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CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑ Yes 0 No See below for Defect Code G TRIM REQU VEGETATIONIRED ❑Yes 0 No ` WATER VALVE ` ' ADJUSTMENT REQD i I ❑Yes Q No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No /i , lie`" LOCATION OF SIDEWALK LI Front Yard 0,Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK In 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED "4"- (2 5 S.F. 5"- S.F. 6 "- S.F. Class S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes LJ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 7 Date: VD- - FORMED POURED COMPLETED CITY OF WATERLO• ERLO• SIDEWALK RE A R SURVEY FORM PROPERTY ADDRESS . -3OC ►' 1,4-23- 47K. - Oc PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED ; Type of Defect $ ❑ Yes I i'No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes fINo — WATER VALVE ADJUSTMENT REQUIRED ♦� •r� / ❑ Yes Er No I I PARKS DEPARTMENT REVIEW REQUIRED lr'Yes ❑ No `- r/ - �q ( )3,5- \ LOCATION OF SIDEWALK © Front Yard El Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1,5.3 Feet ❑ Other DEPTH OF SIDEWALK , J 4 inches A inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- 7/. S.F. 6"- S.F. Class'AT- S.F. — ADDITIONAL REPAIRS 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: /"-Je'� FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes El No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes No WATER VALVE " O((���� ADJUSTMENT REQUIRED ' ❑ Yes t No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes IN No LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 11 Other DEPTH OF SIDEWALK ❑4 inches El 5 inches El 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : Date: 7/7-/i1 FORMED POURED COMPLETED CITY OF WATERL•O SIDEWALK REPAIR SURVEY FO' M PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK C REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes ❑ No - 1 1( WATER VALVE ADJUSTMENT REQUIRED ♦-07r ❑ Yes ❑'No ,04 PARKS DEPARTMENT REVIEW'REQUIRED • (' /L Yes' E"No rzcd LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0-5.3 Feet ❑ Other DEPTH OF SIDEWALK V4 inches 05 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 2.(m.S S.F. 5"-2-e-a•5 S.F. 6 "- S.F. Class'A'- S.F. _ ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes I "No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : PC J1 Date: gfA-"?y FORMED POURED COMPLETED CITY OF WA ERL•'0 SIDEWALK REPAIR SURVEY 41,* I PROPERTY ADDRESS )5 -j3 -4% - 007 r PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes fE111b See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes Li No WATER VALVE ADJUSTMENT REQUIRED I ❑ Yes 0-NO PARKS DEPARTMENT REVIEW REQUIRED - es ❑ No A A - - I4„) LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0-5.3 Feet ❑ Other DEPTH OF SIDEWALK L1 4 inches 0-5 nches ❑ 6 inches Q31,5 2 c,.. ' AREA TO BE REPAIRED 4"-. 2•R' S.F. 5"- r • S.F. 6"- S.F. Class'A'- S.F. ,� ADDITIONAL REPAIRS V 2r5 93104541-✓ CODE F - PATCHES O 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. 1J FIRST INSPECTION AND FORM MADE BY : R'� KT Date: l C� - 9. FORMED POURED COMPLETED • CITY OF WATERLOO) SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f;. `i )27 -, '2. - 415 - c�7e PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I 1 ❑ Yes No — WATER VALVE ADJUSTMENT REQUIRED 3 d j ❑ Yes ❑ No 1,0k PARKS DEPARTMENT REVIEW REQUIRED 3 3c, Yes ❑ No _ LOCATION OF SIDEWALK .hFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .3 Feet ❑ Other DEPTH OF SIDEWALK E(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- i 1 7'6 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : Rg Date: FORMED POURED _ COMPLETED _ CITY SF WATERL•O SIDEWALK REPAIR SURVEY FORM f PROPERTY ADDRESS `` )ems' 7v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect e REQUIRED See reverse side for Defect Codes A-F I ❑Yes allo See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes Elf o \ 1 WATER VALVE ~ - - I ADJUSTMENT REM ❑Yes 0 No I PARKS DEPARTMENT REVIEW REQUIRED - - - - - - 0Yes ❑ No f _ LOCATION OF SIDEWALK 8 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I I-5.3 Feet ❑ Other DEPTH OF SIDEWALK E-4inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-22.3 S.F. 5"- S.F. 6 S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : _ Jai Date: %"` t'" % FORMED POURED COMPLETED CIS OF ` . `ATER OO SIDEWALK ':EPAIR SURVEY FORM PROPERTY ADDRESS 16 T5/ c 5 - 6 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes ❑`No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 0-No "`a` ` WATER VALVE i° ``—* 1/� ADJUSTMENT REQ'D a Ye s s =❑ No PARKS DEPARTMENT REVIEW REQUIRED A ❑Yes 4 No i7 ) LOCATION OF SIDEWALK ❑ Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -0-5.3 Feet ❑ Other f DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- i, S.F. 5"- S.F. 6"- S.F. Class'Al- S.F. ADDITIONAL REPAIRS 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 : K `` Date: FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SU VEY FORM v PROPERTY ADDRESS 4o9 6 2 15113 3t1 .- f PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes LY No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 0 No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 0-NO 411 ,04 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes D-No c; LOCATION OF SIDEWALK 0Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK ,{a] 4 inches ❑ 5 inches ❑ 6 inches J AREA TO BE REPAIRED 4"-2`t-7 S.F. 5"- S.F. 6 "- S.F. Class'A'- _ S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes CNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � Date: (1'. °-19 FORMED POURED COMPLETED CITY OF WATERLO 11 SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS 5 r 4- - S i6 a � . Z / )1 / - '( 2' 0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F -- See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes ❑ No — 1`t jI WATER VALVE ♦. N ...