, 01?13 -zs-3zf -0lr Zy i PARCEL CODE CONTROL NO. Type of Defect � CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes [k No TRIM VEGETATION -" ❑ Yes WNo WATER VALVE ADJUSTMENT REQ'D P0,J) ❑ Yes XNo _ c z o� vj PARKS DEPARTMENT t REVIEW REQUIRED — �d: 3 _ El Yes L� No LOCATION OF SIDEWAL K Xr Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet----:, ❑ 5.3 Feet Z-0t46r DEPTH OF SIDEWALK r'>_4 n s PX5 inches El 6 inches �Z t AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. z=- sq.ft. 6 in. CODE F - PATCHES ❑ Yes X No No. of Squares with Ptches CODE G -NOTE:Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : , LL Date: PERMIT ISSUED _ FORMED POURED COMPLETED -� CITY OF WATERLOO -� SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'b/k Jl $q(3 -25 - 331 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect F ❑Yes 5<No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes AN J WATER VALVE V f ADJUSTMENT REQUIRED ...1 C�CQ�,�` Lo I l�o y ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes VNo onn�nercici� S'�( e2� LOCATION OF SIDEWALK KFrontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1<5.3 Feet ❑ Other DEPTH OF SIDEWALK lg4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 1,2(Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY R S LC_ Date: _N-2( -Iq PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS /3Z 1 C o m m eir6cd Sfii ee l 8�f3 -ZS - 3Z� - aIZ � PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ee- �E N0 See reverse side for Defect Codes A-F r�`" See below for Defect Code G TRIM VEGETATION J Yes ❑ No _ WATER VALVE 'j} ADJUSTMENT REQUIRED oz ❑ Yes ❑ No r PARKS DEPARTMENT at,_� fit. REVIEW REQUIRED ❑ Yes ❑ No — — ` — Z�>'i' C 6 w,r rv►e f e i a� S-�Y'ee�' '- LOCATION OF SIDEWALK P5,Fre,nt Yard ❑ Side Ward ❑ Other _ WIDTH OF SIDEWALK Er4 Feet ❑ 5 Feet � 5.3 Fe OcOthe+-- � DEPTH OF SIDEWALK/ 9 4 inches ❑ 5 inches ❑ 6 inches _ 13�.2 AREA TO BE REPAIRED sq,ft. 4 in. sq.ft. 5,in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No. of Squares Patches CODE 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 : RS LC_ Date: Lf PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �✓3� Cyy��IiG b'9/3 -2s- -331 PARCEL CODE CONTROL NO. Type of Defect / G CLEAN SIDEWALK - See reverse side for Defect Codes A-F ❑ Yes ;<No -' See below for Defect Code G TRIM VEGETATION . 1� �11 ❑ Yes JX/No WATER VALVE a ADJUSTMENT REQ'D �? O V�, 010 61 :� ❑ Yes X No e �`� ®z PARKS DEPARTMENT REVIEW REQUIRED El Yes ,X"No V� G LOCATION OF SIDEWALK Front Yard NMde Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet k5::Fe ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 94 inches ❑ 5 inches Rl`6 inches AREA TO BE REPAIRED sq. ft. 4 in. sq. ft. 5`'in. 3y U sq."fi 6=in: CODE F - PATCHES ❑ Yes Kl No No. of Squares with Patches ! j - CODE G - NOTE : Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. L FIRST INSPECTION AND FORM MADE BY '�s Date: do PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM Hoo a1OC.K PROPERTYADDRESS I 0 �� Co w�w� e,�c+a Siree+ $9'13 -zs -332 - ot2 � 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 'S�No WATER VALVE ! ADJUSTMENT REQUIRED .— U0.Ca+n'1" El Yes ` �No I L o } -;'FA { yo I PARKS DEPARTMENT I lf' 0.�s REVIEW REQUIRED b.1 c�"ra ►��`;�. El Yes No C o MvMe r Ci 0.\ eA- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _ i�WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet J�Otlier — DEPTH OF SIDEWALK :' )\4 inches El inches El 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 : Z S LC- Date: '{-Z i-1 1 _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS- i q o(. - I q to C ommev--1,cL 5�ree+ 6913 -Z.S -33y - oo I s _I PARCEL CODE- �l CONTROL NO. e`.r- i \n,a2ya�� Type of Defect C�— yc;: ae���a LEAN SIDEWALK _I See reverse side for Defect Codes A-F See below for Defect Code G h ❑ Yes No TRIM VEGETATION 5 a V) ❑ Yes --RrNo " s s WATER VALVE O ADJUSTMENT REQ'D El Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes T.No 5 �'wtif'e LOCATION OF SIDEWALK AFront Yard N,SideYard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet '�5.3 Feet �4 OtherC`� r —I DEPTH OF SIDEWALK 4 inches ❑5 inches -&,6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 4JI-2#sq ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - —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: ZS-1 _f PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS l l2a CoM.tit e rc;q l 51r e e f 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 TRIM VEGETATION I ❑ Yes No WATER VALVE .� 2j,l' ADJUSTMENT REQUIRED — ❑ Yes No PARKS DEPARTMENT '- REVIEW REQUIRED ❑ Yes fTNo coM(A2rC) STree LOCATION OF SIDEWALK [X Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 3 F ❑ Other DEPTH OF SIDEWALK4.inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED q.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Yes VNo No.of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S C-- Date: PERMIT ISSUED _ FORMED POURED COMPLETED i -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ) ` ,? I Commer,;af 5}reef 3 t13 -ZS - 33Z - of y �l� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes N o j G_ See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes �.No WATER VALVE �p ADJUSTMENT REQUIRED 1 Q ❑Yes ` I'No o I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No VA i �oN\'y�ercia.� S�rceT LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK E'4 Feet ❑ 5 Feet ❑ 5.3 Feet Otj7K r 1 DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES` ❑ Yes &No No. of Squares with Patches _ CODE G - 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 : 2 Date: y-Z1 -►�{ PERMIT ISSUED -y FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS NO?- Co.Hn erc is S re�7 ✓ i — $c(4,3 25 - 3.3 -ooS ✓ ? '`,,_PARCEL CODE CONTROL NO. — , \ 1 CLEAN SIDEWALK Type of Def t ❑ Yes No — See reverse sib e for Defect Codes A-F See below for Defect Code G 'rJ� TRIM VEGETATION �'1 I ❑ Yes CKNo — '( WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No � 1 � PARKS DEPARTMENT — '`, REVIEVREQUIRED ❑Yes No ('®►M.herrtaf Spree- — LOCATION OF SIDEWALK KFrontYard ❑ Side Yard 0 Other — WIDTH OF SIDEWALK El4 Feet El5 Feet 5.3 Feet ElOther i" DEPTH OF�SIDEWALK CC4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED �� sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — COD�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 : _ KS L- C-- Date: L(-2 3-1V — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM �-3 D PROPERTY ADDRESS C orn per g� S�ree� 1 � 9113 -25- 33y - ©07 }t> PARCEL CODE CONTROL NO. 1 . Type of efect A IC— CLEAN SIDEWALK 1 See rever side for Defect Codes,A F ❑ Yes No See below f Defect Code G �w TRIM VEGETATION 1kA ❑ Yes XNo i d 1 w WATER VALVE Jf' iE ADJUSTMENT REQ'D l ❑Yes P�No 1 i �j G u A(ZIP D a G PARKS DEPARTMENT 1 REVIEW REQUIRED ` 1 5m — .5�,o' 1a3' ❑ Yes )RrNo 1 1 LOCATION OF SID ALK ❑ Front Yard IfSide rd ❑ Other WIDTH OF SID ALK ❑ 4 Feet ❑ 5 Feet 3 Feet ❑Other 1 DEPTH OF S EWALK 54 4 inches ❑ 5 inches ❑ 6 inches V� AREA TO E REPAIRED L 3•40 sq.ft. 4 in. sq.ft. in. sq.ft. 6 in. 1 CODE F - PATCHES ❑ Yes C(No No.of Squares ith Patches CODE G - J. NOTE:Areas marked with an"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 GS, Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 15-00 �,7k C© CrGiu 1 Si- 8�t3 -25 -3�5 - o ►S ; PARCEL CODE CONTROL N0. A e Type of Defect F See reverse side for Defect Codes A-F CLEAN SIDEWALK _ See below for Defect Code G Q o �, ❑ Yes 9� No TRIM VEGETATION ❑ Yes 9 No V WATER VALVE La ^' ADJUSTMENT REQ'D r� ❑ Yes q No a= PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes K No Commercio�k Sir ee.A- LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet E15.3 Feet Y1 Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED' / Z sq.ft. 4 in. sq.ft. S in. sq.ft. 6 in. CODE F - PATCHES FA Yes IKNo No.of Squares with Patches CODE G -NOTE:Areas maimed with an "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 �-C— Date: t4 -Z s't4 — PERMIT ISSUED _ FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS moo (6(oc,K Co Nnn�erc�al S{re2{ F-1 3`,' 2 5 - 33-7 - 0 13 / 1 r' PARCEL CODE CONTROL NO. r CLEAN SIDEWALK Type of Defect A p Yes K No See reverse sides-for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes R No WATER VALVE ADJUSTMENT REQUIRED �] GAR �' ❑Yes N No PARKS DEPARTMENT REVIEW REQUIRED l ' ❑Yes AND CD AnY"2u C10.( SfreJ LOCATION OF SIDEWALK t4 Front Yard ❑ Side Yard ❑ Other,. WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -45.3 Feet ❑ Other _ J DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches N'6 inches Y*�F AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 4 71 sq.ft. 6 in. CODE F - PATCHES El Yes tK-No No. of Squares with Patches CODE G - _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 : fu Date: _I PERMIT ISSUED ') FORMED POURED COMPLETED I I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 17,90 61 tnt,�Gr / 57, 3 -zs- its I - Cxa 3z.c� 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 J�(No Col, TRIM VEGETATION _ `v h ❑Yes XN.o t" WATER VALVE ADJUSTMENT REQ'D El Yes EX/No PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes JX/No G�JI�ltne7ZGt/?G '- LOCATION OF SIDEWALK NC Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Fe ❑ Other DEPTH OF SIDEWALK LX4 incites ❑ 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 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 1'tI6 Date: YtiG �-�s'>� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I7ee Gornm111,111- -- 327 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 10,50 `t N ❑Yes K No I PARKS DEPARTMENT REVIEW REQUIRED - ❑Yes P(No 4 F LOCATION OF SIDEWALK X Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet eet1 Oth r I DEPTH OF SIDEWALK 94 inches ❑ 5 inches ❑ 6 inches = =_. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq� CODE F - PATCHES IrYes ❑ No No. of Squares with Patches CODE G - �I NOTE .Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by —I reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY �� Date: ,2S_I� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'S PARCEL CODE CONTROL No. CLEAN SIDEWALK Type of Defect 14 ❑Yes N1 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes �U No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ANo _ PARKS DEPARTMENT REVIEW REQUIRED '- ❑ Yes Pi No ,5.0 _ LOCATION OF SIDEWALK `Front Yard ❑ Side Yard E Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet a 5.3 Fe t ❑ Other DEPTH OF SIDEWALK 4 inched ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z Cr- ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes RNo No. of Squares with Patches _ CODE G - NOTE:Areas marked with an"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 Date: •Z5-jq PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4,yycra)/i PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Q No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes ,9 No WATER VALVE 1Q,3o�� ADJUSTMENT REQUIRED ❑Yes k9-No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes .l�Ao A LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -) Feet -MOth r `1 DEPTH OF SIDEWALK, )�'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED s q ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. '��- 4 J CODE F - PATCHES ❑ Yes WIN No.of Squares with Patches _ CODE G - NOTE :Areas marked with an"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 t7 22 ,5"2113 -LS`!{5j PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ' ❑ Yes Oa No See reverse side for Defect Codes A-F See below for Defect Code G CX TRIM VEGETATION ❑ Yes t No 0��` WATER VALVE EST CIJ ADJUSTMENT REQUIRED — N �,Eev:ems ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Jf i No A — lei �w — Covr�rYlEtzG�i. s�. �' LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet _X2 Feet -0 Othe- ��4 �) DEPTH OF SIDEWALK X'4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED ��fi.�? " 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 VC, Date: 5,1 PERMIT ISSUED — FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 89i3 -25` Y55- -0Qy ✓ � PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect L ❑Yes XNo 1 See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION p to, I ❑ Yes X No �e WATER VALVE J ADJUSTMENT REQUIRED 1 N ❑ Yes I No PARKS DEPARTMENT 1 REVIEW REQUIRED ❑ Yes XNo LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑ 4 Fe _�<5 Feet ❑ Other 1 DEPTH OF SIDEWALK.' ,1k4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED -4!i sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 1 CODE F - PATCHES ❑ Yes lz9.No No. of Squares with Patches _— CODE G - y NOTE :Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED i T CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS / 5 _ 0,V3 337 PARCEL CODE CONTROL NO. - Type of Defect 1q, CLEAN SIDEWALK — See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes No TRIM VEGETATION ❑ Yes lid`No IJ WATER VALVE ADJUSTMENT REQ'D ❑ Yes [9 No t _ PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes [&No Na 5/cam LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet X Oth r 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 ONO No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : SN 8S Date: `1--25"-& '- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ur a6e, 0913 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A ❑Yes X NO See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 9/No WATER VALVE ADJUSTMENT REQUIRED ]� r ' l�i�Gi4111 i Lv? ❑Yes No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes XNo LOCATION OF SIDEWALK PTFrontYard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (:k:5.3 Fe ❑ Other — DEPTH OF SIDEWALK ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ft• 4 in• sq•ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes J-10 No No. of Squares with Patches _ IV 7cS �r l .44116'a �P�1 w OK,�Y �i�6� Ta W2&y6- NOTE :Areas marked with an"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 —I FORMED POURED COMPLETED i CITY OF WATERLOO i SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9 f U)r,A - A V e 810 - aG - 97>- 00 q PARCEL CODE : CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes �d No See reverse side for Defect Codes A-F i I See below for Defect Code G TRIM VEGETATION [I Yes No WATER VALVE ADJUSTMENT REQUIRED _ N ❑ Yes » No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes J&NO P G VC, _ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ Other DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches _ Ff. AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes [9 No No. of Squares with Patches CODE G - i i NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by j reconstruction of full sidewalk panels. i FIRST INSPECTION AND FORM MADE BY -pq ri� Date: '1-17 -Iq _ PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' yq UceAA*- Ave- 1 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK 1. t See reverse side for Defect Codes A-F ❑Yes ;�FNo See below for Defect Code G 1 �l e TRIM VEGETATION L' ❑Yes &No 1 r WATER VALVE + ADJUSTMENT REQ'D ❑ Yes No 1 � PARKS DEPARTMENT REVIEW REQUIRED ❑Yes J4 No 1 1 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ---❑ 5 Feet 5.3 Fe t ❑ Other _ DEPTH OF SIDEWALK K4 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 9 No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY _DF Date: PERMIT ISSUED �' FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS I0d3-1603 k- Glwj- 9113 - a6 - 976) - 0/2 ro PARCEL CODE' OZ,� CONTROL NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes �K No TRIM VEGETATION — �� ❑ Yes jx] No ' N WATER VALVE ADJUSTMENT REQ'D ❑ Yes No PARKS DEPARTMENT '�1 �� •1 REVIEW REQUIRED — `� 14 Yes ❑ No LOCATION OF SIDEWALK )�I Front Yard Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK %4 inch s ❑ 5 inches 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 i Z6'0 a ft. 6 in. — CODE F - PATCHES El Yes [ ( No No. of Squares wi ches CODE G - — NOTE:Areas marked with an"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: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS P CONTROL NO. PARCEL CODE CLEAN SIDEWALK -Type of Defect El Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes C4,No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ;.No PARKS DEPARTMENT o,c i REVIEW REQUIRED Yes ElNo G R A LOCATION OF SIDEWALK V�FrontYard ❑ Side Yard ❑ Other _ er ��y WIDTH OF SIDEWALK El Feet El Feet Feet DEPTH OF SIDEWALK l 4 inches '' ❑ 5 inches ❑ 6 inches AREATO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. q --� CODE F - PATCHES ❑Yes � No No.of Squares with Patches _ CODE G J NOTE--Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. s_'� FIRST INSPECTION AND FORM MADE BY T Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS r`��� A vc PARCEL CODE s CONTROL NO_ _ C M Type of Defect ,o CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G El Yes ( No lQ `J N7� TRIM VEGETATION ❑ Yes 0 No a N WATER VALVE ADJUSTMENT REQ'D ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes ❑ No a1c. r` LOCATION OF SIDEWALK [X Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK IA 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 : D Q d-- -r2F Date: y lG"j PERMIT ISSUED _ FORMED POURED COMPLETED -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO_ L fit }Os Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ( ❑ Yes P�:No 4 TRIM VEGETATION ❑ Yes Di No YI 4z N Q WATER VALVE ADJUSTMENT REQ'D ❑Yes &t% PARKS DEPARTMENT REVIEW REQUIRED 0 �. 'fir _ Yes ❑ No I J LOCATION OF SIDEWALK IgFrontYard �T Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet motet _3 Feet ❑ Other DEPTH OF SIDEWAL ,94 inche ❑ 5 inches ❑ 6 inches AREATO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ff. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches /t'd --� NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY `tS Date: i6-14 -� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /lOS AV, _ 0(� ra PARCEL CODE CONTROL NO_ fA Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F k See below for Defect Code G ( ❑Yes k No r r TRIM VEGETATION — 9Yes ` No WATER VALVE � J l ADJUSTMENT REQ'D F. ❑Yes (No — PARKS DEPARTMENT REVIEW REQUIRED -.