� , }`! ADJUSTMENT REQUIRED — ❑ Yes 0-No PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes ❑'No I-.' LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0`5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ` S.F. 5"- S.F. 6"- S.F. Class'AV- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes LI No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : $ Date: AI-I'd 0 — FORMED POURED COMPLETED CITY OF WATERED• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS , L: C Z �. Ili - 2, - 3i7-- Q15 t PARCEL CODE CONTROL NO. CLEAN SIDEWALK ��10 REQUIRED Type of Defect / ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED 5/ ❑ Yes ❑ No I C, 14 I PARKS DEPARTMENT -- REVIEW REQUIRED ❑ Yes ❑ No 43 � LOCATION OF SIDEWALK .0 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 4"- =' S.F. °5" S.F. 6"- S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS 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: /6 FORMED POURED COMPLETED CITY OF ' 'ATERL(•S SIDEWALK REPA' SURVEY FORM PROPERTY ADDRESS -500 /3 3cc - . PARCEL CODE CONTROL NO. IZ ' CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes No See below for Defect Code G TRIM VEGETATION — kr REQUIRED ti ❑Yes ❑ No s .., WATER VALVE ADJUSTMENT REQ'D Lv ❑Yes i No PARKS DEPARTMENT REVIEW REQUIRED 5 0 �=� ❑Yes tl No V'V//tj 38-,t . LOCATION OF SIDEWALK -0 Front Yard Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED 4"- A.5.S,F. 5"- S.F. 6"- �l ' S.F. Class IN- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes [ 'No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.Ali other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : P 5 Date: l0/2./i t _ FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO M PROPERTY ADDRESS _FCC .(2X . ,506 577"' `)% 'zLi aG=' L >3 13 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes El No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes 0 No — , w WATER VALVE ADJUSTMENT REQUIRED �ad Ke,1� El Yes ] No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes M No ,S ,�I � L. 3r LOCATION OF SIDEWALK ':L7 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet k Other '' ‘- DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches a6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- 030,fa'S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ® No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : /--` Date: :,� 2/1 i FORMED POURED COMPLETED Crry OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS S l L PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK T REQUIRED -- See reverse side for Defect Codes A-F ❑ Yes Li No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No WATER VALVE ADJUSTMENT REQ'D ♦ a I ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK ❑ Front Yard t] 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 4"- ^ S.F. 5"- S.F. 6"- S.F. Class`A'- S.F. ADDITIONAL REPAIRS 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: s , FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L 3 rc?_ reJ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑Yes -El No WATER VALVE 4 ADJUSTMENT REQUIRED ❑ Yes `❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 9,1 LOCATION OF SIDEWALK Et Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LI 5.3 Feet ''0 Other SSI DEPTH OF SIDEWALK O 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 3 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS `- CODE F - PATCHES ❑ Yes 4L No No. of Squares with Patches CODE G - NOTE:Areas marked with an"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 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS >:= PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes Cl No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes E No \t WATER VALVE — ADJUSTMENT REQUIRED Q� Yes El No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C7 No — _ — Sb3rU LOCATION OF SIDEWALK `0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet 1 ;Other 6, DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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: `i /2 3 h ci FORMED POURED COMPLETED CITY OF ATERLODO �- SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5x2 2 E. 37'6 sr- _ - - ') I 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes [] No t WATER VALVE �-- —► �' e ADJUSTMENT REQ'D \ - ❑Yes <0 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK El inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ;`;,' S.F. 5"- S.F. 6"- S.F. Class S.F. ADDITIONAL REPAIRS 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: I E` FORMED POURED COMPLETED C1`( OF ATE; LI• SIDEWALK REPAIR SURVEY FIIR'. PROPERTY ADDRESS _ 5 " 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes ❑"No fifi WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK []'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK Cl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' i S.F. 5 S.F. 6"- S.F. Class'As- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L"No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /6 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2/ (- Z/ 3 ,4/• 8I15 -24 - .6l - off _ aG PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ft ❑ Yes LJ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes No 4 WATER VALVE 2/ ) ... 26, ADJUSTMENT REQUIRED ` ❑ Yes E to PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes B-IQ-o torrile111 I r�k,i LOCATION OF SIDEWALK Font Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ©`ether DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- "7 LI.`I -S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes i I1 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 : RS la Date: -a Ip FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS � 2.4 _ 1 -z4-- 4.4 - 0 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes IE No -- See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes Et1S o -' WATER VALVE _ z,1 o ADJUSTMENT REQUIRED ❑ Yes @-No 1\ I _ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes CTICIoIsA — LOCATION OF SIDEWALK I Yfront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Er Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- ,' - S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Ole No. of Squares with Patches CODE G NOTE : Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : trZ() � Date: -7-3-1 i FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAll SURVEY FORM PROPERTY ADDRESS `7217 E, ` ' A .� MI5 -7 - 361 - ®h - 7 PARCEL CODE CONTROL NO. h � Imo" N J CLEAN SIDEWALK Type of Defect e � REQUIRED See reverse side for Defect Codes A-F z_ ❑Yes Ei No See below for Defect Code G ‘A TRIM VEGETATION •c g '2 \ REQUIRED �aN N x°M o ❑Yes ®No t " WATER VALVE 2`7 - 2 ! -> • ADJUSTMENT REQ'D ❑Yes [� lo o M ra 3 N x - `, PARKS DEPARTMENT ® 1� \ REVIEW REQUIRED c� Q ❑Yes Er No ;V )\\ LOCATION OF SIDEWALK ❑ Front Yard 1-Bide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ` 5.3 Feet Other DEPTH OF SIDEWALK ICJ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '3 S.F. 5"- S.F. 6 "- S.F. Class'IV- 2.5&.2 S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes [AID No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : IN - Date: 9- -} FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 301 e. 4 8h3 -% - 0 -oro PARCEL CODE CONTROL NO. ,f CLEAN SIDEWALK Type of Defect / REQUIRED See reverse side for Defect Codes A-F I ❑Yes f Tlo See below for Defect Code G TRIM VEGETATION REQUIRED — ❑Yes 0-No 1�� 1 "` if WATER VALVE I ADJUSTMENT REQ'D I�j Ii ❑ Yes D No — PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes Ca-No r / c A A 'c A )/ nA' s,2.*8.0 z 41.r. A`'=G/AFkY E l'4ll z s LOCATION OF SIDEWALK ❑ Front Yard `ti-Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet -iT--Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- ' , I S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes ❑'No No.of Squares with Patches CODE G - -- NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by .,._. reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ,� )L Date: 9--3 -/9 k.. FORMED _ POURED COMPLETED CITY OFWA ER O SIDEWALK REPA SURVEY FOR' i PROPERTY ADDRESS 52 - 73 Z,ce-,4"4- r.: 3 - 4- / - 0 ' - 43 PARCEL CODE CONTROL NO. �j NZ \, >G g9 J . 1\\"I ' CLEAN SIDEWALK Type of Defect ! , - REQUIRED — See reverse side for Defect Codes A-F I ❑Yes 1No See below for Defect Code G 1- I TRIM VEGETATION REQUIRED — v ge ❑Yes ErNo i;, WATER VALVE — .4.-0 323-"Li ADJUSTMENT REQ'D Je \ I \ L Yes ❑ No l I i 4 ail o it I . PARKS DEPARTMENT I to REVIEW REQUIRED 11 u — — — — — — — 1 CI Yes ❑ No I I ®� 'raj \_5" r 6,k ,t,3`- L1(9t4T l LOCATION OF SIDEWALK gl.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet p Other _ DEPTH OF SIDEWALK II-4 inches ❑ 5 inches 4 6 inches AREA TO BE REPAIRED 4"-9Z-9 ' S.F. 5"- S.F. 6 "- r76.1 S.F. Class'A'- 2 I%-1 S.F. — ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes EL No No, of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : le.-52 Date: ,"Z3")7 FORMED POURED COMPLETED CITY .F WATERLOO - S DEWAL< REPAIR SURVEY FORM PROPERTY ADDRESS 4 t5- c 1 i £ 'I s' S — 3 - 2q- 313 - �_ac< i PARCEL CODE CONTROL NO. -- CLEAN SIDEWALK Type of Defect '. + Zq REQUIRED See reverse side for Defect Codes A-F `' I ❑ Yes D No See below for Defect Code G -- TRIM VEGETATION REQUIRED ❑Yes ❑'No — `01' WATER VALVE ~ `•'� ADJUSTMENT REM)i ❑Yes No — I PARKS DEPARTMENT Lr REVIEW REQUIRED \ G — — — — — j;l �rG=.i r ❑ Yes L7 No J LOCATION OF SIDEWALK ❑ Front Yard Q Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Ci'Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- g 27,E S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : 42 --5 Date: tr-l3/1/9 FORMED POURED COMPLETED r... CITY OF WATERLS SD SIDEWALK REPAIR SURVEY 70 ',.i PROPERTY ADDRESS - _ 6. 19 . 'h St . Z°113- 2 - ; PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect ' ❑ Yes E l No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes CI No WATER VALVE '` , ADJUSTMENT REQUIRED t-- ` I �vOk Li Yes No PARKS DEPARTMENT REVIEW REQUIRED • Co-® ) :1) ❑ Yes 0 No !` `, ice/ - - - - - L . . +t"\ SA- LOCATION OF SIDEWALK U Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet lal Other DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 S.F. 5"- S.F. 6 S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ,.:=I No No.of Squares with Patches _ CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : - Date: I hitq FORMED POURED COMPLETED CITY OF 5r'ATERLOO SIDEWALK EPA➢' SURVEY FORM PROPERTY ADDRESS i E. _ 4 a® -2 - cQ - 0/4-- PARCEL CODE CONTROL NO. -- I CLEAN SIDEWALK Type of Defect it REQUIRED See reverse side for Defect Codes A-F I ❑Yes LINo See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes nL`No _ 'moo WATER VALVE f ' �� 76 I . ;®.1 ADJUSTMENT REM)I� a ❑Yes ❑`No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes LINO 3.4 /ft IAA E- LOCATION OF SIDEWALK ❑•Front Yard LI Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0 5 Feet E`5.3 Feet ❑ Other — DEPTH OF SIDEWALK - 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- I S.F. 5"- S.F. 6 "- - `L." S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: re-3-0 FORMED POURED COMPLETED CITY OF '.F 'T ER�LO SIDEWALK REPAID' SUN VEY =ORM PROPERTY ADDRESS / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect r` REQUIRED See reverse side for Defect Codes A-F ❑Yes 0`No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes L No / WATER VALVE � V� — ADJUSTMENT REQ D ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes O No j LOCATION OF SIDEWALK ❑ Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other `- DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. pp FIRST INSPECTION AND FORM MADE BY : I"� � Date: /0- 4 -69 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAY: SURVEY FORM PROPERTY ADDRESS zri PARCEL CODE CONTROL NO. -- w CLEAN SIDEWALK Type of Defect REQUIRED F See reverse side for Defect Codes A-F I 0Yes ❑ No See below for Defect Code G -- I TRIM VEGETATION REQUIRED Eyes No WATER VALVE � `I 1 ADJUSTMENT REQ'D i ❑Yes ❑ No PARKS DEPARTMENT "'- REVIEW REQUIRED ❑Yes ❑ No J LOCATION OF SIDEWALK ❑ Front Yard E Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other -- DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- t? 