� El Yes ,1�No G LOCATION OF SIDEWALK 0 Front Yard Side Yard _D ,ther WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet �5.3 Feef/ ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIREDl $ 7 sq.fL 4 in. sq.ft. 5 in. sq.fE. 6 in. — CODE F - PATCHES Yes ❑ No No.of Squares with Patches 1 — CODE G - 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 : 12 Tj5 Date: Y-,a2`/y PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Ifq3 GV&A-�, AVe- - PARCEL CODE" CONTROL NO. xx CLEAN SIDEWALK Type of Defect /t ❑ Yes 2 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes Q No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No KIA _I 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 -1 AREA TO BE REPAIRED,. a7.ca sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes [A No No. of Squares with Patches — i I CODE G - _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: �' ��-�� PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 115-1 foj,Arty- 1,1C­ — PARCEL CODE,' CONTROL NO. Type of Defect G CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes No TRIM VEGETATION 0 ❑ Yes J4 No WATER VALVE ADJUSTMENT REQ'D ❑Yes No — PARKS DEPARTMENT REVIEW REQUIRED g Yes ❑ No LOCATION OF SIDEWALK ❑ Front Yard (�Side Yard--- E] Other ' WIDTH OF SIDEWALK ❑ Feet ❑ 5 Feet j ICI 5.3 et ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED_ IIN 0 q ft. 4 in. sq.ft. 5 in. sq.ft. 6 in_ — CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE.Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D 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 ❑Yes �S No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 4N No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes �No LOCATION OF SIDEWALK p Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK El Feet El Feet d�5.3DFee ❑ Other DEPTH OF SIDEWALK T�l 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED s ft. 4 in. sq.ft. 5 in. sq. . 6 in. �`� q- ft. CODE F - PATCHES ❑Yes V3 No No.of Squares with Patches _ CODE G i ( NOTE .Areas marked with an"F may be repaired by patching.All other areas shall be repaired by —j reconstruction of full sidewalk panels. hh FIRST INSPECTION AND FORM MADE BY : �l`j i�jZY�7 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ 1 3-� PROPERTY ADDRESS- PARCEL �3 � CODE = CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes PNo See reverse side for Defect Codes A-F 3 See below for Defect Code G �a TRIM VEGETATION ❑ Yes 9 No WATER VALVE ADJUSTMENT REQUIRED _ N ❑ Yes 1F 1 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes [�I,No 9 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet P75-3�Feet EJ'Othe ' DEPTH OF SIDEWALK= l 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 ® No No. of Squares with Patches CODE G - 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: Zk PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE a CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes n No -L3 WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes f 7 No �oJr LOCATION OF SIDEWALK fp Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑ 4 Feet El5 Feet (9 5.3 Fe ❑ Other DEPTH OF SIDEWALK lii 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -.� CODE F - PATCHES ❑ Yes l No No.of Squares with Patches CODE G - i ' NOTE:Areas marked with an F y re" may be aired by patching_All other areas shall be repaired by P —I reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY Dater —1 l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -. i PROPERTY ADDRESS ( A-W 5- Jv\ F PARCEL CODE - CONTROL NO. Type of Defect ' See reverse side for Defect Codes A-F CLEAN SIDEWALK _ See below for Defect Code G ❑ Yes [F ]No TRIM VEGETATION ❑ Yes Il No t 7r N j WATER VALVE ,4z! ADJUSTMENT REQ'D ❑Yes Q No PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes No LOCATION OF SIDEWALK ❑ Front Yard 1�9 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �� 35 F et ❑ Other f DEPTH OF SIDEWALK ❑ 4 inches 5 inch ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: "(> PERMIT ISSUED _ FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Flo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION El Yes ESI--No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes Cd No I I PARKS DEPARTMENT REVIEW REQUIRED PYes ❑ No V:p LOCATION OF SIDEWALK ipFrontYard ❑ Side Yard Other 1 WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Fee ❑ Other — DEPTH OF SIDEWALK inches El inches El inches AREA TO BE REPAIR `�5 ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes V7 No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 31� �� Date:PERMIT ISSUED ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS' �- 39 - PARCEL CODE r CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F _. See below for Defect Code G I ❑ Yes 9--No 't� I TRIM VEGETATION to ❑ Yes L5�No N WATER VALVE — ADJUSTMENT REQ'D ❑ Yes �T-No I — �e PARKS DEPARTMENT o�$L REVIEW REQUIRED ❑ Yes Flo LOCATION OF SIDEWALK ❑ Front Yard �Side Yard ether, — WIDTH OF SIDEWALK ❑ 4 El5 Feet ' : E] Fe ❑ Other 1 DEPTH OF SIDEWALK � IgC4 inches ❑ 5 in 6 inches AREA TO BE REPAIRED ` q. ft. 4 in. sq. ft. 5 in. l sq.ft. 6 in. CODE F - PATCHES es V�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 : S Date: -�� 4- PERMIT ISSUED FORMED POURED COMPLETED i -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' 0---{, -z( - (09- o � 3 PARCEL CODE CONTROL NO. �1 CLEAN SIDEWALK I "> Type of Defect ❑Yes El,,No v See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I' ► I ❑Yes C�LNo p WATER VALVE ADJUSTMENT REQUIRED N ❑Yes C�-No 1 I PARKS DEPARTMENT REVIEW REQUIRED e [' Yes ❑ No X LOCATION OF SIDEWALK �9 Front Yard ❑ Side Yard ❑ Other J WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet �5_ F ❑ 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 �T No No. of Squares with Patches CODE G - --1 NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY7 Date: ([,o—1 —I - PERMIT ISSUED --I FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS Z I �3 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 I ❑ Yes F No WATER VALVE j 6J ADJUSTMENT REQUIRED ❑ Yes E�,No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes la No LOCATION OF SIDEWALK [,g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5. Feet El Other DEPTH OF SIDEWALK � . -inches— ❑ 5 inches tEl 6 inches cps, j AREA TO BE REPAIRED s 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 Date: I,4- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ZZZ 4,.00veo 1b &,25 -z/. -478 -USl Sal PARCEL CODE CONTROL NO. --� CLEAN SIDEWALK Type of Defect ❑ Yes V�] No J See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes No WATER VALVE e. iy\ ADJUSTMENT REQUIRED \g N ❑ Yes No J I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes f 7 No '9 � t '' AM(Jl LOCATION OF SIDEWALK P Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet p 5.3 Feet Other DEPTH OF SIDEWALK ❑ 4 inches in ❑ 6 inches AREA TO BE REPAIRED sq.ft. in. �J sq. 5 in. sq.ft. 6 in. J 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 ._I reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ►3'� 3�l Date-. 4_1—1 PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTYADDRESS 2Z3 IkAAM6N2�, 09(3 -Z5- 35-1 - 01l b PARCEL CODE CONTROL No_ CLEAN SIDEWALK _ Type of Defect A ❑ Yes eKINO See reverse side for Defect Codes A-F -' See below for Defect Code G TRIM VEGETATION ❑ Yes KNo — WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes Ids NO — PARKS DEPARTMENT — _ REVIEW REQUIRED 4" ❑ Yes ;i'No q - Ai LOCATION OF SIDEWALK N Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ Other DEPTH OF SIDEWALK 4 inches El inches El inches AREA TO BE REPAIRE Z?•Q sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes O'No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels- FIRST INSPECTION AND FORM MADE BY : X13 )51Y Date: 4-1G-1 y — WC- PERMIT ISSUED T FORMED POURED COMPLETED --� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM J PROPERTY ADDRESS Z j �A4ksjv^'\-V"VJ CJJ�� -1�- 479 OSJ TD PARCEL CODE 957 CONTROL NO. a CLEAN SIDEWALK Type of Defect ' y ❑Yes [P No See reverse side for Defect Codes A-F y I� See below for Defect Code G I TRIM VEGETATION R A c, ❑ Yes [�'No j WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes No I I i I I PARKS DEPARTMENT ,.j REVIEW REQUIRED ❑Yes 1P No LOCATION OF SIDEWALK 7 1fFrontYard ❑ Side Yard ❑ Other J WIDTH OF SIDEWALK ❑ 4 ❑ 5 Feet / 5.3 Fee ❑ Other j DEPTH OF SIDEWALK to 4 inches; ❑ 5 i ❑ 6 inches J 1 AREA TO BE REPAIRED 23, .ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. J CODE F - PATCHES ❑ Yes 9NO No. of Squares with Patches CODE G - NOTE:Areas marked with an "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 `�U5 Date: PERMIT ISSUED ...� FORMED POURED COMPLETED 1 i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect F01 Yes M No See reverse side for Defect Codes A-F 'See below for Defect Code G 'TRIM VEGETATION —' �\ ❑Yes ❑`No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED — '.S Yes ❑ No qj tj 1 LOCATION OF SIDEWALK R Front Yard �Side Yard Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet &5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches, El \inhes; ❑ 6 inches _ AREA TO BE REPAIRED 10 i'e- sq.ft. 4 in. \sq.ff. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes M No No. of Squares with Patches i CODE G - \ — o her NOTE :Areas marked with an"F" may be repaired by patching.g All � areas shall be repaired by — reconstruction of full sidewalk panels_ \ FIRST INSPECTION AND FORM MADE BY i 6 r Date: `���l �� PERMIT ISSUED FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -' PROPERTY ADDRESS Z57 //,4m i / WY� PARCEL CODE CONTROL NO. EAN SIDEWALK Type of Qefec ❑Yes 'No See reverse side Defect Codes A-F See below for Defect ode G TRIM VEGETATION I ❑Yes CR�No WATER VALVE ADJUSTMENT REQUIRED Z57 Yes El No /ex, d d✓�-rz s/r� I PARKS DEPARTMENT REVIEW REQUIRED Ayes ❑ No wl S,3' HAM/ m -ve LOCATION OF SIDEWALK ront Yard ❑ Side Yard \EE1O WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet �5.3 Fee DEPTH OF SIDEWALK t,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAI D Cl °4' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATC ES ❑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 : 016 Date: PERMIT ISSUED _( FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS _ 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 ❑Yes ® N o I WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [5r No _. I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 3. No LOCATION OF SIDEWALK E'S Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L- e5 3 F3 F et ❑ Other DEPTH OF SIDEWALK IS�4 inches ❑ 5 inches ❑ 6 inches y q.ft. 4 in• sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIR D CODE F - PATCHES ❑ Yes FA No No.of Squares with Patches — CODE G NOTE.Areas marked with an"F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. (� FIRST INSPECTION AND FORM MADE BY : ��13 L'�N Date: PERMIT ISSUED POURED COMPLETED FORMED "� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 f 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 TRIM VEGETATION ❑Yes ® No \V _ WATE.RA4AWIE A TMENT EQUIRED N z 79 Y Yes No PARKS DEPARTMENT REVIEW REQUIRED N Yes ❑ No to 01.9 60 LOCATION OF SIDEWALK R Front Yard ❑ Side Yard I] Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �-3et ❑ Other — DEPTH OF SIDEWALK t5Z; in-che El inches ❑ 6 inches AREA TO BE REPAIRED S ✓q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes �J No No.of Squares with Patches _ CODE G - NOTE .Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by Ireconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY —I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS Z� 5 OckvvNry ock( . PARCEL CODE CONTROL NO. Type of Defect /CLEAN SIDEWALK See reverse side for Defect Codes A-F See'below for Defect Code G ❑ Yes [&No TRIM VEGETATION — '�. ❑ Yes Q No J i s WATER VALVE — ` ADJUSTMENT REQ'D K " ❑ Yes No l PARKS DEPARTMENT REVIEW REQUIRED — y ® Yes ❑ No — LOCATION OF SIDEWALK ❑ Vont Yard 19 Side i� ❑ Other — WIDTH OF SIDEWALK d 4 Feet ❑ 5 Feet © 5. Feet El Other j DEPTH OF SIDEWALK ` N 4 inches0 5 inches j ❑ 6 inches AREA TO BE REPAIRED �3 J sq.ft. 4 in. sq.ft. 5 in.\- sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No. of Squares with�atches CODE G - NOTE :Areas marked with an"F"may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY rl h rl Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' CONTROL No. PARCEL CODE CLEAN SIDEWALK r` Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 5�,No _ WATER VALVE ADJUSTMENT REQUIRED WNo bJevj�,l . PARKS DEPARTMENTS REVIEW REQUIRED ❑Yes �'No . sWV 1114 Il . l LOCATION OF SIDEWALK 17 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet ,K0 Cer - `E DEPTH OF SIDEWALK 4 inches 5 inches, ❑ 6 inches J 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 ��7 Date: 4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a Zl 4D-3 PARCEL CODE i CONTROL NO. CLEAN SIDEWALK _ Type of Defect ❑Yes M No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION -- ❑Yes 9�-No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes allo _ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes �9 No /�-2 ' LOCATION OF SIDEWALK M Front Yard ❑ Side Yar 1 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5. et ❑ Other '- DEPTH OF SIDEWALK 4 inch ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes l No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels_ _ FIRST INSPECTION AND FORM MADE BY 31� �p� Dater 4 PERMIT ISSUED FORMED POURED COMPLETED -- --� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I1An"P kyeT PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes No TRIM VEGETATION 1 ❑ Yes kNo �I WATER VALVE ADJUSTMENT REQ'D v ❑ Yes ? No b PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes k-No LOCATION OF SIDEWALK t-Front Yard (Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet et -1<O er� .1 DEPTH OF SIDEWALK ¢,4 inches ❑5 inches El 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes O,No No.of Squares with Patches CODE G - t r NOTE:Areas marked with an"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: zk"n-l PERMIT ISSUED —! FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect [I Yes t�]-No See reverse side for Defect Codes A See below for Defect Code G TRIM VEGETATION 0 Yes No WATER VALVE ADJUSTMENT REQUIRED 0 Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED L) El Yes 9No C. C&\V� El Other LOCATION OF SIDEWALK [Front Yard 0 Side Yard WIDTH OF SIDEWALK MA Feet El 5 Feet 0 5.3 Feet 0 Other DEPTH OF SIDEWALK E14inches [A 5inches El 6 inches V 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 NOTE :Areas marked with an"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 b Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO f Ul- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /D 1 -12 7 ST J f gl3 -26 - 20z - o)q 47110 eft C1 �� ►� PARCEL CODE CONTROL NO. V __ J 0 ,73 _ Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F JSee below for Defect Code G ( ❑ Yes ,ENO TRIM VEGETATION ❑Yes Jl No J &M> WATER VALVE �. ADJUSTMENT REQ'D a ❑ Yes DN6 J � PARKS DEPARTMENT REVIEW REQUIRED I S.v•_ .o' S:0'_ _ El Yes JXNo " �EFFEIzSc�N 5T• ! LOCATION OF SIDEWALK :q Front Yard IK Side Yard ❑ Other J WIDTH OF SIDEWALK ❑4 Feet Z5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK -;R-4 inches ❑5 inches mchea''� AREATO BE REPAIRED sq.ft. 4 in. sq.ft 5 in._' :5 sq.ft. 6 in. --� CODE F - PATCHES -❑Yes ❑ No No. of Squares with Patches _ CODE G - --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: PERMIT ISSUED —I FORMED POURED COMPLETED I F 7— CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS /Z-7 3o Fr-czz z,aiv >% te 9/3 - 2J,,- Z02 -e)/y y� 3 PARCEL CODE CONTROL NO. 7 a Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F r ' See below for Defect Code G ( El Yes No TRIM VEGETATION ❑ Yes K No WATER VALVE ADJUSTMENT REQ'D ❑ Yes ANo r -74 ' PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes )&No Af LOCATION OF SIDEWALK XFront Yard X Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1<4 inches ❑ 5 inches ❑ 6 inches AREATO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq_ft 6 in. CODE F - PATCHES XYes ❑ No No.of Squares with Patches CODE G - f + �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 /�-_S L4C Date: �"ILI"/q PERMIT ISSUED _ FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS cn,00 -A l cc K _ S9 ►3 -2L- 233- 00-7 �14 PARCEL CODE CONTROL NO. GLEAN SIDEWALK Type f Defect A C-- ❑Yes KNO See re rse side for Defect Codes A-F See belo for Defect Code G TRIM VEGETATION ❑ Yes V No _ WATER VALVE Vol C ADJUSTMENT REQUIRED ❑Yes P�No PARKS DEPARTMENT 04 QQrK� REVIEW REQUIRED LA ❑Yes No 9 LOCATION OF SIDEWA Front Yard ❑ Side Y d ❑ Other WIDTH OF SIDEWA ❑4 Feet ❑ 5 Feet ❑ 3 Feet Other DEPTH OF SIDE ALK )<4 inches ❑ 5 inches ❑ 6 inches —I �-�6.3 ft. 6 in. AREA TO B EPAIRED sq.ft. 4in. sq.ft. 5 s q- _I CODE F - PATCHES ❑Yes �No No.of Squares wi Patches CO G - —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 G Date: — I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 6,00 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes XNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION — JJj� \� El Yes No 5 .20 -- �� WATER VALVE ADJUSTMENT REQUIRED ❑Yes No _ PARKS DEPARTMENT P n REVIEW REQUIRED ❑Yes `�No LOCATION OF SIDEWALK XFrontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet P�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 bg�No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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 w1 B Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c..0D 81cck je,4ersch Sfree4 OZ4 Sg13 -24- -2-7 1 - 000 4t(P 027 PARCEL CODE CONTROL NO. 029 CLEAN SIDEWALK -02`% -03 o Type of Defect — ` ,'❑ Yes No ©32 See reverse side for Defect Codes A-F -032 See below for Defect Code G /i 1 x TRIM VEGETATION ❑Yes No ae �a WATER VALVE \� S ADJUSTMENT REQUIRED ss �' ❑Yes P<No L14 PARKS DEPARTMENT �1.3 REVIEW REQUIRED ❑Yes �d No _ ,�a:•se�. Car�crp�t a,�:o t � �e S�ersor 54re LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet PTTDther DEPTH OF SIDEWALK 4 inches V\-, ~`❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED �—sq•ft- min• sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ' $4_No No. of Squares with Patches — CODE G - I NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by _I reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY B Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS J e4ecs o✓` S}-ree.4' �►3 -Z�- ��� -ooy 410 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect v ❑Yes �No See reverse side for Defect Codes A-F See below for Defect Code G RIM VEGETATION � ❑Yes No WATER VALVE — �0.. ADJUSTMENT REQUIRED y,e �2� �'S � c���� PARKS DEPARTMENT �a �o ah.