'S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 ; P-' Date: FORMED POURED COMPLETED CITY OF WATERAi• SIDEWALK REPAIR SURVEY FORM I / PROPERTY ADDRESS E (-- -- c it3 - zi - 304- - cog PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A 6 7, REQUIRED err ` e . See reverse side for Defect Codes A-F 1 ❑ Yes riNo See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes L10 — ` 1 \S WATER VALVE G .` c ADJUSTMENT REQ'D a ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes l o Cc - -C — A- - 'i 73 /t o 1•3\ 1.7 lipI alt LOCATION OF SIDEWALK Fr Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet IE Feet ❑ 5.3 Feet L315ther 94 3 DEPTH OF SIDEWALK { 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- (11'7 S.F. 5"- S.F. 6"- f a1 f S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes a44o No. of Squares with Patches CODE G - NOTE :Areas marked with an"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-T Date: /6-Z./"(6) FORMED POURED COMPLETED CITY OF '.1ATE LO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS g2s' F. 4' ° - gq►3 - 304 -Qo1' PARCEL CODE CONTROL NO. Type of Defect f CLEAN SIDEWALK — yp r REQUIRED See reverse side for Defect Codes A-F I ❑ Yes -No See below for Defect Code G TRIM VEGETATION — I REQUIRED ❑Yes 17:1--No �- N � �2-5 ADJUSTMENT WATER VALVE ADJUSTMENT REQ'D ❑Yes 2'No PARKS DEPARTMENT —cix0 EQUIRED 4_ — C C — — Yes [ o — tom 5,ty i Rr, /�J" ¢ (j J, Afrotio LOCATION OF SIDEWALK i Font Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Feet ❑ 5.3 Feet 2'0ther 7,3 _ DEPTH OF SIDEWALK l inches ❑ 5 inches 1t6 inches AREA TO BE REPAIRED 4"- G�3� 7 S.F. 5"- S.F. 6 "- ��lf S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Kr-No No. of Squares with Patches CODE 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 V� FIRST INSPECTION AND FORM MADE BY : li-s �`� Date: I° Ya/- Ic — FORMED POURED COMPLETED CITY OF WAT ERLS,• S➢DEWA_K !SEPAIR SURVEY FORM PROPERTY ADDRESS / 5913 -2,4 - /&A - cCi PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect �� I REQUIRED See reverse side for Defect Codes A F I I ❑Yes „MCI() See below for Defect Code G I TRIM VEGETATION _ REQUIRED ❑Yes aL'No A `Q q— WATER VALVE �0 ADJUSTMENT REM) j, ❑Yes fl-No PARKS DEPARTMENT REVIEW REQUIRED ` - - - - - ❑Yes 2No 4,3 A Lk,E, LOCATION OF SIDEWALK ❑ Front Yard 2 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ®15 Feet ❑ 5.3 Feet Other _ Y$ DEPTH OF SIDEWALK L7 4 inches ❑ 5 inches ET 6 inches AREA TO BE REPAIRED 4."-9�. 'S.F. 5"- S.F. 6 "- 38.6 S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes a No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: (p-- 23 - FORMED POURED COMPLETED CITY OF WATERED• SIDEWALK REPAIR SURVEY Fa*PROPERTY ADDRESS tit; -7 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 1, ❑ Yes 7No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I ❑ Yes No WATER VALVE Dols �p27 ADJUSTMENT REQUIRED ❑ Yes -a-No PARKS DEPARTMENT ��6 REVIEW REQUIRED ID ❑ Yes LI-NO — . c . c c 17. .1i. e. LOCATION OF SIDEWALK I i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑°`5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches El-6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- l'f S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L 1 -lo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �q FIRST INSPECTION AND FORM MADE BY : R c Date: / ' FORMED POURED COMPLETED -� CITY OF WATERLOG SIDEWALK REPAIR SURVEY F•RM PROPERlY ADDRESS f:.7G0 ee-K E., 4 -24-105 . -De PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C ❑ Yeso See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED❑ Yes Ao � I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ? No is c Yvq,4 tr;‘,1 ,�i� (59 _ E, LOCATION OF SIDEWALK Lront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Q'5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ❑ 4 inches { inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- ,© S.F, 6"- S,F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : r- Date: /0 Z3 —/7 FORMED POURED COMPLETED CITY OF WATERLOG SIDEWALK REPAIR SU *VEY FORM -- PROPERTY ADDRESS _ /9O ez 4771' s ,.. j1 -z4 - (o . - oll PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _ ❑ Yes C'i% See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes 0-do WATER VALVE ADJUSTMENT REQUIRED ~ ``` ❑ Yes C No \ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes �No 53 6. Potu - 4 LOCATION OF SIDEWALK I(Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -r5.3 Feet ❑ Other DEPTH OF SIDEWALK finches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- or( S.F. 5"- S.F. 6"- S.F. Class'AT- S.F. ADDITIONAL REPAIRS 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: 4b"7-�' /1 FORMED POURED COMPLETED q CITY OF t`:'/ vTERL,OO SIDEWALK REPAIR SURVEY EY FORM PROPERTY ADDRESS /4 j I E. 41A-- -L4 - fo3 -�Ai vra PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C REQUIRED See reverse side for Defect Codes A-F 20 Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes No -- ,. U WATER VALVE f 0` (/� � ADJUSTMENT REQ'D 4. a I ❑Yes El-No 7-4 PARKS DEPARTMENT REVIEW REQUIRED 60 CL /}/1 ❑Yes .2-No 5'1G - r alb OC1 LOCATION OF SIDEWALK L Front Yard OSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet K.5 Feet 121'5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches er6 inches q(2g• AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'Al- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes dfiNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 16 kr Date: /0.-ZI.A FORMED POURED COMPLETED CITY ll OF WAT ERLO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (621 - 161-5 •- i -a4 - /o 5 - 62-5 PARCEL CODE CONTROL NO, rwKSieL CLEAN SIDEWALK Type of Defect /"y 0 o REQUIRED See reverse side for Defect Codes A-F ❑Yes ❑ No See below for Defect Code G TRIM VEGETATION — REQUIRED ❑Yes ❑ No t ` WATER VALVE 4— (021 - G Ly ADJUSTMENT REQ'D Ces ❑ No de. PARKS DEPARTMENT 43,441-y 3 REVIEW REQUIRED — _ 4 — _ ❑Yes ❑ No la, �73 LOCATION OF SIDEWALK Front Yard bide Yard ❑ Other WIDTH OF SIDEWALK -- ❑ 5 Feet X5.3 Feet Z Other 4.c , ',Z DEPTH OF SIDEWALK [ inches ❑ 5 inches l—inches AREA TO BE REPAIRED 4."- 11°' I S.F. 5"- S.F. 6"- S.F. Class'A'- 50.O S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ No No. of Squares with Patches CODE G - NOTE _Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. kFIRST INSPECTION AND FORM MADE BY : Date: / Z3 .. 7 FORMED POURED COMPLETED — CITY OF WATERLO SIDEWALK REPAIR SURVEY F• PROPERTY ADDRESS . (o'L► A"r5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED ❑ Yes ZrNo See reverse side for Defect Codes A-F j See below for Defect Code G TRIM VEGETATION REQUIRED r j ❑ Yes Eil No 1` jI WATER VALVE 1 ti ADJUSTMENT REQUIRED I l ❑ Yes 121Io PARKS DEPARTMENT REVIEW REQUIRED �} .11-es ❑ No _ 4DA v LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet el.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 3) p a S.F. 5"- S.F. 6"- _ S.F. Class`A- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes I'-1 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : f-5 Date: 0.2-5-f 1q FORMED POURED COMPLETED CITY OFWATTE!LO SIDEWALK REPAIR SURVEY FIRM PROPERTY ADDRESS . f/'7 ADMvt5 j t - 1�r- - c O l '' ?7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ErNo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 2-No WATER VALVE ADJUSTMENT REQUIRED �— --► tri ❑ Yes ErNo ,04 PARKS DEPARTMENT REVIEW REQUIRED nn ❑ Yes I'No !l - - - - - - fi — 31, Oho LOCATION OF SIDEWALK 2-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 65.3 Feet ❑ Other — DEPTH OF SIDEWALK 13 4inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- l S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. -" ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes lErNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: �©'G.5"r-` -- FORMED POURED COMPLETED — CITY OF WATE LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 327 A- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect f f REQUIRED ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED — ❑ Yes 2-No WATER VALVE -11 ADJUSTMENT REQUIRED V•► ❑ Yes El No \ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Cl No r r✓ G C (2, \ 4,0 4, $.a 3.? /1110)4-0 LOCATION OF SIDEWALK i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 9-5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches Q-5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-/056 S.F. 5"- I` ,1 S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes El-ic6— No. of Squares with Patches CODE G - X ' CA Ott' ��. (i) citti IF P�XfM NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : Date: /0 FORMED POURED COMPLETED CITY 'OAF WATER_®O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS —i A t -2i-SD-Z• - 00 ' , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect fl REQUIRED See reverse side for Defect Codes A-F I ❑Yes ❑`No — See below for Defect Code GI TRIM VEGETATION REQUIRED ❑Yes I'No s- WATER VALVE --► g. ADJUSTMENT REQ'D — I(l\ I v ❑Yes Er No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes 2"No 4f 1' 1 %( / �I.5 5.2- ; — /ILI'UtiaJ> — LOCATION OF SIDEWALK Er Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK 'El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"-— S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — 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 : ' Date: it 1. )i) FORMED POURED COMPLETED CITY OF WATER__,* • SIDEWALKS REPAIR SURVEY FIRM PROPERTY ADDRESS C) AZM 9t3 -2%- - - cC=t PARCEL CODE CONTROL NO. Type of Defect E® CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F faYes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED _ * CI Yes El No r WATER VALVE ADJUSTMENT REQ'D \ ❑Yes ❑ No PARKS DEPARTMENT C £ REVIEW REQUIRED — — ❑Yes ❑ No ys 4 a tt i) LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard Li Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet /7 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches 0-5 inches ❑ 6 inches — AREA TO BE REPAIRED 4" v S.F. 5"- _: =°5 S.F. 6 "- S.F. Class'A'- S,F. ADDITIONAL REPAIRS 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: (' ",f FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM �t�" /��1'+r`l�:it' ) / PROPERTY ADDRESS --- - ` ' 7 �E PARCEL CODE CONTROL NO. - CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED CI Yes ElNo WATER VALVE — �I ADJUSTMENT REQUIRED 41-- `a —► ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ( CIYes El No C ! - ! .i LOCATION OF SIDEWALK .J=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 4"- '3.S S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : I' Date: rt''411 '" FORMED POURED COMPLETED _ j CITY OF A TERLo. SIDEWALK REPAID-: SURVEY FOR . PROPERTY ADDRESS . 570,o 13tX 4tmoid6 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect El Yes Li No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED — I ❑ Yes ❑ No WATER VALVE 411-42) ` ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK _0'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -0 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- `° S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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 j (; '&1 Date: l`� � �7 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO,RM PROPERTY ADDRESS . 