•,_� REVIEW REQUIRED _ ❑ Yes No NJ i" Ski 1\°J�,� LOCATION OF SIDEWALK $�FrontYard ❑ 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 , 46 _sq.- 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 -- 1 CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM 1 -7a -7o(o -Teffersen S��ee� ✓ lYv - PROPERTY ADDRESS 3a 1, 3 a-7 301 w . S},reed cY �- $ql3 -26-2$a - bo Izv PARCEL CODE t O OL NO. t 0 wre 4 Type of Defect A ,C,E '; CLEAN SIDEWALK See reverse side for Defect Codes~A-F 1 See below for Defect Code G [I Yes No �5•�1��, TRIM VEGETATION ❑ Yes N0 e v3 . N alas WATER VALVE ApJb� T REQ'D Yes ® No M,ssin9 ca PA PARTMENT �y8_94k REVIEW REQUIRED El Yes No,: .� 77 �ersoA Sfreef 1�jhf LOCATION OF SIDEWALK Front Yard [Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other �a M q DEPTH OF SIDEWALK J<4 inches ❑ 5 inches 'El 6 inches AREA TO BE REPAIRED - a '_ sq._ft 4_i� ' -=sq.ft. 5 in. J CODE F - PATCHES Yes —❑ No No. of Squares with Pat es ) CODE G - NOTE:Areas marked with an "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 _ /w NO- CLEAN SIDEWALK — Type of Defect A,c. 0 Yes X6 No See_reverse_ side - -- TRIM VEGETATION See below for Defect Code G El Yes gNo ~- WATER VALVE ADJUSTMENT REQUIRED 0 No | ~- oeevk PARKS DEPARTMENT ° L.J01, REQUIREDREVIEW - 14� 0 Yes No LOCATION OF SIDEWALK J6,Front Yard 0 Side Y ard 11 Other WIDTH OF SIDEWALK El 4 Feet El 5 Feet El 5.3 Feet ><I Other K El 6 inches DEPTH OF SIDEWALK inch s j—; El 5 inches 11 es 0 No No.of Squares with P;�tches CODE 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's L C- Date: q'f FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED _ -~ -- _ _ ~- _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 11q 7/6 0-c4er-s—i oZ l ✓ 4-Z,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 KNo WATER VALVE ADJUSTMENT REQUIRED Yes ❑ No Mi 39)NTJ co-f 0. PARKS DEPARTMENT REVIEW REQUIRED El No pe ,u aV �E?firer sor` S� r'et_ LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑A Feet ❑ 5 Feet ❑ 5.3 Feet KOther _ DEPTH OF SIDEWALK ] 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7(p 7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. J 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 _I 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 c'36o g-1 13 -Z5 - IS t - c-A-Y7 425 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK _ See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes [YNo 1 TRIM VEGETATION ❑ Yes 9 No IV WATER VALVE ADJUSTMENT REQ'D u- ❑ Yes X No PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes 9No T,jlK � 7IZ�/G LOCATION OF SIDEWALK Xf 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 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ,Kyes ❑ No No.of Squares with Patches CODE G - '- NOTE=Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST NSPECTION AND FORM MADE BY : Date: -- WL PERMIT ISSUED — FORMED POURED COMPLETED it CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS gay 611� SFE25o/d srt 8113 -Z 5- 157 - ao� 4Z9 PARCEL CODE CONTROL NO. �I Type of Defect ACLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I ❑Yes I No TRIM VEGETATION L ❑Yes 1?1 No S WATER VALVE ADJUSTMENT REQ'D \ I. ❑Yes IX No \` PARKS DEPARTMENT REVIEW REQUIRED ❑Yes lg�No <TQtr-fe�rSovi S r e+v� LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard Q 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' d7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES rKYes ❑ No No. of Squares with Patches CODE G - i 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 L-C— Date: '18"t`{ _I PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ i PROPS TY ADDRESS q oO bk-cK -Tej-fers on 5 free � $ 13 -25- 5-7 -Do 4.30 \ PARCEL CODE CONTROL NO. \ Xr[] EAN SIDEWALK Type df Defect / Yes 1 No — See rev\ rse side for Defect Codes A-F / See belo for Defect Code G TRIM VEGETATION f ❑Yes ffNO — WATER VALVE ADJUSTMENT REQUIRED _ ❑ Yes t� No PARKS DEPARTMENT -- REVIEW REQUIRED ❑ Yes No — �e C rson +ree} LOCATION OF SIDEWALK ::9 Fron�Yard ❑ Side and El Other — WIDTH OF SIDEWALK ❑J4'Feet ❑ 5 Feet L5.3 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' J?�,Yes ❑ No No. of Squares V,�ith Patches �✓ CODE G - — i NOTE :Arms marked with an "I"' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY h5 (mac Date: PERMIT ISSUED FORMED POURED COMPLETED -� GIN OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ° poi - Cr-) 463 PARCEL CODE CONTROL NO. -1 CLEAN SIDEWALK Type of Defect ❑ Yes [ No See reverse side for Defect Codes A-F - I See below for Defect Code G I TRIM VEGETATION ❑ Yes © No WATER VALVE ADJUSTMENT REQUIRED 1 N ❑ Yes 0 No I I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes © No - - A � T vv/) LOCATION OF SIDEWALK N-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ­®-met -E] her r ° DEPTH OF SIDEWALK E. 4che El5 inches ❑ 6inches AREA TO BE REPAIRsq.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 Date: PERMIT ISSUED --1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS' W10 blK a�r��'C_5c • -::Tr `�13 - 15- 50y - C, 44�, PARCEL CODE: CONTROL NO. b`t Type of Defect CLEAN SIDEW-AL- q See reverse side for Defect Codes A-F — `�S See below for Defect Code G / Qyes, No TRIM VEGETATION — rD ❑ Yes E No WATER VALVE ADJUSTMENT REQ'D ❑ Yes Ef No PARKS DEPARTMENT °" ; REVIEW REQUIRED _ \ )), _ _ f Yes ❑ No ���rSVn LOCATION OF SIDEWALK © Front Yard _�Z Side Yard ❑ Other - - — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet 1Z Other DEPTH OF SIDEWALK "N�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 Jq°No No.of Squares with Patches CODE 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 t I FIRST INSPECTION AND FORM MADE BY : �T� ��L. Date: iC) l� — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS //C-) -7 �JEFF6256.y 25- 302 - 0/6 i/Iyg PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 14 ❑Yes 00o See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes gNo WATER VALVE t 5k — ADJUSTMENT REQUIRED ❑Yes CR�No PARKS DEPARTMENT REVIEW REQUIRED ,$ Yes ❑ No LOCATION OF SIDEWALK XFront Yard ❑ Side Yard ❑ Other —y WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet Other DEPTH OF SIDEWALK j-4--inches ❑ 5 inches El6 inches AREA TO BE REPA RED q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F may be repaired by patching. All other areas shall be repaired by �I reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY �5 L`G Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTYADDRESS Bcl13 -2s - 302- - ooO a�� PARCEL CODE CONTROL NO_ /CLEAN SIDEWALK Type of Defect ( Yes E7 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION a y 1'i I I ❑Yes ❑ No — WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes ❑ No I � PARKS DEPARTMENT — REVIEW REQUIRED —� ❑ Yes ❑ No �JCir�efSOY� S-�cee,�' LOCATION OF SIDEWALK EX-Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet R - eet Oth r • '� 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"I"' 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 C,C_ Date: PERMIT ISSUED — FORMED POURED COMPLETED -j CITY OF WATERLOO 4 - SIDEWALK REPAIR SURVEY FORM PROPERTY—,ADDRESS,- iZC4- ,Ft Sc>t� Si. _ PARCEL CODE CON fR0 O. -I i Type of Defect CLEAN SIDEWALK —I See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes /9 No TRIM VEGETATION ❑ Yes M No 3 WATER VALVE o l ADJUSTMENT REQ'D - C9 Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED � 51-Yes ❑ No LOCATION OF SIDEV\�4LK 1�1.Front Yard ❑ Side Yard ❑ Other � WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Fee ®,Other �I DEPTH OF SIDEWALK a4 inches ❑ 5 inchesEl 6 inches AREA TO BE REPAIRED a , sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. "I CODE F - PATCHES ❑ Yes ((Y 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 M�� y �ti� Date: —I - PERMIT ISSUED '!( FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS )Z I qjers��✓� RI 3 -7.-5- 3�DG -coo 6 4s-7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes V-No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑ Yes No �J WATER VALVE \\ ADJUSTMENT REQUIRED vt N ❑ Yes [A No PARKS DEPARTMENT a�� I REVIEW REQUIRED ff ❑ Yes C No A LOCATION OF SIDEWALK X FrontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK El Feet El Feet 5.3 Fee> El Other . DEPTH OF SIDEWALK ,1 4 inches ❑ ches ❑ 6 inches — AREA TO BE REPAIRED'. 2 Z sq.ft. 4 in. -` sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES 0 Yes )a No No. of Squares with Patches CODE G - — NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED i !� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _I PROPERTY ADDRESS /3co Y Jr r--r -<o/f/ 5T,� 7 -25 -331 - ooq --"" -}se, PARCEL CODE CONTROL NO. '—� CLEAN SIDEWALK Type of Defect D ❑ Ye ;<r No �i See reverse side for Defect Codes A-F See below for Defect Code G TRIM EGETATION Yes Kl No �I ATER VALVE t 3 _T a Cain ADJUSTMENT REQUIRED - ! N ❑ Yes No �I PARKS DEPARTMENT REVIEW REQUIRED P�k�ti 1-7. '7 ❑Yes No LOCATION OF SIDEWALK ? Froyt Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4/Feet ❑ 5 Feet .19 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 'ta�-Y-es ❑ No No.\ Squares with Patches r �I CODE G 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 : S t-C_ Date: y-Z t'lq PERMIT ISSUED .I FORMED POURED COMPLETED l I� I — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS T,66,52e 1 -�%- �l/3 -25- 33 - v25 471 PARCEL CODE CONTROL NO_ Type of Defect e4, G F CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes XNo See below for Defect Code G v� TRIM VEGETATION is —� ❑ Yes k No C"s WATER VALVE ADJUSTMENTREQ'D ❑ Yes XNo F ` ' PARKS DEPARTMENT REVIEW REQUIRED _ L tL ❑ Yes XNo 7 ' � q.3 OV. 13 ST — LOCATION OF SIDEWALK ,PC'Front Yard Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet '�JV5.3 Feet \l❑ Other DEPTH OF SIDEWALK 94 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED If sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES NrYes ❑ No No,of Squares with P ches l t CODE G - — NOTE:Areas marked with an"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 46 Date: 7-ZI-,Jy PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / 5DZ 1���e�sores 5�r•e e.� "� $113 -25 - 377 - ool '� 474 PARCEL CODE CONTROL NO. �I Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G El Yes No N TRIM VEGETATION (f) ❑ Yes No -� WATER VALVE M ADJUSTMENT REQ'D ` ❑ Yes ' No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes CZNo �Se��erson �}-ree} LOCATION OF SIDEWALK *ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5.Feet ❑ 5.3 Feet ❑ Other — 1 DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. ft, n. CODE F - PATCHES A-Yes ElNo No.of Squares with P tQhes j CODE 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 j FIRST INSPECTION AND FORM MADE BY IS L Date: LI 23'lq PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1.508 �2��'erso.l S4ree.f" V" gg l 3 - 25- 3-77 -T1 oy ✓ '115 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes No k See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes ANo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes _KNo — °M t I I PARKS DEPARTMENT — �� REVIEW REQUIRED � ❑ Yes No VIA LOCATION OF SIDEWALK C%(Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet Feet qOt er DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches — pZ.o AREA TO BE REPAIRE ► � q.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 : (�S L� Date: PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO r SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I&t5 �I 913 -25 -37 -oo "7 Ago PARCEL CODE CONTROL NO. r;S r`) CLEAN SIDEWALK Type of Defect o6 El Yes No fi See reverse side for Defect Codes A-F j See below for Defect Code G _�• iI '� TRIM VEGETATION rI r ❑ Yes U(No i WATER VALVE ADJUSTMENT REQUIRED L ❑ Yes LN�No �. PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 07 40 j of evsa,� Sly-eef LOCATION OF SIDEWALK X Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet Other 2 j DEPTH OF SIDEWALK 4 inche El inches ❑ 6 inches _l AREA TO BE REPAIRE �6-� ` .ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. .1 CODE F - PATCHES ❑ Yes Rf No No. of Squares with Patches CODE G - NOTE -.Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED I i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM / 22 PROPERTY ADDRESS 1 U 2.0 3010 -'LS' -3'19 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Typ@ of Defect -A ElYes W No See reverse side for Defect Codes A-F See be w for Defect Code G ;fir, TRIM VEGETATION ❑ Yes 9 No ` WATER VALVE O� Z_ ADJUSTMENT REQUIRED _ N ❑Yes N No ` PARKS DEPARTMENT REVIEW REQUIRED ❑Yes M No =75!� / 0. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWAL/ ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDE ALK [ '4 inches ❑ 5 inches �6 inches - ✓ S], `�S . . 6 in. AREA TO BE REPAIRED S� sq.ft. 4 in sq. ft. 6 in. q ft 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: Z'- t PERMIT ISSUED _ FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 172 SEF�IrrL Sow 5% if�j►3 -25 - 3j3 t - 0(,,/ PARCEL CODE CONTROL NO. T CLEAN SIDEWALK y i Type of Defect } El Yes No f'1 1 See reverse side for Defect Codes A-F See below for Defect Code G ��. TRIM VEGETATION e ��f i� ❑Yes P�No ATER VALVE Zd �ADJUSTMENT REQUIRED ..,I 7tSF �izson 1 Yes No Z> rl PAR TMENT REVIEW REQUIRED ❑ Yes .k'No LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other vl WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet 5. eet ❑ Other DEPTH OF SIDEWALK &2' riche ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED i !. sq/q.ft. 4 in. sq.ft. 5 in. sq.ff. 6 in. CODE F - PATCHES ❑ Yes XNo No. of Squares with Patches I' CODE G - 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 : _�R )rJL Date: J PERMIT ISSUED _..I FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS /yZ7 .T 5aAl gM/3 zs- ys7 -cbs 1410 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWA K See reverse side for Defect Codes A-F ❑Yes rNo See below for Defect Code G t TRIM VEGETATION _ ❑ Yes 010 1 , r7 z WATER VALVE - J ADJUSTMENT REQ'D (� i✓L \ �`� ❑Yes 10"N o PARKS DEPARTMENT /J s REVIEW REQUIRED C L ❑ Yes >r o 7. LOCATION OF SIDEWALK WFrontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 04 inches ❑ 5 inches 06 inches AREA TO BE REPAIRED � .D sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes U/No No.of Squares with Patches CODE G - -` NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Wei Date: ZS��y PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS P1 J va n-�v� s f, $� ! 3 -ap - y51 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4 ❑ Yes [ I,No See reverse side for Defect Codes A-F " See below for Defect Code G TRIM VEGETATION ❑ Yes XNo i WATER VALVE 0 k ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED i ❑ Yes No J�tvt LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet eet her 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. �I CODE F - PATCHES ❑ Yes Po No.of Squares with Patches CODE G - NOTE:Areas marked with an"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: IS�Orf �I 1 PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - 31y- Sao -JA45,61/1 5f• CONTROL NO. v PARCEL CODE CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F TRIM VEGETATION I See below for Defect Code G ❑Yes f}7 No I WATER VALVE ADJUSTMENT REQUIRED r � �a ❑Yes X No — �a, I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes JO No �oti�so4 5�-• �. — LOCATION OF SIDEWALK KFront Yard� 0 Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet f 1 5't El5.3 Feet El Other DEPTH OF SIDEWALK inches�-� i ❑ 5 inches ❑ 6 inches . sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAID � 9po--�-�q•�• 4 in. — e No No. of Squares with Patches -- CODE F - PATCHES El Yes CODE G NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY } �E PERMIT ISSUED FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - 171 H jd�,1,5.0 5{ g q i3 -.26 - y 5-7 - 00-2 So3 PARCEL CODE` CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes YQ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes JK No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT i_- A REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK Front Yard ❑ Side Yard I] Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet s Xi her �`� DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches �I AREA TO BE REPAIRS J s 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes t4 No No.of Squares with Patches CODE G - 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 : '�I!D 4- rF Dater y'J:�--1 y PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect L El Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION \❑ Yes XNo WATER VALVE ADJUSTMENT REQUIRED `� .� e N es No o 5 'jai PARKS DEPARTMENT 1 a 23 REVIEW REQUIRED ❑ Yes O No -�D%AQ 56 LOCATION OF SIDEWALK XFront Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑ 4 Feet El5 Feet )4 5.3 F ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches GeD&G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED _ FORMED POURED COMPLETED --I CITY OF WAT ERLOO SIDEWALK REPAIR SURVEY FORM j PROPERTY ADDRESS 54 . —I elf>> - - Ys' - co y PARCEL CODE' CONTROL NO. Type of Defect 1-4 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes 14 No vt � 3vTRIM VEGETATION ❑ Yes No N q�z �I �� iax.cr i o� WATER VALVE ADJUSTMENT REQ'D ❑ Yes RNo .. L va' PARKS DEPARTMENT `G REVIEW REQUIRED v ❑ Yes )4 No �v�,nsoR 54-. LOCATION OF SIDEWALK Front Yard [A Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inchesN 6 inches AREA TO BE REPAIRED Jsq. 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 panes. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM RTYADDRESS 01- 6!q 5913 - G - - 00 N PARCEL CODE` CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes ;9 No See below for Defect Code G I TRIM VEGETATION J t ❑Yes [X No C . 