50 4 rVtiba 677 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect j21es ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No 11/4 WATER VALVE — 4 jI ADJUSTMENT REQUIRED -- --► ❑ Yes ❑ No — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No /1-1 Liclictsf LOCATION OF SIDEWALK -❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '' S.F. 5"-_ S.F. 6 "- S.F. Class'A'- — S.F. ADDITIONAL REPAIRS 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 Date: l _ -`- FORMED POURED COMPLETED CITY OF `,1ATER_00 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS >5s-1 3 PARCEL CODE CODE CONTROL NO. CLEAN SIDEWALK Type of Defect r REQUIRED See reverse side for Defect Codes A-F i0 Yes IYNo See below for Defect Code G TRIM VEGETATION REQUIRED 0 Yes 0.No WATER VALVE 7 N ADJUSTMENT REQD Aae \14 IQ 0 Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED 0 Yes ,b No t1/2 I ol e S4- .... LOCATION OF SIDEWALK Front Yard LI Side Yard 0 Other WIDTH OF SIDEWALK 0 4 Feet LI 5 Feet \LI 5.3 Feet El Other DEPTH OF SIDEWALK -0 4 inches 0 5 inches El 6 inches AREA TO BE REPAIRED 4 u- - S.F. 5"- S.F. 6 "- S.F. Class S.F. ADDITIONAL REPAIRS CODE F - PATCHES El 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: /t2 FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY FOr'M PROPERTY ADDRESS �- i't:a / � U 1 1 5 4 y „>_ •` f rj'tee PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect Eli Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED i ❑ Yes ❑ No WATER VALVE — jI ADJUSTMENT REQUIRED �--Q—► J L La ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No VW- LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ .3 Feet ❑ Other DEPTH OF SIDEWALK 4 4 inches 0"5-in-ehes- E l 6 inches AREA TO BE REPAIRED 4"-- ' " S.F. 5"- _S.F. 6"- '-.°C''S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. izm FIRST INSPECTION AND FORM MADE BY : Date: /e L ! 1 FORMED POURED COMPLETED • CITY OF WATERLOO ERLOO SIDEWALK REPAIR SURVEY FOR 1 PROPERTY ADDRESS /,� /titlAp/V PARCEL CODE CONTROL NO. Type of Defect ACLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F - ❑ Yes See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes L9 No t WATER VALVE ` "g ADJUSTMENT Q'D a ��� ❑Yes 11 No PARKS DEPARTMENT REVIEVy REQUIRED Yes ❑ No 14i ref— LOCATION OF SIDEWALK KJ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet — Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- aS•;) A S.F. 5"- S.F. 6 "- S.F. Class' '- — S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 12-No No. of Squares with Patches CODE G - NOTE ;Areas marked with an "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 ii. Date: /0"1.3-4 FORMED POURED COMPLETED CITY OF WATERLS® SIDEWALK REPAIR SURVEY FOB:.`, PROPERTY ADDRESS . o . Aa/k,6-Ar t - - — 9/ 3 -24 -!o>' - OZ PARCEL CODE CONTROL NO. - CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes C N° See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ZiNo Oa/ 11/4 tit WATER VALVE — ADJUSTMENT REQUIRED ❑ Yes leriClo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes B'No - - - - - A — q S\ LOCATION OF SIDEWALK I'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet V(5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 121.-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 56.4) S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes io No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. pp�� FIRST INSPECTION AND FORM MADE BY : t' [CT Date: /v 23--1 FORMED POURED COMPLETED CITY OF WA-ERLOs SIDEWAL< REPAIR SURVEY FORM PROPERTY ADDRESS 303 4- , 1 .' ✓10 -zit- (°4 - �a PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A REQUIRED See reverse side for Defect Codes A-F I ❑ Yes ©'No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yeso WATER VALVE 4 . ADJUSTMENT REQ'D s ,► I ❑Yes e No PARKS DEPARTMENT REVIEW REQUIRED — _ [» Yes ❑ No 1.041 KIXI WA St 5:1 51 0 iv* LOCATION OF SIDEWALK ❑ Front Yard ia'Side Yard ❑ Other WIDTH OF SIDEWALK ❑�4 Feet '1�L 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- lt S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS e`4, key CODE F - PATCHES ❑Yes 4lo No. of Squares with Patches CODE G - NOTE ;Areas marked with an"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: In FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 3 H H Z 110 4a PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑Yes rlo —' See reverse side for Defect Codes A F TRIM VEGETATION See below for Defect Code G 1 REQUIRED ❑ Yes WATER VALVE — 4 i ADJUSTMENT REQUIRED t-- N —'W'' ��! ❑ Yes Z1io PARKS DEPARTMENT RE EQUIRED Yes 1 A 4,3 LOCATION OF SIDEWALK VI-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 4"- ar'o c S.F. 5"- S.F. 6"- S.F. Class'A`- S.F. — ADDITIONAL REPAIRS 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 : K5 Date: l° FORMED POURED COMPLETED '- CITY OF WATER-S SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS fe L ,., „ 03 -Z4- 6)3 - 023 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F I fes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED es ❑ No *1 ` WATER VALVE � -0. 472-r ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 4: — — ❑ Yes CI No /ti OIJ'1 LOCATION OF SIDEWALK Ci-Front Yard l3Side Yard El Other WIDTH OF SIDEWALK Cl 4 Feet 2-5-Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK -�4 inches El5 inches El6 inches AREA TO BE REPAIRED 4"- (153..3 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : !jc Date: /° '/9 FORMED POURED COMPLETED CITY OF WA ERL•• — SIDEWALK REPAI' SURVEY FORM PROPERTY ADDRESS !O /rfi1?.. — gc i3 - - 103 . -b32..