1 �,✓ , WATER VALVE ' N s ADJUSTMENT REQ'D r i ❑ Yes C(No I -- PARKS DEPARTMENT REVIEW REQUIRED 5-� El Yes No i f 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 �6 No No. of Squares with Patches CODE G - 1 NOTE :Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED _ FORMED POURED COMPLETED i -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' 707 z(- - 484- - vV , �07 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 No �I j4\ WATER VALVE p,g ADJUSTMENT REQUIRED � 4f ❑Yes No el D PARKS DEPARTMENT REVIEW REQUIRED ❑Yes X_No �otFs�.So� 5T- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Fe ❑ Other DEPTH OF SIDEWALK [�4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 78.l -sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. J CODE F - PATCHES J ❑Yes f$j No No. of Squares with Patches CODE G - NOTE : Areas marked with an"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 N E,DS Date: J PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS. 71 So�rJsorl sT. 84-2 13 - Z(11 PARCEL CODE— CONTROL NO. CLEAN SIDEWALK Type of Defect A , C ❑Yes C No See reverse side for Defect Codes A-F \ — See below for Defect Code G TRIM VEGETATION ❑Yes No _ WATER VALVE ADJUSTMENT REQUIRED El Yes No ra"7 e �,� ,� PARKS DEPARTMENT _ Via= �°�G-{ a° REVIEW REQUIRED Co 1^ Yes ❑ No A� _Z7. � . fj e paJ��� 3G o l�t�SO al �T LOCATION OF SIDEWALK M Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet a5.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR /sa_ f+ ^ '- —sq.ft. 6 in. CODE F - PATCHES �, :hes CODE G - t ✓�, r= o _ NOTE :Areas marked with an Shall be repaired by _ reconstruction of full si, FIRST INSPECTION AND FOF late: PERMIT ISSUED _ FORMED I i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS GE,r,y/i 7- �- - I 89l3 - 76 - -o y,V PARCEL CODE CONTROL NO. Type of Defect C See reverse side for Defect Codes A-F CLEAN SIDEWALK e S I� See below for Defect Code G ❑ Yes W40 TRIM VEGETATION ❑Yes KNo _I , WATER VALVE ADJUSTMENT REQ'D ❑Yes L�No � PARKS DEPARTMENT t O V REVIEW REQUIRED — — ❑Yes ,�rjqo 9.0'X s.H'_ f. 7 " ; _ LOCATION OF SIDEWALK ['Front Yard XSide Yard ❑ Other ,— WIDTH OF SIDEWALK El4 Feet m - et ❑ 5.3 Feet _ Other S.q `I 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 ,W"No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. y FIRST INSPECTION AND FORM MADE BY Date: I' PERMIT ISSUED —` FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9tD caVIVI r(5-3 - 002, 5/Z 0 13 - AR CEL CODE-' CONTROL NO. PAR CLEAN SIDEWALK R Type of Defect A El Yes No See reverse side for Defect Codes A-F � See below for Defect Code G � TRIM VEGETATION — � ❑Yes 9-No WATER VALVE 1 ADJUSTMENT REQUIRED o r G �� N ❑Yes .9 No — PARKS DEPARTMENT REVIEW REQUIRED ❑Yes �1 No s� LOCATION OF SIDEWALK [).Front Yard ❑ Side Yard 0 Other 4 Feet ❑ 5 Feet eet aOther WIDTH OF SIDEWALK El '` � DEPTH OF SIDEWALK El inches 5 inches ❑ 6 inches _ y ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. q 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. TIE Date: y /6 l'f FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5�- 4�gt3 - ,26 �S`I - pig 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 TRIM VEGETATION ❑Yes L�No + 3 WATER VALVE ADJUSTMENT REQUIRED P/ '�'� [I Yes [�.No ko I PARKS DEPARTMENT REVIEW REQUIRED -� ❑Yes g No �-ea., LOCATION OF SIDEWALK VLFront Yard ❑ Side Yard ❑ Other ' WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 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 �4 No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY d Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4eA",+ 5 i3 -�6 - qYq - v17 51z - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes K No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 9 N o WATER VALVE �4 ADJUSTMENT REQUIRED ❑Yes IX No t — y� PARKS DEPARTMENT ` REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK �Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 153 Fe t ❑ 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� �� Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS qJ ( �rave PARCEL CODE,- CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes O�No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes P4 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes [X No PARKS DEPARTMENT REVIEW REQUIRED fla�� `Yes ❑ No 0A LOCATION OF SIDEWALK &Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feeti 15.3 F ❑ Other DEPTH OF SIDEWALK V4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —I 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 : {` TE Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS.- i;l 5}• �6 - �5-3 P _ CONTROL NO. PARCEL CODE CLEAN SIDEWALK _ Type of Defect A ❑Yes Pa No See reverse side for Defect Codes A-F I — See below for Defect Code G TRIM VEGETATION ❑Yes 0 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes IV-No PARKS DEPARTMENT REVIEW REQUIRED _ ❑Yes V1 No o k LOCATION OF SIDEWALK [g Front Yard ❑ Side Yard Other 7 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet Other inches ❑ 5 inches ❑ 6 inches DEPTH OF SIDEWALK �,4 - -- s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. q 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. Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED '- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - q31 Lcavt+4 5V. �_(o- 4 -y 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 j$No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes X No PARKS DEPARTMENT REVIEW REQUIRED e S® � El Yes M No LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -Feet r a 0 er-� DEPTH OF SIDEWALK ❑4 inches 5 inches\ ❑ 6 inches AREA TO BE REPAIRED sq. ft. 4 in: sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes KNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"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 Date: y9_16 Y PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS=' ff 3 y �cav'4-1 54-' 4 t3 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 139 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT tib REVIEW REQUIRED 54 Yes ❑ No CO ., LOCATION OF SIDEWALK Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet DEPTH OF SIDEWALK 4 mches ` ❑ 5 inches ❑ 6 inches �_ �AREA TO BE REPAIRED sq. -- - ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes t9 No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels_ Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS- J V913 -20 - YS`3 - oa PARCEL CODE- CONTROL NO. Type of Defect el, \ J See reverse side fo efect Codes A-F \ CLEAN SIDEWALK See below for Defect ode G ❑ Yes Z No TRIM VEGETATION ❑ Yes )'No J N WATER VALVE ADJUSTMENT REQ'D ❑ Yes P No �I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No 0 d LOCATION OF SIDEWALK Front Yard CA Side Yard El Other �I 1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K5.3 Feet ❑l Other DEPTH OF SIDE ALK 56 4 inches ❑ 5 inches ❑ 6 inch s 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 \\ rl CODE G - _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: �I PERMIT ISSUED _I FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS ldC9s te.CA-;H S--- -;2(0 - ` Ff - fJo( 57-y PARCEL CODE:' CONTROL NO. Type of Defect CLEAN SIDEWALK T See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes No WATER VALVE ADJUSTMENT REQ'D ❑ Yes 4 No _ PARKS DEPARTMENT REVIEW REQUIRED A,C G A ❑Yes No —' �i LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Oth r S•y DEPTH OF SIDEWALK K4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 5��-7 sq.'J ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. a� d- FIRST INSPECTION AND FORM MADE BY : ;� �� Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' 10111 LLaJI44 5f ' �G - 4S O = PARCEL CODE ' CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes �Z No See reverse side for Defect Codes A-F t I See below for Defect Code G I TRIM VEGETATION I ❑Yes EqNo WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT o�` p tJ-1' REVIEW REQUIRED ❑Yes K No LOCATION OF SIDEWALK %Front Yard ❑ Side Yard El Other 1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0Ot ,yf 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. rI CODE F - PATCHES ❑ Yes IN No No.of Squares with Patches CODE G - -I i NOTE:Areas marked with an T"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY � F Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS '' 102!d 51 U -26 - V51 -063 �z 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 g No — N WATER VALVE ADJUSTMENT REQ'D �s V ❑ Yes �Z No Z-° �� PARKS DEPARTMENT REVIEW REQUIRED ❑Yes PdNo LOCATION OF SIDEWALK 34 Front Yard ❑ Side Yard ❑ Other — %`�r1 WIDTH OF SIDEWALK El4 Feet El5 Feet ❑ 5.3 Feet P 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 T-F Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS � \C>b I PARCEL CODE CONTROL NO. Type of Defect 1 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I 1 ❑ Yes ❑ No u v3.°� (0 o r TRIM VEGETATION e o c v �� I ❑Yes ❑ No Ala 'NP k �' WATER VALVE .L � < ADJUSTMENT REQ'D I 0 �2 I 7 El Yes El No I � PARKS DEPARTMENT _ I kek REVIEW REQUIRED tr — — r els. CK Yes ❑ No 'A _ LOCATION OF SIDEWALK ❑ Front Yard E�Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Feet Ot er 15'2 DEPTH OF SIDEWALK 4 inched, ❑ 6 inches ❑ 5 inches AREA TO BE REPAIRED sq,ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes No No,of Squares with Patches CODE G - 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: d.,Z-3 ' (4— PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS llf 3 Ravi�f s�' 8cw -d-& - y$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 )Z No — WATER VALVE ADJUSTMENT REQUIRED to _ ❑ Yes No PARKS DEPARTMENT 9 REVIEW REQUIRED i [ Yes ❑ No _ LOCATION OF SIDEWALK C'Front Yard ❑ Side Yard El Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Fe ❑ Other DEPTH OF SIDEWALK JA 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 �a �� Date: PERMIT ISSUED FORMED POURED COMPLETED -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM J PROPERTY ADDRESS 1123 L c-fAvr'44 5{ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes P6 No _ See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes jai No t a` WATER VALVE ADJUSTMENT REQUIRED J N ❑ Yes 9 No I o PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ® No J `1 — J �0.%/14 5� LOCATION OF SIDEWALK ] Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet eet -,�dO er JDEPTH OF SIDEWALK 11 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 V 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 : D13 T Date: - �y —I PERMIT ISSUED —I FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS ' l\ z c. 4v� iTf Z6- [k e4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect [I Yes C+No See reverse side for Defect Codes A-F See below for Defect Code G ( TRIM VEGETATION I ❑Yes T No — WATER VALVE ADJUSTMENT REQUIRED — ❑Yes lR No �A I ^ I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No A LOCATION OF SIDEWALK Ig Front Yard ❑ Side Yard El Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet N-5=-3 Feet -E] Other DEPTH OF SIDEWALK [?9 4 inches ❑ 5 inches ❑ 6 inches T AREA TO BE REPAIRED sq. ft. 4 in. sq.it. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [B No No.of Squares with Patches CODE G - — NOTE-_Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. r � FIRST INSPECTION AND FORM MADE BY E Date: 4 2- — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO i SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 827 bt�o,,),` - 0;3 53/ PARCEL CODE- CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes f No See reverse side for Defect Codes A-F —.1 See below for Defect Code G TRIM VEGETATION ❑Yes No ..� �i� 3 WATER VALVE (J N ADJUSTMENT REQUIRED ❑ Yes X No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No o W, 5V- LOCATION OF SIDEWALK �Z Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -Feet __EI_Ot er _ 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. —_I 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: y-az�iy _ I - PERMIT ISSUED FORMED POURED COMPLETED l CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM .- PROPERTY ADDRESS` 1137 l ��� `# 5�- o -A - y81 - 02,1 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect A ❑ Yes l No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes iP No WATER VALVE S xy ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ;- - " Yes ❑ No M LOCATION OF SIDEWALK � Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet, 5.3 Fe ❑ Other ��- DEPTH OF SIDEWALK 4 inches } El inc es ❑ 6 inches AREA TO BE REPAIRE _�9'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 Date: PERMIT ISSUED FORMED POURED COMPLETED _I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS r jly( Lc.,74� 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 TRIM VEGETATION ❑Yes 7 No J WATER VALVE. ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No L LU V LOCATION OF SIDEWALK X Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 F ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches El inches AREA TO BE REPA D �.3 q. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - -j NOTE :Areas marked with an"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 _I FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS - � 14 Z `J 1 -Z 6 -14 ejL- c- 9 S 3 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes Cx No See reverse side for Defect Codes A-F See below for Defect Code G ( TRIM VEGETATION ❑Yes Q No ` WATER VALVE ADJUSTMENT REQUIRED ❑Yes 19 No PARKS DEPARTMENT i� REVIEW REQUIRED ❑Yes [P No LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ® 5.3 Feet , ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE ZA '9 q. 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 "I"' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: ¢-z ?._ I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' IZat 1 GK,/J T S� H$( - ctq �38 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 Z No — I WATER VALVE ADJUSTMENT REQUIRED _ I N ❑Yes ($1 No eJ PARKS DEPARTMENT (� REVIEW REQUIRED ❑ Yes No L ,! f LOCATION OF SIDEWALK C9 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet =s.3 eet 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. _ I CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE.Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Q 4 T� Date: Y- 22 PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - PARCEL CODE CONTROL No. r CLEAN SIDEWALK — Type of Defect ❑ Yes U No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑ Yes N No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [,No — �� PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ibNo LOCATION OF SIDEWALK (J Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet (5 3 e ❑ Other — DEPTH OF SIDEWALK 4-i Idles El inches ❑ 6 inches — AREA TO BE REPAIRED `!5 -sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes D-No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: �- PERMIT ISSUED FORMED POURED COMPLETED -I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1)13 Lauvt� aG - W - 01-7 PARCEL CODE v' CONTROL NO. CLEAN SIDEWALK Type of Defect —_— ❑ Yes No _I See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes % No _I WATER VALVE �p ADJUSTMENT REQUIRED ❑ Yes No 0 �J -�� PARKS DEPARTMENT _I REVIEW REQUIRED ❑ Yes No -� L LOCATION OF SIDEWALK [�Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches —I AREA TO BE REPAI D ac))'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 TT Date: PERMIT ISSUED _ I FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS--' 1217 L-ca V1 -}- S 01(. PARCEL CODE, CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Rj No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 14 No WATER VALVE ADJUSTMENT REQUIRED _ ❑Yes (X No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes �0 No L e4, + LOCATION OF SIDEWALK R Front Yard ❑ Side Yard 0 Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet _.9 t ther 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 : t Date: PERMIT ISSUED FORMED POURED COMPLETED —) CITY OF WATERLOO —i SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS, 1;.2 3 4cA f•{-}- S� • y,�l _o IF '54(,, PARCEL CODE-'" CONTROL NO. --I, CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F —I See below for Defect Code G TRIM VEGETATION ❑Yes j No -I 4 WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet rs `) 1 Feet � he —I DEPTH OF SIDEWALK K4 inch&§ ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES ❑ Yes D� No No. of Squares with Patches _I CODE G - —1 NOTE:Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY TE Date: —I PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS ' ( ZZ Z1, 40 S47 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G ❑ Yes Na TRIM VEGETATION ❑ Yes No N WATER VALVE — ADJUSTMENT REQ'D v� ❑ Yes [9 NoI o a t 1 \ PARKS DEPARTMENT C' r3 REVIEW REQUIRED �0 — �„ ❑ Yes 44 No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK El4 Feet El5 Feet ,-Feet =®Oth r s` DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED - ' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [U No No. of Squares with Patches CODE G - NOTE:Areas marked with an"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 J CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /3bo, 6l/-< (fir o r ji., _ J 8513 -0(, -ot 546 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes �9 No See reverse side for Defect Codes A F See below for Defect Code G ( TRIM VEGETATION I Yes No 3Z] ` 3 TER VALVE N � ADJUSTMENT REQUIRED ❑ Yes If No I � I I PARKS DEPARTMENT �12) 'p`0 \A REVIEW REQUIRED s�`' , El Yes No I.\ \Y - Q.9 —I LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ee Oth DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches —I L ✓.. AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G - NOTE:Areas marked with an "I"' may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION.AND FORM MADE BY L $ 5 Date: 4 4- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 130 Z 0913 -2(O - 48G- 00 1 PARCEL CODE CONTROL NO. 36—�� Type of Defect Z v \ °� CLEAN SIDEWALK See reverse side for Defect Codes A-F i See below for Defect Code G r)Yes K No TRIM VEGETATION ❑ Yes P5 No WATER VALVE ADJUSTMENT REQ'D ❑ Yes X No PARKS DEPARTMENT (� REVIEW REQUIRED - - ; Yes IS No LOCATION OFSIDEWALK gFrontYard EgSldeYard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet eet ❑ Other DEPTH OF SIDEWALK 14 inches Pir5 inches ❑ 6 inches AREA TO BE REPAIRED`__f67_o sq.ft. 4.in. so.ft. 5 in. -sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches ,V67v- / 649B1=-G- - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY SN A-" Date: 7-j3 ) / PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS" (3oS L � � -Z,� -4W -a)Z_- ssc� PARCEL CODE >- CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes R No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes M'No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes n No PARKS DEPARTMENT REVIEW REQUIRED F ❑Yes No VA S�� LOCATION OF SIDEWALK Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet (5��F et El Other DEPTH OF SIDEWALK 4 inch s El inches El inches AREA TO BE REPAIRED 9•Z sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES ❑Yes @ No No.of Squares with Patches l CODE G - _ 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: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS O /3-2&- 502 -0/Z >�3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C ❑Yes [9/No See reverse side for Defect Codes A-F - See below for Defect Code G TRIM VEGETATION ❑ Yes (<No WATER VALVE ADJ_USTTMENT REQUIRED _ [V �Yes [ o PARKS DEPARTMENT 1� S,o� 0. 3 ske9 REVIEW REQUIRED J r ElYes ,NrNo LO Q� LOCATION OF SIDEWALK [-Front Yard ❑ Side Yard 0 Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,93 Feet 9 Other(:56�) 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 J No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 6V 5lSS Date: GYM 7-z-/Y PERMIT ISSUED , FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' t_Y - 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 No WATER VALVE ADJUSTMENT REQUIRED ..des kNo octSyt��' o -'-,4 eat alYe PARKS DEPARTMENT 00-r�� I REVIEW REQUIRED I .8 ❑ Yes t0•`lx �.Z r[�No ewv ( /x 5• l ` CD LOCATION OF SIDEWALK [B Front Yard ❑ Side Yard ❑ Other —I WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK S 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _I CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - — 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 e� Date: Q PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS- 132.Cn -zG- 4�1&- 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 TRIM VEGETATION ❑Yes CB=No WATER VALVE ADJUSTMENT REQUIRED El Yes f�No _ O� PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK a Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet El5 Feet T-3 F t ElOther DEPTH OF SIDEWALK hes ❑ 5 inches ❑ 6 inches _ /?�.O �s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRS q 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 8 � Date: — PERMIT ISSUED POURED COMPLETED FORMED — CITY OF WATERLOO -I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - t 3-33 ALA (mac CHIC? 55C� PARCEL CODE CONTROL NO. Type of Defect ! 1 C -' CLEAN SIDEWALK —i See reverse side for Defect Codes A-F / ; 1 See below for Defect Code G 4 X ❑ Yes �a No `o TRIM VEGETATION ❑ Yes C9,No WATER VALVE ADJUSTMENT REQ'D �s XNo PARKS DEPARTMENT l p REVIEW REQUIRED Yes ❑ No vi c ` LOCATION OF SIDEWALK ❑ Front Yard (Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet j��5.3 Fe ❑ Other -� DEPTH OF SIDEWALK ",E 4 inches ❑ 5 inches . ❑ 6 inches i AREA TO BE REPAIRED 1 ��s IA. 4 in. sq.ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - —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 : Jq 13 I Date: —I PERMIT ISSUED —I FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESSF PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK — Type of Defect ❑ Yes C No See reverse side for Defect Codes A-F I — See below for Defect Code G TRIM VEGETATION ❑Yes N No WATER VALVE 2Z v ADJUSTMENT REQUIRED `p' N 106 ❑Yes q No — PARKS DEPARTMENT REVIEW REQUIRED ❑Yes X No r- f �w A A Ia — LOCATION OF SIDEWALK N Front Yard ❑ Side Yard - Other i . `t WIDTH OF SIDEWALK El Feet El5.3 F ❑ Other 5 Feet �� ❑ 5 inches ❑ 6 inches DEPTH OF SIDEWALK -- � ft. 6 in. AREA TO BE REPAIREC�\t �q.ft. 4 in. sq.ft. 5 in. s q — 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: _ PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS.- (23 PARCEL CODE- CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes t�A 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 �a No D. n,22'�'\ PARKS DEPARTMENT] _ REVIEW REQUIRED 0,A ❑ Yes P� No LOCATION OF SIDEWALK I)Front Yard ❑ Side Yard ❑ Other —) WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet5.3 Fee ❑ Other _I DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z�'`� /.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _I 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 Date. Z PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESSCONTROL NO. PARCEL CODE CLEAN SIDEWALK — Type of Defect ❑Yes No See reverse side for Defect Codes A-F _ See below for Defect Code G TRIM VEGETATION ❑Yes C No WATER VALVE �I ADJUSTMENT REQUIRED ❑Yes XNo — PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes M No LOCATION OF SIDEWALK Ca Front Yard ❑ Side Yard I] Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet i\Oth r ❑ 6 inches DEPTH OF SIDEWALK �inches ❑ 5 inches _ AREA TO BE REPAIRE L 7, S ft. 4 in. sq.ft. 5 in. sq.ft. Ei in. CODE F - PATCHES ❑Yes ® No No.of Squares with Patches — CODE G - NOTE:Areas marked with an"I"' may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. Date: ��`(� I� FIRST INSPECTION AND FORM MADE BY �- ��� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ��L PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes [X.No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes C25 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes N No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes R No G �-1�W-DOl7 LOCATION OF SIDEWALK Eg Front Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ff5.3 Fe ❑ Other DEPTH OF SIDEWALK jf9;4inch_ ❑ 5 inches ❑ 6 inches s ft. 6 in. AREA TO BE REPAIRED D .ft. 4 in. sq.ft. 5 in. 4 CODE F - PATCHES ❑Yes M No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'S c I - - 3. - c1060 Slo► PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes R No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes R No WATER VALVE — ADJUSTMENT REQUIRED (� ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED — �� ❑ Yes 0 No l o �:4F1 �`•�i-1 LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5- 5.3 eet ❑ Other DEPTH OF SIDEWALK 'i—nches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE[ L7 T�q.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES �❑ Yes ® No No. of Squares with Patches — CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED — -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /39—z5/o 111A1,1VAd t Z5- 352 - ov a 5c0 2- PARCEL CODE CONTROL NO. 1 CLEAN SIDEWALK Type of Defect AA ❑ 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 N'No I I I PARKS DEPARTMENT Q t REVIEW REQUIRED 0 , i . 'Yes ❑ No 0' S• ° 3, LOCATION OF SIDEWALK ,� Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet �5.3 Feet ❑ Other J DEPTH OF SIDEWALK X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED wm sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -1 CODE F - PATCHES ❑ Yes 9No No.of Squares with Patches _ CODE G - 7 sjBt 6 J�C -�/nE�yT c,�= S/CJ 1 I,c�6� - 2S�pyyzn4 �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: PERMIT ISSUED -I FORMED POURED COMPLETED I CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS" -(3 t-l�\A�,' O9 (3 3S.3 - 04 1 -- 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 ❑ Yes [5� No WATER VALVE ADJUSTMENT REQUIRED Yes) ❑ No — �, PARKS DEPARTMENT REVIEW REQUIRED — z ❑Yes 6d No LOCATION OF SIDEWALK Yg Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet / F ❑ Other — DEPTH OF SIDEWALK n 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2�' ° scVft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES R Yes ❑ No No. of Squares with Patch CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED -I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM i PROPERTY ADDRESS 1"16 Linwood s&q PARCEL CODE CONTROL NO. �I CLEAN SIDEWALK Type of Defect C ❑ Yes PMO See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes WNo WATER VALVE A ADJUSTMENT REQUIRED ❑ Yes N'No PARKS DEPARTMENT SP -� tp REVIEW REQUIRED ❑ Yes 0 LOCATION OF SIDEWALK I�rFront Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Fedt ❑ Other DEPTH OF SIDEWALK c es ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED // �3•.S ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. �4 CODE F - PATCHES ❑Yes NNo No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching. All other areas shall be repaired by �1 reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ZVA 8i/ Date: Ali-�Y 1�YG G •se y PERMIT ISSUED —I FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS AEVU� e113 -25--3s2 - yc>p 66 s- PARCEL CODE CONTROL No. CLEAN SIDEWALK Type of Defect G ❑ Yes XNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes ,xiI No �J{J\, A WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ."No 22,E l0 PARKS DEPARTMENT REVIEW REQUIRED a. + •h ❑ Yes , li1 o LOCATION OF SIDEWALK ($Front Yard ❑ Side Yard ❑ Other .., WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet R'& Feet ❑ Other DEPTH OF SIDEWALK ;W4 inches J'5 inches ❑ 6 inches AREA TO BE REPAIRED �sq. ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ;-10 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by s reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /91'� /` Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS; A9 ✓9i 3 -Z� CONTROLNO. PARCEL CODE CLEAN SIDEWALK ❑Yes PS No Type of Defect See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G -+ ❑ Yes 17'No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ( ] No �0,22 PARKS DEPARTMENT REVIEW REQUIRED f Yes ❑ No k S• a L.i i LOCATION OF SIDEWALK WrontYard El Side Yard Other / t WIDTH OF SIDEWALK El Feet ❑ 5 Feet eet � r�---Oth DEPTH OF SIDEWALK N-4 inches ❑ 5 inches ❑ 6 inches s ft. 6 in.ft. 5 in. q AREA TO BE REPAIRED sq.ft. 4 in. s 4 CODE F - PATCHES El Yes No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by G„I reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY _I PERMIT ISSUED � POURED COMPLETED FORMED CITY OF WATERLOO -- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 353 PARCEL CODE, CONTROL NO. CLEAN SIDEWALK Type of Defect ;' ❑ Yes P�No See reverse side for Defe Codes A-F r See below for Defect Code - I TRIM VEGETATION I I ❑ Yes [ No ,X WATER VALVE rf ADJUSTMENT REQUIRED ❑ Yes Y�l No _ If �o I PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes C�No VIVA I LOCATION OF IDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF IDEWALK ❑ 4 Feet ❑ 5 Feet � 5.3 Feet ❑ Other DEPT OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AR TO BE REPAIRED S sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 2S Yes o No. of Squares with Patches -- CODE G - NOTE =Areas marked with an"P' may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Ulf a�JS Date: - t 4 - (4- PERMIT ISSUED FORMED POURED COMPLETED — _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS; zvS 05 13 -2- -353 - c ( S70 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 TRIM VEGETATION ❑ Yes 7 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No _h PARKS DEPARTMENT REVIEW REQUIRED ❑Yes [0 No I 7 G LOCATION OF SIDEWALK M Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Fee ❑ Other DEPTH OF SIDEWALK C�-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 Ireconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY : )M?S PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' Zy6 L--Wv-rW� �-355 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 El Yes S�,No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes No PARKS DEPARTMENT 10 REVIEW REQUIRED ❑Yes IV No L LOCATION OF SIDEWALK p Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑ 4 Feet ❑LFeet I�'5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 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 �D7 Date: '�S PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS-" Zc-)9 -►�-��°`�`` � -ZS- 3S3- aav 1;-72- 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 PARKS DEPARTMENT e r REVIEW REQUIRED p, ® Yes ElNo _ A l LOCATION OF SIDEWALK P4 Front Yard ❑ Side Yard El Other -`I WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Fee ❑ Other DEPTH OF SIDEWALK C,4,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. �I 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 : aD 5 Date: 4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS- Z« L-)1_(WCV Q 73 PARCEL CODE ' CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑ Yes E°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 E?No PARKS DEPARTMENT _ REVIEW REQUIRED ❑Yes �3 No LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet C- �_3e ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z4`� 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: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' ZZ-E) t,44:i.roULD \3 -zS -9 5-5 - c'�1�o PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes [�I 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 C] No I � PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ®No Q U i\ CkX7 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Qt-3:F>dt ❑ Other i DEPTH OF SIDEWALKVi4chsq.. ❑ 5 inches ❑ 6 inches .�J AREA TO BE REPAIRED 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 FIRST INSPECTION AND FORM MADE BY a� ��� Date: �S PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' ZL 5 L,2/ -Z:; -353 - 03-7 � PARCEL CODE s 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 N No WATER VALVE ADJUSTMENT REQUIRED N -es No PARKS DEPARTMENT 2- CREVIEW REQUIRED � El Yes No LOCATION OF SIDEWALK [P Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet FO5.3:F�eet, ❑ Other -_( DEPTH OF SIDEWALK l 4 inches Q 5 inches ❑ 6 inches _ 7 — Y s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in q- 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. 3�5 Date: A Q - FIRST INSPECTION AND FORM MADE BY 3N -t f 4- PERMIT ISSUED POURED COMPLETED FORMED �. CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' Z3 S -� e25 13 PARCEL CODE, CONTROL NO. CLEAN.SIDEWALK - Type of Defect ❑Yes [�i No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes M No ... WATER VALVE ADJUSTMENT REQUIRED N ❑Yes Q No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Q No y — .�1 LOCATION OF SIDEWALK PFront Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet fS4.3-Feet -J!�Othe 5 y DEPTH OF SIDEWALK 0 4 inches )15 inches ❑ 6 inches i AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. �I CODE F - PATCHES ❑Yes ® No No.of Squares with Patches CODE G - - 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: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM .- PROPERTY ADDRESS' 4yc. . F-f!3 -a�, - 4W PARCEL CODE` J CONTROL NO. Type of Defect ,L �✓ CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G El Yes t No TRIM VEGETATION ❑Yes �J No WATER VALVE -' ADJUSTMENT REQ'D ❑Yes k'No — - ^ PARKS DEPARTMENT t REVIEW REQUIRED _ L12,_ � CR Yes ❑ No X ° .v. (`` n - Vea.sg.i4- Av,. — LOCATION OF SIDEWALK 4 Front Yard IN Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet i 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ;-" 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4W, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Od No No. of Squares with Patches CODE G NOTE :Areas marked with an"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 17 d- T� Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS y S/`b f lca9 A, f /4yc.. 6,113 y5"1 - 00 5n� PARCEL CODE.y CONTROL NO. p CLEAN SIDEWALK Type of Defect / F ❑ Yes y No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes N No WATER VALVE ADJUSTMENTRE(�UIRED N ❑Yes t9 No Ojf , ;` PARKS DEPARTMENT �\ REVIEW REQUIRED a � 30.E ❑Yes QZ No o OV. �eu�art-�- �✓�.. LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard ❑ Other -3I WIDTH OF SIDEWALK ❑ 4 Feet t ❑ 5.3 Feet >rJ Other DEPTH OF SIDEWALK [�4 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '�sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"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 L Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `' Sda PleaSail� ve . 00 CONTROL NO. PARCEL CODE' CLEAN SIDEWALK _ Type of Defect A El Yes i No See reverse side for Defect Codes A-F I TRIM VEGETATION I See below for Defect Code G ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes SBl No _ i PARKS DEPARTMENT REVIEW REQUIRED .— �J 1� XYes ❑ No LOCATION OF SIDEWALK ',I Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet J1 5 Feet ❑ 5.3 Feet ❑ Other 6 inches //( 4 inches El inches ❑ DEPTH OF SIDEWALK / i 5 ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED SQ' sq.ft. 4 in. sq_ 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. L/^` FIRST INSPECTION AND FORM MADE BY Tf Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - ve, -� Sa►3 - �26- Y4 - 007 505 PARCEL CODE r CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes X No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes 51 No WATER VALVE L� ADJUSTMENT REQUIRED p N ❑ Yes [ f No PARKS DEPARTMENT (0,3o F i REVIEW REQUIRED ❑ Yes ;4'No 50 W.V. LOCATION OF SIDEWALK Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet (!�5F�eet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches El inches ❑ 6 inches AREA TO BE REPAIRED( �� � sq 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"I"'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. a FIRST INSPECTION AND FORM MADE BY Date: _I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS/ 535- P1 e2s a✓4 A,e, tia,3 -? - ys-f - 007 S 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 I ''3` TRIM VEGETATION CV 2�,- ❑ Yes f1 No P N WATER VALVE ADJUSTMENT REQ'D ❑ Yes JZ No i 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 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED fk 7 s .ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 1� a- T Date: PERMIT ISSUED FORMED POURED COMPLETED CIT Y OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - 6oS - Ptaasu,74 ;,f- _'I ��t3 -aG -ys(19 - 507 PARCEL CODE�" CONTROL NO. 31, -3 � zo ° �0 Type of Defect i3 d l 0, z See reverse side for Defect Codes A CLEAN SIDEWALK -F �° See below for Defect Code G r ❑ Yes 9 No Ck" TRIM VEGETATION �.. y\ ❑ Yes No ...I N r WATER VALVE v ADJUSTMENT REQ'D _a ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED wymG 54 Lj 7• 5.2 El Yes °I9 No �ILj LOCATION OF SIDEWALK fA Front Yard 1�f Side Yard ❑ Other —_ WIDTH OF SIDEWALK ❑ 4 Feet U)-5 Feet ❑ 5.3 Feet N Other,_,,; _--� DEPTH OF SIDEWALK 4 in es ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -�I CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - �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 : d Date: ,I PERMIT ISSUED --I FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1p� 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 s IPA, r TRIM VEGETATION - ❑Yes No WATER VALVE os ADJUSTMENT REQ'D ❑Yes XNo, — o T PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes No LOCATION OF SIDEWALK Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet j4-5 eet ❑Other _ DEPTH OF SIDEWALK j 4 inches ❑ 5 inches ❑ 6 inches \ 5�,1-"✓ AREA TO BE REPAIRED sq.1t. 4 in. sq.ft. 5 in. CODE F - BATCHES Yes No No. of Squar with Patches — CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : �� TF Date: PERMIT ISSUED FORMED POURED COMPLETED �I I CITY OF WATERLOO !I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' 190q 5f -,Z� - N24 - oiz — �— ?1 PARCEL CODE!. CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes A No See below for Defect Code G TRIM VEGETATION I ❑ Yes 24 No WATER VALVE VI ADJUSTMENT REQUIRED oU�z� I ❑ Yes i%No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes P�No 4- LOCATION OF SIDEWALK I�f Front Yard ❑ Side Yard ❑ Other -'I WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -fffeet 200the� S_��Y_� �.i DEPTH OF SIDEWALK 4 inch ❑ 5 inches 11 ❑ 6 inches AREA TO BE REPAIRED sq. ft. 4 in. sq.ft. 5 in. -sq.ft. 6 in. _I CODE F - PATCHES ❑Yes §4 No No. of Squares with Patches CODE G - �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 : Dl3 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes 5d No — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 9 No T WATER VALVE ADJUSTMENT REQUIRED N El Yes No ,j,f b , I PARKS DEPARTMENT — L REVIEW REQUIRED ❑Yes g No LOCATION OF SIDEWALK % Front Yard ❑ Side Yard El Other _ ^ et Oth S; WIDTH OF SIDEWALK ❑ 4 Feet El Feet F e. DEPTH OF SIDEWALK 4 inch s ❑ 5 inches ❑ 6 inches 490 s ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. q. _ CODE F - PATCHES ❑ Yes L9 No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY f �� Date: -!g _ PERMIT ISSUED FORMED POURED COMPLETED j CITY OF WATERLOO i SIDEWALK REPAIR SURVEY FORK( PROPERTY ADDRESS If aLvall PARCEL CODE CONTROL NO. �I Type of Defect 14 6- -- �I See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G El Yes No I � --• TRIM VEGETATION t h V) ❑ Yes ,�No WATER VALVE ADJUSTMENT REQ'D 5 � �I `�1•,y� 2 I y� ❑ Yes No PARKS DEPARTMENT I (f _ A --- REVIEW REQUIRED kyes ❑ No 10.1, —I _ LOCATION OF SIDEWALK RFrontyard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Ar5.3 Feet ❑Other --� DEPTH OF SIDEWALK _K4 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 V, No.of Squares with Patches COD G A/GL J 7 S% S/ F a 1 1UE'6' JQY -- I NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall reconstruction of full sidewalk panels. be repaired by FIRST)NSPECTION AND FORM MADE BY : _. 2�8 iE Date: Ale- PERMIT ISSUED I FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORK[ PROPERTY ADDRESS t0Qj GI SJ (2 Fill -)-6 - 1-I32- - 017 Cam✓ PARCEL CODE. CONTROL NO. Type of Defect A CLEAN SIDEWALK —. See reverse side for Defect Codes A-F ❑ Yes X No See below for Defect Code G TRIM VEGETATION �.1� ❑Yes No o� Z, WATER VALVE .D i � ADJUSTMENT REQ ❑ Yes !gl No — w��� I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes JK No t5•� 1�'3 LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other r � 1 WIDTH OF SIDEWALK El :Feet Ed Other 4 Feet ❑ 5 Feet _ DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. 4 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- � Date: FIRST INSPECTION AND FORM MADE BY �13 � PERMIT ISSUED FORMED POURED COMPLETED _,,, CITY OF WATERLOO �I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` (002. l��(ilrie' h s _I - $q PARCEL CODE CONTROLNO. Type of Defect rl See reverse side for Defect odes A-F 3 CLEAN SIDEWALK See below for Defect Code G ElYes No �I o� TRIM VEGETATION ❑ Yes No a 1 WATER VALVE �� ao ADJUSTMENT REQ'D M I 3 ❑ Yes No PARKS DEPARTMENT % a REVIEW REQUIRED Yes ❑ No LOCATIO/SIDALK ❑ Front YardSide Yard ❑ Other WIDTH O ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH O4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED X7.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 b reconstruction of full sidewalk panels. y FIRST INSPECTION AND FORM MADE BY : 7F Date: y�FS_A/ I' PERMIT ISSUED FORMED— POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 1010 �`�°t P� ' -,W(p - y3� - 00q &64- 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 g No 9-1u� WATER VALVE _ i ADJUSTMENT REQUIRED c v ' ❑ Yes FX[No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes f�No fSanc 012 T i LOCATION OF SIDEWALK Front Yard ❑ Side Yard/— Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feetf 5.3 Fee ❑ Other DEPTH OF SIDEWALK 4 inches' ` ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRE[l��s 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 J SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS J 005- 5 PARCEL CODE°' CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes K No � See below for Defect Code G � � TRIM VEGETATION ❑Yes P'No p WATER VALVE our� `, ADJUSTMENT REQUIRED� N El Yes W No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ONO LOCATION OF SIDEWALK Front Yard ❑ Side Yard rI El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet (:X:5!3!F�) El Other DEPTH OF SIDEWALK inches ❑ 5 inches `I ❑ 6 inches AREA TO BE REPAIR 'D oZ • d ft. 4 in. r I q sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes KNo No. of Squares with Patches I CODE G - INOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. y I FIRST INSPECTION AND FORM MADE BY : 1�'U '- Date: PERMIT ISSUED I FORMED — POURED COMPLETED I CITY OF WATERLOO 7PROPERTY IDEWALK REPAIR SURVEY FORM RESSA(e- t(32 - CONTROL NO. PARCEL CODE CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes W.No �— - ' WATER VALVE oY\� ADJUSTMENT REQUIRED 'Y) N ❑Yes M No PARKS DEPARTMENT o�L REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK KFront Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK El4 Feet ❑ 5 Feet eet KOther 4 inches El5 inches El inches DEPTH OF SIDEWALK �. ; ✓ s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq. ft. 4 in. q CODE F - PATCHES ❑Yes VNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" panels. by patching.All other areas shall be repaired by reconstruction of full sidewalkp FIRST INSPECTION AND FORM MADE BY : '-T� Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO `i SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE ( CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes X No See below for Defect Code G TRIM VEGETATION ❑Yes No WATER VALVE JN ADJUSTMENT REQUIRED ❑ Yes g No J °U PARKS DE 1 PARTMENT REVIEW REQUIRED 4.5• 60 ❑Yes kNo LOCATION OF SIDEWALK �X Front Yard ❑ Side Yard ❑ Other J WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet _Er the� DEPTH OF SIDEWALK Vq.es ❑ 5inches ❑ 6 inches AREA TO BE REPAIRED ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares q s with Patches JCODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. p y FIRST INSPECTION AND FORM MADE BY _ Date: PERMIT ISSUED J FORMED _ POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORK[ FPROPEFRTYADDRESS 'Aell Lek -+- I 9113 - .26 - 93q - 00Z 10,E PARCEL CODE- CONTROL NO_ U 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 �D _ WATER VALVE ADJUSTMENT REUD v ❑ Yes No I PARKS DEPARTMENT `2 REVIEW REQUIRED s XYes ❑ No LOCATION OF SIDEWALK Front Yard Side Yard El Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet I 5.3 Feet El Other DEPTH OF SIDEWALK 14 inches', ❑ 5 inches ❑ 6 inches s AREA TO BE REPAIRED sq- t- 4 in. s q-ft. 5in. qft. 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: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No J I See below for Defect Code G I TRIM VEGETATI N ❑ Yes 7o WATER VALVE jKN F ADJUSTMENQUIRED ❑ Yes No I \ PARKS DEPARTMENT j REVIEW REQUIRED � �' �— I f- ❑ Yes kNo _I - - - - - _ -I s2 LOCATION OF SIDEWALK XFront Yard ❑ Side Yard o� El Other WIDTH OF SIDEWALK ❑4 Feet • ❑ Other i DEPTH OF SIDEWALK 4 inches ❑ 5 inches -, ❑ 6 inches AREA TO BE REPAI ED 7. 4 sq- in- sq.ft. 5 in. sq. ft. 6 in. —� CODE F - PATCHES ❑ Yes WNo No. of Squares with Patches ` CODE G - .�I -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 : 61 —I Date: PERMIT ISSUED —I FORMED _ POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS " �3 5 t3 -Z G-4725 PARCEL NO. CODE CLEAN SIDEWALK Type of Defect t- ❑ Yes No — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION f I ❑Yes i� No e WATER VALVE ADJUSTMENT REQUIRED ❑Yes No � PARKS DEPARTMENT REVIEW REQUIRED Xt> El Yes 0 No IN V LOCATION OF SIDEWALK p Front Yard ❑ Side Yard Other _ WIDTH OF SIDEWALK El4 Feet ❑ 5 Feet 6.3 Feet/ ❑ Other DEPTH OF SIDEWALK ���� ❑ 5(in2__ ❑ 6 inches AREA TO BE REPAIRE Z�,0 4 in. sq.ft. 5 in. � -- CODE F - PATCHES ' Yes ❑ No No.of Squares with P ches CODE G - NOTE:Areas marked with an"I"' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 7 --1 . 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 A [I 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 I ,a ❑ Yes (� No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No 14 �C' LOCATION OF SIDEWALK '3 Front Yard ❑ Side Yard ❑ Other —I WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 'O er S DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED — y/ sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _I CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All.other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Q 'C7— (4—,Date: PERMIT ISSUED FORMED — POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS°` L t ( -1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 15J Yes ❑ No See reverse side for Defect Codes A-F ION I ' See below for Defect Code G `BRIM VEGETAT ❑Yes S No � T WATER VALVE ADJUSTMENT REQUIRED _ El Yes [r No 3 I i° fla PARKS DEPARTMENT REVIEW REQUIRED C\ ❑Yes N No LL - C I�,..lDc�gN LOCATION OF SIDEWALK [�i Front Yard ❑ Side Yard Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Feet -;�ffOthe DEPTH OF SIDEWALK 54 4 inches ❑ 5 inches ❑ 6 inches T a - AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. s q•ft. 6 in. CODE F - PATCHES ,'>Q Yes No No. of Squares with Patc es CODE G - NOTE : Areas marked with an"I"' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Date: 4 r(-7 — FIRST INSPECTION AND FORM MADE BY .._. PERMIT ISSUED FORMED POURED COMPLETED J CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t_3-z<z- PARCEL CODE- CONTROL NO. �.l 1 CLEAN SIDEWALK Type of Defect See reverse side for Defect Codes A-F El Yes E No � See below for Defect Code G � � TRIM VEGETATION ❑ Yes I1�No WATER VALVE N ADJUSTMENT REQUIRED vrV� I es NO a,k , � PARKS DEPARTMENT REVIEW REQUIRED I ❑ Yes S No 1771 J LOCATION OF SIDEWALK ip Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 5 inches ❑ 6 inches i AREA TO BE REPAIR D 2 s 4 in. sq.ft. 5 in. s ft. 6 in. _ q- CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - _I NOTE :Areas marked with an "F may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. y -' FIRST INSPECTION AND FORM MADE BY : 134 So Date: PERMIT ISSUED —I FORMED _ POURED COMPLETED l CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE-' CONTROL NO. CLEAN SIDEWALK Type of Defect A ElYes No T See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G o JCL I ❑ Yes FNo ID WATER VALVE ✓.1 -1' ADJUSTMENT REQUIRED .- 1 D N ❑ Yes i,No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C�PNo A A- o � LOCATION OF SIDEWALK E Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑4 Feet El Feet i 5.3 Feet El Other 4 irtcfies El inches ❑ 6 inches DEPTH OF SIDEWALK � � / s ft. 6 in. AREA TO BE REPAIRED 4�n sq• 5 in. q _ 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 395 Date: _. PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROP ERTY ADDRESS « 1213 �► —�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 TRIM VEGETATION ❑ Yes [5�No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes QT No PARKS DEPARTMENT v REVIEW REQUIRED .� Yes ❑ No -- 2 i LOCATION OF SIDEWALK &Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet O 5 Fee /l '5.3 Feet Other DEPTH OF SIDEWALK „® 4 niche ❑ 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 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 Date: -� PERMIT ISSUED FORMED — POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d\ -z1 CONTROL NO. PARCELCODE,� CLEAN SIDEWALK A ❑Yes f No Type of Defect T See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G El Yes [ No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No 1 L PARKS DEPARTMENT REVIEW REQUIRED ❑Yes [ No /k — — Side Yard Q Other LOCATION OF SIDEWALK Front Yard ❑ _ WIDTH OF SIDEWALK El Feet El Feet r` 5.3 Fee ❑ Other ---- V41D _-1 5 inches El inches DEPTH OF SIDEWALK ,V+4 inches- ❑ sq.ft. 5 in. —sq.ft. 6 in. sq.ft. 4 in. ---— AREA TO BE REPAIRED _ CODE F - PATCHES ❑Yes CNo No.of Squares with Patches _— a CODE G NOTE: :Areas marked with an"F" may be repaired by patching_ All other areas shall be repaired by — reconstruction of full sidewalk panels. 3 � Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' SgL3 -a26 - y3f PARCEL CODE- CONTROL NO. -- CLEAN SIDEWALK Type of Defect __— ❑ Yes 05.No See reverse side for Defect Codes A-F — I See below for Defect Code G I TRIM VEGETATION ❑Yes ® No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes DdNo °JrJ I I PARKS DEPARTMENT REVIEW REQUIRED Q6n� ❑ Yes ( No LOCATION OF SIDEWALK %Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 F et ❑ Other —I DEPTH OF SIDEWALK $�4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED _-` sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an "I'" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY T-F Date: y PERMIT ISSUED FORMED — POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` ��� Soa-)'1 5 _ `�'a__ ►l - - q7) - o 0 q CONTROL N O. pARCEL CODE-' CLEAN SIDEWALK -- ❑Yes ( No Type of Defect See reverse side for Defect Codes A-F 1 TRIM VEGETATION 1 See below for Defect Code G 1 ❑Yes CZ No ' 1 WATER VALVE ADJUSTMENT REQUIRED ❑Yes l No _ 1 1 1 PARKS DEPARTMENT REVIEW REQUIRED -- �(Yes O No 10 5� -- � Other ---- LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard T WIDTH OF SIDEWALK El Feet ❑ 5 Feet 5 ❑ Other __-- 4 inches � ❑ 5 inches ❑ 6 inches DEPTH OF SIDEWALK f 6 in. i/ sq.ft. 5 in. --sq-ft.AREA TO BE REPAIRED 4►n. _--- sq.ft.- ❑Yes �No No.of Squares with Patches CODE F PATCHES __-- CODE G - NOTE --Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. Date: y /$ / FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED FORMED POURED \,0 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM Ik-10 - PROPERTY ADDRESS C//( _I LIay PARCEL CODE CONTROL NO.Type of Defect G 3!`�,✓/ —� See reverse side for Defect Codes A-F CLEAN SIDEWALK 0 See below for Defect Code G � El Yes No TRIM VEGETATION ❑ Yes N No S WATER VALVE ADJUSTMENT REQ'D —� �s _-*�No PARKS DEPARTMENT REVIEW REQUIRED — — Yes ❑ No —I —� 7" 5{• LOCATION OF SIDEWALK Front Yard ❑ Side Yard ther WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet , 5.3 Feet ❑Other —I DEPTH OF SIDEWALK 4 in ❑5 inches ❑ 6 inches _I AREA TO BE REPAIRED _i � sq.{{ 4 in. sq.ft. 5 in. —sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches �I CODE G - —I NOTE.-Areas marked with an"F"may be repaired b P y patching_All other areas shall be repaired by reconstruction of full sidewalk panels_ FIRST INSPECTION AND FORM MADE BY : p C3 7 Date: I' PERMIT ISSUED FORMED— POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS Sc uzy 67. - ?6-Y3l - a�, 5Z 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 ❑ Yes ONO i WATER VALVE ADJUSTMENT REQUIRED _ N ❑Yes Ill No PARKS DEPARTMENT r�v REVIEW REQUIRED b� ❑ Yes1 No `1D �jv v i u. �' • .._. LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard Other _ .3 Feet ❑ Other WIDTH OF SIDEWALK ❑4 Feet El Feet / DEPTH OF SIDEWALK ❑ 5 inches ❑ 6 inches s fit. 6 in. AREA TO BE REPAIRED (;i7� sq4 in. sq.ft. 5 in. q _ CODE F - PATCHES ❑Yes 9 No No.of Squares with Patches CODE G NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _( SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS---' 1a pA '50'4 S J 8q 13 - aG - y 9 - oo i �13�0 PARCEL CODE- CONTROL NO_ Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G \ ❑ Yes No TRIM VEGETATION ❑ Yes XNo WATER VALVE ADJUSTMENT REQ'D I 7]> ❑ Yes JZ No J PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes gNo J J _ LOCATION OF SIDEWALK ❑ Front Yard f Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet �� ��5.3 Feet El Other DEPTH OF SIDEWALK ❑4 inches me es ❑ 6 inches AREA TO BE REPAIRED sq.ft.6 in. sq.5ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No, of Squares with Patches CODE G - JNOTE:Areas marked with an "F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY . Date: PERMIT ISSUED FORMED_ POURED COMPLETED I - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS,` 932 - oo,,� CONTROL NO. PARCEL CODE/ - CLEAN SIDEWALK Type of Defect Ar -- ❑ No Yes Jf See reverse side for Defect Codes A-F I TRIM VEGETATION I See below for Defect Code G ❑ Yes No I WATER VALVE ADJUSTMENT REQUIRED _ N ❑ Yes Y'No I I PARKS DEPARTMENT -- REVIEW REQUIRED Cv �G El Yes gNo------------ — v u v Sou 5} LOCATION OF SIDEWALK Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5 3 Few ❑ Other DEPTH OF SIDEWALK �, 4 inches ❑ 5 inches ❑ 6 inches ` s ft. 6 in. AREA TO BE REPAIRED - sq.ft. 4 in. sq.ft. 5 in. q• CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels_ u !� FIRST INSPECTION AND FORM MADE BY Date: _.. PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO J SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE-' CONTROL NO. Type of Defect iE CLEAN SIDEWALK I..1 - See reverse side for Defect Codes A-F El Yes X No See below for Defect Code G TRIM VEGETATION ❑ Yes X No WATER VALVE N ADJUSTMENT REQUIRED \A ❑ Yes AND PARKS DEPARTMENT REVIEW REQUIRED J ❑ Yes ❑ No J Li.'7 J LOCATION OF SIDEWALK (� Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet .3 Feet El Other DEPTH OF SIDEWALK i es ❑ 5 inches El6 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 �I CODE G - _! NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. \\ y -� FIRST INSPECTION AND FORM MADE BY : tl lj TE Date: Y'al`/!K PERMIT ISSUED +I FORMED _ POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS• O©r,-- 10 \3 PARCEL CODE- CONTROL NO. CLEAN SIDEWALK Type of Defect [I Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes P No WATER VALVE ADJUSTMENT REQUIRED .— N ❑Yes x No I I PARKS DEPARTMENT \'\ I REVIEW REQUIRED Q ❑Yes ig No LOCATION OF SIDEWALK Ig Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK El Feet El5 Feet �5.3 et ❑Other DEPTH OF SIDEWALK 4 in ❑ 5 inches ❑ 6 inches AREA TO BE REPA IR y('k 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 : s `r- Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS t-I32 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK - See reverse side for Defect Codes A-F ❑ Yes J No See below for Defect Code G TRIM VEGETATION ❑ Yes J4 No WATER VALVE _I N ADJUSTMENT REQUIRED El Yes XNo PARKS DEPARTMENT REVIEW REQUIRED IX Yes ❑ No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _ --I WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 FeetetOt er s DEPTH OF SIDEWALK 194 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 sq. ft. 4 in. sq. ft. 5 in. s q.ft. 6 in. -I CODE F - PATCHES El Yes No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. p Y FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED _ POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS' I (U2 Cl �3 -Z&-479 - O�` CONTROL O. PARCEL CODE - Type of Defect CLEAN SIDEWALK _ See reverse side for Defect Codes A-F ❑ Yes PNo See below for Defect Code G TRIM VEGETATION ❑ Yes ® No WATER VALVE N ADJUSTMENT REQ'D ❑Yes (� No T PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes V1 No s�t� LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet .3 Feet ❑ Other EWALK 4 in h) ❑ 5 inches ❑ 6 inches DEPTH OF SID ZS s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ AREA TO BE REPAIRE q CODE F - PATCHES El Yes No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY `C PERMIT ISSUED POURED COMPLETED FORMED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` 1 (3 -7 5yL7T)} PARCEL CODE' CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes EA No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes CXNo WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes p No !1 3, Svc LOCATION OF SIDEWALK 1] Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ,�,1�3 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRER, L9.__ .: sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. t CODE F - PATCHES ❑ Yes M No No. of Squares with Patches CODE G �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: y- 14— PERMIT ISSUED FORMED _ POURED COMPLETED CITY OF WATERLOO 7PROPERTYADD,RESS" IDEWALK REPAIR SURVEY FORM - S- PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK Type of Defect A ❑Yes L No — y See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes N No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ® No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ® No A — — LQ ___- LOCATION OF SIDEWALK Front Yard ❑ Side Yard Other ` — eet Other � • `� -' WIDTH OF SIDEWALK El Feet ❑ 5 Feet Cj�.- eet DEPTH OF SIDEWALK. [2�4 inches El 5 inches El 6 inches AREA TO BE REPAIRED sq.ft. 4 in. s qft. 5in. 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 1 CITY OF WATERLOO i f. 1 SIDEWALK REPAIR SURVEY'FORM PROPERTY ADDRESS 1 PARCEL CODE r CONTROL NO. 1 Type of Defect 1 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G El Yes 0 No i `'I I TRIM VEGETATION 0 ❑ Yes tS No I z, 3� -s+ WATER VALVE ADJUSTMENT REQ'D ❑ Yes ® No ' q, PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes O.No 5 y" LOCATION OF j SIDEWALK ❑ Front Yard [St Side Yard ❑ Other J WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet meet -S Oth �Is DEPTH OF SIDEWALK [ 4 inches Nr 5 inches ❑ 6 inches AREA TO BE REPAIRED — sq.ft. 4 in. 2fsq. ft. 5 in. sq.ft. 6 in. J CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - —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 : f'j 13 � 90 �►5 /w Date: PERMIT ISSUED -I FORMED— POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS= 00 PARCEL CODE CONTROL NO. � '�- CLEAN SIDEWALK Type of Defect ❑Yes No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes [ No WATER VALVE ADJUSTMENT REQUIRED — �" N El Yes C�PNo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No A_ LOCATION OF SIDEWALK P Front Yard ❑ Side Yard Other — '[� � WIDTH OF SIDEWALK El Feet El Feet 5.3 Feet Other — DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches 1 s ft. 6 in. AREA TO BE REPAIRED -X;� q.ft. 4 in. sq.ft. 5 in. q — 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. 11d _ .( 5�17 5 -- FIRST INSPECTION AND FORM MADE BY . Date: PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO J SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS,- J PARCEL CODE.- CONTROL NO. J Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes � No � } ;�� ��I See below for Defect Code G � l0 I I TRIM VEGETATION ❑Yes ®-No WATER VALVE _I N ADJUSTMENT REQUIRED No s -I I PARKS DEPARTMENT REVIEW REQUIRED _I A ❑ Yes f�_No S,tom LOCATION OF SIDEWALK PT Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ��— ❑4 Feet ❑ 5 Feet met LOt r3_'-/ —I DEPTH OF SIDEWALK N 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. 'i CODE F - PATCHES ❑ Yes ® No No. of Squares with Patches s CODE G - _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 : t30 G\DS Date: ( PERMIT ISSUED FORMED _ POURED COMPLETED i I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 3D C) - oc� CONTROL NO. PARCEL CODE CLEAN SIDEWALK ❑Yes �F-No Type of Defect — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes MNo WATER VALVE �Q ADJUSTMENT REQUIRED ❑Yes [TNo N � PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes Co No ❑ Side Yard Other LOCATION OF SIDEWALK �FrontYard — .fit er WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -Peet inches IN 4 El inches ❑ 6 inches DEPTH OF SIDEWALK r —sq.{ 6 in. sq.ft. 4 in. ._._—sq.fit. 5 in. -- — AREA TO BE REPAIRED — 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_ 4 `� , - : — FIRST INSPECTION AND FORM MADE BY . _-� --- Date PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .511 w a s k iAq hA Sf r-e e,i- 232 - a 16 ✓ 07 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C [I Yes iNo See reverse side for Defect Codes A-F See below for Defect Code G - TRIM VEGETATION ❑Yes No WATER VALVE ST T REQUIRED r (� Yes PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes )6 No 2 d M 4: �311 !-- WAshina\ S+,ree+ LOCATION OF SIDEWALK rq Front Yard ❑ Side Yard ❑ Other 1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other DEPTH OF SIDEWALK K'4 inches ❑ 5 inches6 inches AREA TO BE REPAIRED ` sq.ft. 4 in. sq.ft. 5 in sq.ft. 6 in. J CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches ` CODE G - -1 i _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 2S < Date: 4-15-1Y PERMIT ISSUED FORMED _ POURED COMPLETED i T CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l,o07— 1004 kllm)4144TOL �T. M ►3 - Z4,- 433 - 0,7 ��� PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G V2 TRIM VEGETATION ❑Yes &NO K � � WATER VALVE — ADJUSTMENT REQ'D ❑ Yes IQ No PARKS DEPARTMENT — ��' REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other ��\ WIDTH OF SIDEWALK ❑4 Feet El Feet F eet --60th r q DEPTH OF SIDEWALK C�1,4 inches ❑ 5 inches ❑ 6 inches . ft. 5 in. sq.ft. 6 in. — AREA TO BE REPAIRED �sq.ft. 4 in. s q 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. Z ? — Date: _ FIRST INSPECTION AND FORM MADE BY : PERMIT ISSUED FORMED POURED COMPLETED — Ji CITY OF WATERLOO _I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �T J 433 - a-71 _ lr�l PARCEL CODE CONTROL NO. J Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G TRIM VEGETATION J I ❑Yes CN0 _ WATER VALVE �V ADJUSTMENT REQUIRED ❑ Yes No J I � PARKS DEPARTMENT REVIEW REQUIRED Q60 ❑ Yes M No J A c LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑ Other J WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Cq:53 F t ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIREDZ44sq. ft. 4 in sq. ft. 5 in. s q. ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches _ CODE G - NOTE:Areas marked with an"P'may be repaired by patching. All other areas shall be re aired b reconstruction of full sidewalk panels. p y FIRST INSPECTION AND FORM MADE BY : 726 T� Date. PERMIT ISSUED FORMED — POURED COMPLETED 1 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /10 25 7 77 - UO 7 CONTROL NO. PARCEL CODE �f CLEAN SIDEWALK Type of Defect r f G ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes XNO /12f3 ATER VALVE ADJUSTMENT REQUIRED _ ❑Yes tom.NO PARKS DEPARTMENT REVIEW REQUIRED El Yes XINO _ Q°J 1 3 — — �� ,G G A LOCATION OF SIDEWALK Front Yard I]Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Fee 3-Feet El Other DEPTH OF SIDEWALK ' >�4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED q / ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -s 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: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS //(>(� /�/oG� j , y�ry _ly PARCEL CODE CONTROL NO. Type of Defect ` CLEAN SIDEWALK ' See reverse side for Defect Codes A-F El Yes NNo See below for Defect Code G TRIM VEGETATION ❑ Yes "o ',,,> &Ah > STA-ro ) WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Pf No I � PARKS DEPARTMENT REVIEW REQUIRED ti ❑ Yes I$No A C AF WA-411 lriA) LOCATION OF SIDEWALK ,['Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,<5.3 Feet ❑ Other ( DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED / sq. ft. 4 in. 7 •0 sq.ft. 5 in. sq.ft. 6 in. —I CODE F - PATCHES Yes A NO No. of Squares with Pa ches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 1 FIRST INSPECTION AND FORM MADE BY S Date: PERMIT ISSUED FORMED — POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' t t z d 89i3 Z.5 -3oZ -003 ��� PARCEL CODE'" CONTROL NO. CLEAN_5 1 D EWALK El No Type of Defect �]Ye — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes Pi� No WATER VALVE 10' ADJUSTMENT REQUIRED _ ❑Yes 0 No �oa e N R � PARKS DEPARTMENT 'CiREVIEW REQUIRED ❑ Yes � No — 5,� bra/�F/•�-FG- ....1,4t..�. _ %/ — — 6-o•of LOCATION OF SIDEWALK �1 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet t �Othe ZLI DEPTH OF SIDEWALK MI 4 inches El 5 inches El 6 inches 31$- Is ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED q — CODE F - PATCHES ❑Yes D�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_ 4-- FIRST INSPECTION AND FORM MADE BY �� 3Q� Date: PERMIT ISSUED FORMED POURED COMPLETED ` i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM i PROPERTY ADDRESS ' l 1 z. wAsw 8�t 3 _Z!9: -3017 -00 PARCEL CODE- CONTROL NO. .N S EWALK Type of Defect See reverse side for Defect Codes A-F 54 Yes ❑ No See below for Defect Code G TRIM VEGETATION El Yes te No , WATER VALVE .� L ADJUSTMENT REQUIRED ❑ Yes IT No `11 PARKS DEPARTMENT REVIEW REQUIRED f ❑Yes No LOCATION OF SIDEWALK PFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 'Feet -6 Oth J DEPTH OF SIDEWALK , 4 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED -o "sq.ft. 4 in. sq.ft. 5 in. s ft. 6 in. J q� CODE F - PATCHES ❑ Yes 1� No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be re aired b reconstruction of full sidewalk panels. p y FIRST INSPECTION AND FORM MADE BY : 13N 305 Date: PERMIT ISSUED ,I FORMED _ POURED COMPLETED I r - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS ' g� 13 -Z!� - 30-1 - o� PARCEL CODE CONTROL NO. - �f=AN(R Yes.SIDEWALK El No Type of Defect — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes M No - o / WATER VALVE — ADJUSTMENT REQUIRED C� � ❑Yes No PARKS DEPARTMENT J REVIEW REQUIRED ❑Yes [&No — LOCATION OF SIDEWALK P�5'Front Yard ❑ Side Yard Other — WIDTH OF SIDEWALK ❑ 4 Feet 1115 Feet 5d 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED � 0 sq.ft. 4 in. sq.ft. 5 in. s 9•ft.�- — No No. of Squares with Patches CODE F - PATCHES ❑Yes � CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY _ PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z 0 W8-e Clt/G J 9i3 -zs -3?_�7 - a� PARCEL CODE CONTR L NO. Type of Defect T CLEAN SIDEWALK S e reverse side for Defect Codes A-F ❑Yes CS No � Se below for Defect Code G � � TRIM VEGETATION J ❑Yes ONo WATER VALVE ,J N ADJUSTMENT REQUIRED ❑ Yes ,�T`No J I PARKS DEPARTMENT REVIEW REQUIRED J ❑ Yes DO-`No r�= Js LOCATION OF SIDEWALK Front Yard ❑ Side Ward ❑ Other J WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ❑ 5 inches � ❑ 6 inches AREA TO BE REPAIRE 167. / sq. ft. 4 in. sq. ft�`5 in. sq.ft. 6 in. "J CODE F - PATCHE \ ❑ Yes X No No. of Squares with Patches CODE G J NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired b reconstruction of full sidewalk panels. y FIRST INSPECTION AND FORM MADE BY J Date: PERMIT ISSUED FORMED _ POURED COMPLETED _ l CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS i 5 57— -ZS- CONTROL NO. PARCEL CODE - CLEAN SIDEWALK ❑Yes f)b No Type of Defect — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes l!�No I — WATER VALVE ADJUSTMENT REQUIRED ❑Yes �1 No -- PARKS DEPARTMENT \\>a,1'l REVIEW REQUIRED -f ❑Yes No .21 fJ' ❑ Side Yard Other LOCATION OF SIDEWALK i� Front Yard — WIDTH OF SIDEWALK El Feet El ❑ Other 5 Feet f t��•3 eF -- � 6 inches DEPTH OF SIDEWALK 9 4 inches El inches sq.ft. 4 in. ---- q• s ft. 5 in. `-�-•�sq.ft. 6 in. AREA TO BE REPAIRED CODE F - PATCHES El.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 — PERMIT ISSUED COMPLETED FORMED POURED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' z;,D--3s4 - ,�_ &77 PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK ❑ Yes WNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes allo WATER VALVE N ADJUSTMENT REQUIRED $e� Ip,30• i� I ❑ Yes No J PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No i� ''�A LOCATION OF SIDEWALK 1P Front Yard ❑ Side Yard ❑ Other J WIDTH OF SIDEWALK 0 4 Feet, ❑ 5 Feet E2'5.3 Fee El Other J DEPTH OF SIDEWALK T 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED may. ' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ___/ ❑ Yes No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �- FIRST INSPECTION AND FORM MADE BY : D S Date: _4 -t e- I d_ I' PERMIT ISSUED FORMED _ POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS — °�t 3 Z5 - 7--,S�- 6 k c> 670 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK ` A El Yes E�No Type of Defect -- See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes C No _ WATER VALVE ADJUSTMENT REQUIRED } N ❑ Yes C No I — I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 9 No C) LOCATION OF SIDEWALK fl Front Yard ❑ Side Yard ❑ Other ) WIDTH OF SIDEWALK El Feet ❑ 5 Feet _ et ®'Ot r�.,s 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 Q No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. aDate: 4FIRST INSPECTION AND FORM MADE BY . .(f-�'._ t — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i F oo ( I tjQsh;" �0,, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of D' ect J�r _ / ❑Yes M No See reverse 'de for Defect Codes A-F See below for efect Code G / TRIM VEGETATION ❑ Yes Q,No or k�,.y WATER VALVE N \ ADJUSTMENT REQUIRED o� ❑ Yes Q�No PARKS DEPARTMENT \, REVIEW REQUIRED J ❑ Yes C�No J z4 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ OtheXEh J WIDTH OF SIDEWALK ❑4 Fe ❑ 5 Feet R 5.3 Fe DEPTH OF SIDEWALK T 4 i hes ❑ 5 inches AREA TO BE REPAIREDsq. ft. 4 in. sq.ft. 5 . 6 in. CODE F - PATCHES ❑ Yes R No No. of Squares CODE G - �— —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 : 64 1&0-/ Date: Q -Z2-(� PERMIT ISSUED -_I FORMED — POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -� PROPERTY ADDRESS M3 -26 501 - 6'©5 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 J4 No a d WATER VALVE I`'i ADJUSTMENT REQUIRED N El Yes No I � _ PARKS DEPARTMENT REVIEW REQUIRED El Yes )4 No T �1t1linS�o� .5-�-- LOCATION OF SIDEWALK �(Front Yard ❑ Side Yard Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet, ❑ Other DEPTH OF SIDEWALK r �6 El inches 5 inches El 6 inches ; ft. AREA TO BE REPAIRED sq--- / 4 in. sq.ft. 5 in. s q• 6 in. , CODE F - PATCHES ❑ Yes VNo No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. r LA`4 FIRST INSPECTION AND FORM MADE BY �3 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO ,I SIDEWALK REPAIR SURVEY FORM I PROPERTY ADDRESS e PARCEL CODE CONTROL NO. J Type of Defect CLEAN SIDEWALK � I-]Yes �No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑Yes q No pp WATER VALVE ADJUSTMENT REQUIRED �U Cj- tw I El Yes R1 No PARKS DEPARTMENT REVIEW REQUIRED M Yes ❑ No = l Ayo LOCATION OF SIDEWALK MFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 FeetLj; Feet El Other !I DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ZZ-3 q.ft. 4 in sq. ft. 5 in. sq.ft. 6 in. -�I CODE F - PATCHES ❑ Yes JK No No. of Squares with Patches —� CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. i _ FIRST INSPECTION AND FORM MADE BY : � i E Date: PERMIT ISSUED I FORMED - POURED COMPLETED i - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS: P6 PARCEL CODE -' CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑ Yes JK No — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes No — � ATER VALVE '" ADJUSTMENT REQUIRED Yes ❑ No I PARKS DEPARTMENT — °� REVIEW REQUIRED y ❑ Yes 1 No -h �0 -- LOCATION OF SIDEWALK Front Yard ❑ Side Yard 0 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet '�i 3- eet KOth r 114 DEPTH OF SIDEWALK ❑ 4 inches lP 5 inches ❑ 6 inches s ft. 4 in.—�'- sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED q� _ 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. 4- 'rfF- Date: FIRST INSPECTION AND FORM MADE BY — PERMIT ISSUED FORMED POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS j j;i PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes �fl No See below for Defect Code G � TRIM VEGETATION ❑Yes LX! No WATER VALVE N ADJUSTMENT REQUIRED Q ojc t_ ( El �No \ IO4 I � PARKS DEPARTMENT D t7t`��. REVIEW REQUIRED Ip. :D ❑Yes No ---------------- "vF— LOCATION OF SIDEWALK S Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �A Feet Ot r 1 DEPTH OF SIDEWALK R1,4inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE I. - PATCHES ❑ Yes Q No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST I NSPECTION AND FORM MADE BY : pl `z —E7Date: 1 f- PERMIT ISSUED FORMED _ POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS' ��fl PARCEL CODE CONTROL NO. — Type of Defect A. �, �� CLEAN SIDEWALK T See reverse side for Defect Codes A-F i;_,i Yes 9,No See below for Defect Code G TRIM VEGETATION ❑Yes ;1 No N �O' WATER VALVE ADJUSTMENT REQ'D .7 ❑ Yes X No PARKS DEPARTMENT _ REVIEW REQUIRED tat.3` � I1Yes ] No c (� -7" LOCATION OF SIDEWALK ( Front Yard R Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1*3�Fee ❑ Other DEPTH OF SIDEWALK �A 4 inches X 5 inches ❑ 6 inches -- ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED s q. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - Ian"F" may be repaired by patching"All other areas shall be repaired by NOTE: marked with Y reconstruction of full sidewalk panels. - r Date: � / — FIRST INSPECTION AND FORM MADE BY f ` /'i" PERMIT ISSUED FORMED POURED COMPLETED J CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS F �Z I�GI(inv 1�,� 5-�. J -orb -- r� PARCEL CODE' CONTROL NO. J Type of Defect J See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G rc ❑ Yes iZ No J . � x TRIM VEGETATION ❑ Yes g No \p WATER VALVE x r ADJUSTMENT REQ'D 7:� ❑ Yes No u.tf� PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No _ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �t JA�Oth r ° y , i� DEPTH OF SIDEWALK ]4 inches ❑ 5 inches - ❑ 6 inches AREA TO BE REPAIRED q.ft. 4 in. sq.ft. 5 in. —sq.ft. 6 in. —I CODE F - PATCHES El Yes 64 No No. of Squares with Patches J CODE G - rl 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 : 1�3 v, 7,�_ Date: PERMIT ISSUED FORMED— POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS' qvu, - PARCEL CODE CONTROL NO. ` CLEAN SIDEWALK Type of Defect El Yes No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G � El Yes No _ t WATER VALVE C. j° ADJUSTMENT REQUIRED — t�' El Yes )4No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No � f — LOCATION OF SIDEWALK Front Yard ❑ Side Yard_ _ Other �J WIDTH.OF SIDEWALK El Feet ❑ 5 Feet 5.3 Feet ❑ Other, 6 inches T DEPTH OF SIDEWALK /I 4 irtres El5 inches ❑ 104y s ft. 4 in. sq.ft. 5 in. sq_ft. 6 in. AREA TO BE REPAIRE� � ' q- '- CODE F - PATCHES El Yes No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. /7 FIRST INSPECTION AND FORM MADE BY D� Date: — PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` Dy 54- $1 l3 -�24 - q,7S - - PARCEL CODE" s f CONTROL NO. 1 Type of Defect C CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes ,Bj No --I � See below for Defect Code G TRIM VEGETATION ❑ Yes 0 No WATER VALVE jKN ADJUSTMENT REQUIRED g.1 ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes (K No 34. LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (:�5 F OF ❑ Other j DEPTH OF SIDEWALK 4 inches ❑ 5 inches ..1 ❑ 6 inches J AREA TO BE REPAIR D 6)Z•`/ q. ft. 4 in. sq. ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 7 E JDate: PERMIT ISSUED J FORMED _ POURED COMPLETED I CI TY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESSo�l, — ►3 q 30 - d rt2 PARCEL CODE (o�l� CONTROL NO. � --• CLEAN SIDEWALK Type of Defect _A--- El Yes CNo See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G I ❑ Yes [ (No — WATER VALVE ADJUSTMENT REQUIRED — �,� N ❑ Yes No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes J No 1 - r'7 f LOCATION OF SIDEWALK J!� Front Yard ❑ Side Yard Other J — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .3 Feet [S-0th �' 4 inches ❑ 5 inches El inches — DEPTH OF SIDEWALK � sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED = sq•ft_ 4 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. �S_ly Date: FIRST INSPECTION AND FORM MADE BY �--- — PERMIT ISSUED FORMED POURED COMPLETED i CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS , PARCEL CODE L' CONTROL NO. s 4 CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A-F oa See below for Defect Code G o��,n-� �� I TRIM VEGETATION y J' ❑ Yes Z No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes jai No J I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK aFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -Feet ther ,• y DEPTH OF SIDEWALK 4 inches ❑ 5 inches - ❑ 6 inches AREA TO BE REPAIR D -/V'&_,�sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes rkNo No. of Squares with Patches CODE G - r NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 15-ic� Date: __ �- PERMIT ISSUED FORMED — POURED COMPLE TED ICITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS' ►Q(''J 11�n �an s r 5113 -.26 - 476 - 00J 7aa PARCEL CODE r 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 Z No 1d"�JI� WATER VALVE ADJUSTMENT REQUIRED — �` N ❑ Yes V No I _ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes LRI No — y•3� / _[Other — LOCATION OF SIDEWALK Front Yard El Side Yarn /1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet V[5.3 Feet El Other _ DEPTH OF SIDEWALK 41nc s ❑ 5 inch ❑ 6 inches ft. 6 in. AREA TO BE REPAIRED aa•�'sq.ft. 4 in. sq.ft. 5 in. s q — CODE F - PATCHES ❑ Yes C4 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Y �7 �Y FIRST INSPECTION AND FORM MADE BY Dtj i Date: — PERMIT ISSUED FORMED POURED COMPLETED 1 CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /D!$ icic)l ing7u� 5{ 1 9113 -,�6 - q76 PARCEL CODE CONTROL NO. 1 _ k Type of Defect /t CLEAN SIDEWALK El See reverse side for Defect Codes A-F Yes 0No See below for Defect Code G TRIM VEGETATION 1 I ❑ Yes M No WATER VALVE 1 N ADJUSTMENT REQUIRED ❑ Yes 5f No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0 No _l WC. LOCATION OF SIDEWALK �4 Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 F ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches i AREA TO BE REPAIRE 5` .3 sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 1�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 ; _ �� y/7-/`� Date: PERMIT ISSUED FORMED _ POURED COMPLETED { CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE COAT TROL NO_ Type of Defect CLEAN SIDEWALK r See reverse side for Defect Codes A-F El Yes �(No See below for Defect Code G TRIM VEGETATION El Yes EJNo, WATER VALVE ADJUSTMENT REQ'D 0 Yes KNo PARKS DEPARTMENT REVIEW REQUIRED Yes 0 No q LOCATJ'ON OF SIDEWALK �Front Yard RSide Yard 0 Other WIDTH OF SIDEWALK El 4 Feet 0 5 Feet W5:3-Feet. Both r- DEPTH OF SIDEWALK Id4 inches D 5 inches El 6 inches AREA TO BE REPAIRED _�j �L__sq_ft. 4 in. -sq.ft. 5 in. sq-ft. 6 in. CODE F PATCHES � .Yes El No No.of Squares with Patches Nei O 6r� 7A rt is lhi/u �Gr NOTE:Areas marked with an"F"may be repaired by patching-All other areas shall be repaired by reconstruction of full sidewalk panels. Date: FIRSTINSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS=` //og t,��l/,, �� ,q qV0 - 003 7C PARCEL CODE'' CONTROL NO. �1 CLEAN SIDEWALK Type of Defect A El Yes �No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes VNo WATER VALVE J K ADJUSTMENT REQUIRED ❑ Yes J No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I,NO J _ s o J ` LOCATION OF SIDEWALK 1A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -- DEPTH OF SIDEWALK1`4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq. ft. 4 in. —sq.ft. 5 in. —sq. ft. 6 in. —.I CODE F - PATCHES ❑ Yes ` No No. of Squares with Patches - CODE G - 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: PERMIT ISSUED ._ FORMED — POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS` '14� 4Jollin �vrt 5� ' t3 -�,6 - �i�o - 601-I PARCEL CODE - CONTROL NO. CLEAN SIDEWALK Type of Defect _ G ❑ Yes 0 No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes 9 No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes 14 No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No +e. 4 o' LOCATION OF SIDEWALK �4 Front Yard ❑ Side Yard El Other �� _ WIDTH OF SIDEWALK El Feet El Feet eet �Othe Sz i r t DEPTH OF SIDEWALK X4 inches` ❑ 5 inches ❑ 6 inches s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED - q _ 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 �' T Date: _ PERMIT ISSUED '- FORMED POURED COMPLETED CITY OF WATERLOO _I SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS- ��03 �,�;) �t o Ave - -;4 - YS-9 - 0�2 J/ PARCEL CODE`- CONTROL NO_ _I Type of Defect A _I See reverse side for Defect Codes A-F CLEAN SIDEWALK e See below for Defect Code G ❑ Yes No —I S TRIM VEGETATION ❑ Yes Z No T � N WATER VALVE ADJUSTMENT REQ'D ❑ Yes ,K No t9 PARKS DEPARTMENT `I a REVIEW REQUIRED ❑ Yes ® No `I LOCATION OF SIDEWALK Front Yard 0 Side Yard ❑ Other I —I WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet- 5 3 F t ❑ Other _I DEPTH OF SIDEWALK 44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPA ED j sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —I 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 7`E Date: PERMIT ISSUED -� FORMED - POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ,/ PROPERTY ADDRESS'- _ 811 3 _,2G -y fg O.?0 - CONTROL NO. PARCEL CODE r CLEAN SIDEWALK44 -- ❑Yes No Type of Defect See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes JS No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes R) NoF1 _ PARKS DEPARTMENT REVIEW REQUIRED 0 Yes ❑ No r � �T ❑ Side Yard I] Other LOCATION OF SIDEWALK Front _ _ _ ❑ 4 Feet ❑ 5 Feet (�5.3 eet ❑ Other -- WIDTH OF SIDEWALK �� DEPTH OF SIDEWALK �i 4 inche ❑ 5 inches ❑ 6 inches ;' sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. _---sq.ft. 5 in.❑ — - PATCHES Yes [�l No No.of Squares with Patches CO DE F _-- CODE G - „ patching-All other areas shall be repaired by ^ NOTE :Areas marked with an F' may be repaired by p 9• reconstruction of full sidewalk panels. r Dater FIRST INSPECTION AND FORM MADE BY _ PERMIT ISSUED COMPLETED FORMED POURED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS= �(T fI vc 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 ❑ Yes 1U No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes 4 No PARKS DEPARTMENT REVIEW REQUIRED 9 Yes ❑ No LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 F El Other DEPTH OF SIDEWALK inches El inches El inches AREA TO BE REPAIR 4 sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. ..,Iy 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 l7Cj Date: PERMIT ISSUED FORMED - POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS v CONTROL NO. PARCEL CODE,` CLEAN SIDEWALK ❑Yes [g No Type of Defect _ See reVe�se side for Defectodes A-F TRIM VEGETATION See below-for DefectCode G El Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes M No — PARKS DEPARTMENT REVIEW REQUIRED f [I Yes Q No LOCATION OF SIDEWALK Front Yard ElSide Ya E] Other _ WIDTH OF SIDEWAL ❑4 Feet ❑ 5 Feet 5. Feet [9 Other DEPTH OF SIDEWXLK 4 inches [ (5 inches ❑ 6 inches al sq.ft. 5 in. —sq.ft. 6 in. il,S a s ft. 4 in. — — — AREA TO BE REPAIRED -- q _ CODE F - PATCHES ❑Yes ICI No No. of Squares with Patches _-- CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by N panels-reconstruction of full sidewalk p 4- TF Date: FIRST INSPECTION AND FORM MADE BY — PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `®DI 113 - 2 - Y2 - ��x -� - PAhCEL CODE CONTROL NO. Type of Defect\-A, / See reverse side fbr Defect Codes A-F i CLEAN SIDEWALK See below for Defect Code G ❑ Yes No vI o � TRIM VEGETATION ❑ Yes X No � N r °F WATER VALVE . ADJUSTMENT REQ'D ❑ Yes No o • PARKS DEPARTMENT - 5.7 — REVIEW REQUIRED f — Yes ❑ No � A LOCATION OF SIDEWALK F ont Yard Side Yard ❑ O er WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet JK5.3 Feet ❑ ther DEPTH OF SIDEWALK P44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR D 15`1 j, \, sq. ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATC S El J4 No No. of Squares with Patches ` CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY -rF_ Date: Li %y PERMIT ISSUED —I FORMED _ POURED COMPLETED I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS iLU5 io i PARCEL CODE CONTROL NO_ Ty of Defect --- CLEAN SIDEWALK _ See verse side for Defect Codes A-F ❑ Yes. I No See b low for Defect Code G / TRIM VEGETATION i ❑ Yes No WATER VALVE ADJUSTMENT REQ'D ❑ Yes )(No — 1, PARKS DEPARTMENT — REVIEW REQUIRED e \, 1�,Yes ❑ No :o I��,r�usTo�t- LOCATION OF SIDEWALK Nront Yard S i de Yard El other _ 1 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1_5.3 Feet ❑ Other A DEPTH OF SIDEWALK / K4 inches El inches ❑ 6 inches `J s ft. 4 in. sq.ff. 5 in. sq.ft. 6 in. _ AREA TO BE REPAI D � q \ CODE F - PATCHES KYes Elwi No No.of Squares th Patches CODE G - i NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. '15- _ ,jJ15 Date: — FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -I PROPERTY ADDRESS `Z7,/ I PARCEL CODE CONTROL NO. 1 �.1. C 1 Type of Defect LEAN SIDEWALK ,�'• See reverse side for Defect Codes A-F ❑Yes N No — I See below for Defect Code G I I TRIM VEGETATION —( I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED —I ❑Yes 1P, No .I 1a I I PARKS DEPARTMENT REVIEW REQUIRED L)Yes ' ❑ No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet -Feet aOthe i• y 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. —I 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 A, _Z�-( 4- —I Date: PERMIT ISSUED —f FORMED — POURED COMPLETED I. F-- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ 1 _ PROPERTY ADDRESS' PARCEL CODE:. CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑Yes E3 No — See reverse side for Defect Codes A F - See below for Defect Code G I TRIM VEGETATION I ❑Yes [51 No WATER VALVE ADJUSTMENT REQUIRED — ❑Yes ® No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No o LOCATION OF SIDEWALK q Front Yard ❑ Side Yard Q Other -- eet ❑ Other WIDTH OF SIDEWALK El Feet El Feet 6- — DEPTH OF SIDEWALK 4 inc!7s ❑ 5 inches ❑ 6 inches 24 5 s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIR Bp �sq ft. 4 in. q CODE F - PATCHES �❑/Yes iM)No No.of Squares with Patches CODE G - NOTE =Areas marked with an"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 2_6- PARCEL CODE = CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Pt No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑Yes IL No WATER VALVE ADJUSTMENT REQUIRED pJi I ❑Yes ;X-No PARKS DEPARTMENT REVIEW REQUIRED i C�kYes ❑ No 0 -I LOCATION OF SIDEWALK SPFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 eet ❑ Other _I DEPTH OF SIDEWALK s ❑ 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 N No No. of Squares with Patches j CODE G - NOTE:,Areas marked with an "F may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. _I FIRST INSPECTION AND FORM MADE BY : Date: d _LS - (4- PERMIT ISSUED FORMED - POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 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 �l � TRIM VEGETATION ❑Yes -No WATER VALVE — j ADJUSTMENT REQ'D ❑Yes L,No PARKS DEPARTMENT REVIEW REQUIRED — �v'' E�Yes ❑ No '3, LOCATION OF SIDEWALK Df Front Yard f Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ .3 F et ElOther — ` ❑ 5 inches ❑ 6 inches DEPTH OF SIDEWALK � ,,E,4 inches 1 t�� sq. 4 ft. 5 in. sq.ft. 6 in. — AREA TO BE REPAIR�D q in. sq. CODE F - PATCHES ❑ Yes q No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �O--( Date: FIRST-INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO 1 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. 1 Type of Defect C J. See reverse side for Defect Codes A-F v CLEAN SIDEWALK See below for Defect Code G I — ❑ Yes No 4 ' I 1 TRIM VEGETATION 7 ❑ Yes Q No 1 N WATER VALVE J ADJUSTMENT REQ'D I � ❑ Yes No a O PARKS DEPARTMENT I REVIEW REQUIRED ❑ Yes V No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet a§-F et ELOth 'W DEPTH OF SIDEWALK '_134 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 JCODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _I FIRST INSPECTION AND FORM MADE BY _�3 3�� Date: 4 -Z Z - (4 PERMIT ISSUED -I FORMED - POURED COMPLETED ,I CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS- I Z-( \/�/ U'9l -A, -40;, - CONTR NO. PARCEL CODE — 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 allo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [ L No PARKS DEPARTMENT \D� REVIEW REQUIRED av� � El Yes No VlV I l t�Ty'A LOCATION OF SIDEWALK �g Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK . ❑4 Feet ❑ 5 Feet -id ` eet -,.Other i�- DEPTH OF SIDEWALK ❑ 4 inches fg 5 in ❑ 6 inches — s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. q• — 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 ADS Date: — PERMIT ISSUED -' FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS" 131' PARCEL CODE =` CONTROL NO. _ CLEAN SIDEWALK Type of Defect [I Yes N 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 i N ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes SNo sit 1 LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (�O5.3 et ❑ Other DEPTH OF SIDEWALK ❑ 5 inches ❑ 6 inches AREA TO BE REPAIR rD 74:in2che ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [P No No.of Squares with Patches CODE G - -� NOTE :.Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ` 3a 6� Date: Q '(7 r PERMIT ISSUED FORMED- POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS, CONTROL NO. PARCEL CODE� CLEAN SIDEWALK _ El Yes No Type of Defect [ See reverse side for Defect Codes A _ See below for Defect Code G I TRIM VEGETATION El Yes [z-No I f f '�� WATER VALVE ADJUSTMENT REQUIRED 00 �� N ❑ Yes 54�No _ i PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes L�?No -- LOCATION OF SIDEWALK Front Yard ❑ Side Yard Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ([�'5>3Fet El Other DEPTH OF SIDEWALK. [� 4 inches El inches ❑ 6 inches s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. 4 CODE F - PATCHES ❑ Yes No No. of Squares with Patches —' CODE G - NOTE:Areas marked with an"I"' may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Date: FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED FORMED POURED COMPLETED - CITY OF "IATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l 50�1 `Nth s�f >-353- �3Z -7 PARCEL CODE, CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes [9 No See reverse side for Defect Codes A-F See below for Defect Code G ( TRIM VEGETATION ❑Yes i*No WATER VALVE ADJUSTMENT REQUIRED _XNo o'j-�-s; e o PARKS DEPARTMENT g. REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet [�5 Feet [15.3 Feet ❑ Other DEPTH OF SIDEWALK IT4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED fl sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. J CODE F - PATCHES ❑ Yes PT No No.of Squares with Patches CODE G - -I - _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 : -13d 325 Date: " 5 " (4- PERMIT ISSUED _ I FORMED - POURED COMPLETED _:G CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS` Z: - PARCEL CODE. CONTROL NO. Z 4- Type of Defect o CLEAN SIDEWALK — See reverse side for Defect Codes A-F � , ` ❑ Yes No See below for Defect Code G r TRIM VEGETATION -- �a � ►� ❑ Yes ® No WATER VALVE ADJUSTMENT REQ'D ❑ Yes [)No — 0 PARKS DEPARTMENT _ d I REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK E�'Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet q5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK T�4 inches ❑ 5 inches ❑ 6 inches s ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. q _ 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`31�. 3� � Date: 4 PERMIT ISSUED '- FORMED POURED COMPLETED