- 51 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes 1No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑lo + WATER VALVE — 1 ADJUSTMENT REQUIRED 410 ❑ Yes ❑ No I � .04 I — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes iJ No 9,0 / huo LOCATION OF SIDEWALK C ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet i15 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK I (4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 45",o9 S.F. 5"- _S.F. 6 "- S.F. Class IN- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ill-No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : tT1 Date: ro 23 FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . . ,4-i ffic7 Jai -003 f PARCEL CODE CONTROL NO. CLEAN SIDEWALK 4 REQUIRED Type of Defect ❑ Yes ®'No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes eNo WATER VALVE \ 1y ADJUSTMENT REQUIRED 4// ❑ Yes l to PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes Q�iito _ _ (-7/4 .50 ti-Pkgivr LOCATION OF SIDEWALK .iJ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet C a Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK [4:inches inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- .925 O r S.F. 5"- S.F. 6"- S.F. Class'A- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: /6)—r1—l? FORMED POURED COMPLETED CITY OF WATE!!'tOii SIDEWALK REPAIR SURVEY POEM PROPERTY ADDRESS f1/1 F - j`3 -z-4 - Ida -o ) PARCEL CODE CONTROL NO. - CLEAN SIDEWALK REQUIRED Type of Defect ' ❑ Yes ifl-No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED / ❑ Yes Ll No WATER VALVE — ADJUSTMENT REQUIRED £ 4/1 ❑ Yes (4lo PARKS DEPARTMENT REVIpN REQUIRED Yes ❑ No 5:0\ LOCATION OF SIDEWALK ( -Ffont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet C 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK fl`4 inches iY5 inches ❑ 6 inches �1�' AREA TO BE REPAIRED 4"- c25:© S.F. 5"- g � S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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. 1� FIRST INSPECTION AND FORM MADE BY : Date: /0 — FORMED POURED COMPLETED CITY OF ATER_®® SIDEWALK REPAIR SUf-*VEY FORM PROPERTY ADDRESS . / ciJ il PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes '<No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED _ I I ❑ Yes EfrNo WATER VALVE F ADJUSTMENT REQUIRED 4/9' D Yes ❑allo PARKS DEPARTMENT y�uQ REVIEW REQUIRED • ❑ Yes ETI‘lo w r >, P LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet /Z 'Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK winches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- X - S.F. 5"- S.F. 6"- S.F. Class'A'- — S.F. ADDITIONAL REPAIRS _ CODE F - PATCHES ❑ Yes to No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : - Date: /0✓z FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 42-27- /1r,'a/iv 13 " 2 - - /05 - G`o " 55 _ - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A REQUIRED See reverse side for Defect Codes A-F ❑Yes erNo See below for Defect Code G TRiM VEGETATION REQUIRED ❑Yes 2-No WATER VALVE 422 I ADJUSTMENT REQ'D ©\ ❑ Yes 12'No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I -No 40 LOCATION OF SIDEWALK ❑ Front Yard Zide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Lr ether ` DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- I e'$ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes c'No No. of Squares with Patches CODE G - NOTE: Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /d FORMED POURED COMPLETED CITY OF WATET L.O SIDEWALK REPAIR SURVEY FO M PROPERTY ADDRESS 1 c ' ,¢/fi t 9 I - zn;' - o cr.-) PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect [i Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes El No WATER VALVE FQ--* ADJUSTMENT REQUIRED ❑ Yes II No PARKS DEPARTMENT REVIEW REQUIRED 50-- 1©( 4 o' ❑ Yes ❑ No LOCATION OF SIDEWALK L2-Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK (]"4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,L-3 4 inches inches ❑ 6 inches AREA TO BE REPAIRED 4"- IIoL',t S.F. 5"- `°"" S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ` ` Date: / )_.7 J 7? FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SU .VEY F•RM PROPERTY ADDRESS 1/ ? // :k i . - PARCEL CODE CONTROL NO. - CLEAN SIDEWALK REQUIRED Type of Defect .E -Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE — ADJUSTMENT REQUIRED 0 -Z-- //4 ❑ Yes Li No I I - PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 114 s LOCATION OF SIDEWALK iFront Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK l=i 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK Er4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- = •L 'S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: /e__`J-/ I — FORMED POURED COMPLETED _ CITY OF WATE LOO SIDEWALK REPAIR SURVEY FOF•lUl PROPERTY ADDRESS ;I-, PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes '0 No "`4 WATER VALVE ADJUSTMENT REQUIRED 411 /12)....1110. I� a ❑ Yes ',CI No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 'El No L/ i' — LOCATION OF SIDEWALK LI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK M 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 04 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ° -L S.F. 5"- S.F. 6"- S.F. Class'Al- S.F. ADDITIONAL REPAIRS 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: le l7/1 i FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAI r' SU VEY FORM PROPERTY ADDRESS r _` a'1 `:i 11') - - _�F Z 13 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect .0 Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE — ADJUSTMENT REQUIRED 4--0-0- (, ❑ Yes ❑ No 11\ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No G7 3,7 LOCATION OF SIDEWALK EL Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 0-4 Feet ❑ 5 Feet CI 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : L 4_` Date: /0—7_ 1M. — FORMED POURED COMPLETED _ CITY OF WATERLO. SIDEWALK REPAI . SURVEY FORM PROPERTY ADDRESS bf PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes El No 11/4 4 WATER VALVE ADJUSTMENT REQUIRED ❑ Yes I❑ No PARKS DEPARTMENT i REVIEW REQUIRED ❑ Yes 0 No 5 <, f I I i LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 0 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 'Q 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- `' % ` ' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes El No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /47/rq FORMED POURED COMPLETED CITY Y OF WATERLOG SIDEWALK REPAIR SURVEY REIF PROPERTY ADDRESS - 1 03 - - Z . - 0 ( PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes E'No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes E o WATER VALVE ADJUSTMENT REQUIRED 4-0 ❑ Yes 0-No ,, I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes E° to e 116 LOCATION OF SIDEWALK 6 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 04 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '` - S.F. 5"- S.F. 6"- S.F. Class'IV- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes IZ(No No. of Squares with Patches CODE G - NOTE:Areas marked with an"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: '''' ../tI -- FORMED POURED COMPLETED CITY OF WATERLOO) SIDEWALK REPAIR SURVEY FO WI PROPERTY ADDRESS - (4d° 6 c =. ' '1 - i -�3 - z '- `7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes El No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes Q No 1�t jI WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0-No / 1& LOCATION OF SIDEWALK Et 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 4"•• S.F. 5"- S.F. 6 "- NS.X -S.F. Class`A'- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Lilo No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /° 7.--1 7 FORMED POURED COMPLETED CITY OF WATE LO SIDEWALK REPAIR SURVEY F •Ri. PROPERTY ADDRESS /l ° L PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect — ❑ Yes ❑'No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 0--No WATER VALVE l ADJUSTMENT REQUIRED f —► ❑ Yes ❑'No i I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ®`No if � - - - ! 'j LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 0-4—Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0'4 inches 0'5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' " S.F. 5" S.F. 6"- S.F. Class Al- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes i] No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Fq FIRST INSPECTION AND FORM MADE BY : _ // Date: f 7/ — FORMED POURED COMPLETED — CITY OF WATERL011 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . Ji PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 12- See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes 0No \tit WATER VALVE ADJUSTMENT REQUIRED �( I ❑ Yes L No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0 No 9: � LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Cl 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ti 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- > ✓S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: Si FORMED POURED COMPLETED CITY OF WATERLOtt SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C, ❑ Yes ENo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes Dy°No WATER VALVE 11 ADJUSTMENT REQUIRED f— —► 1 ❑ Yes 0-NO I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes R`No iii C - _ /44-„) LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK EI 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 124 inches ❑ 5 inches 0-6 inches i AREA TO BE REPAIRED 4"- ? V S.F. 5"- S.F. 6 "- 1 -' S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 16- Date: _ ('4 FORMED POURED COMPLETED CITY OF WAYERL•* SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . (fig /fk PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑ Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes ❑ No jI WATER VALVE FQ--"► ADJUSTMENT REQUIRED ) ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK La-front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Lei 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK {7 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- /G8,0 S.F. 5"- S.F. 6 " - S.F. Class `A'- S.F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERL•• SIDEWALK REPAIR SURVEY F.)'sM PROPERTY ADDRESS 5i - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ; C- ❑ Yes0 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes Ei No • WATER VALVE - JI ADJUSTMENT REQUIRED 4•— —* ❑ Yes C�7 No \ , - PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes hi No d 3 I LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet \(I 5.3 Feet ❑ Other — DEPTH OF SIDEWALK E 4 inches 1] 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- g tj S.F. 5"- L S.F. 6"- S.F. Class'A- S.F. ADDITIONAL REPAIRS 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: r L °_' FORMED POURED . COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS "S3 ! iti;..6y[_i — `Its ,Z . ;07 Z47 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes ,!] lo WATER VALVE ` t ADJUSTMENT REQUIRED FQ—0•• �( { ❑ Yes 0 No PARKS DEPARTMENT • REVIEW REQUIRED ❑ Yes 1=1 iVo Sb - AkOng LOCATION OF SIDEWALK k'7 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet C15 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK I2 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- d5.6' S.F. 5"- S.F. 6"- S.F. Class TAR- S.F. ADDITIONAL REPAIRS 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 : e c (C,T /© Date: FORMED POURED COMPLETED CITY OF WATERLOO: _ SIDEWALK REPAIR SURVEY FO,PIVI PROPERTY ADDRESS /41.2-Ly r -Z1 -3a 2 001 ��)l PARCEL CODE CONTROL NO. — CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes EfNo _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑`No WATER VALVE Z ADJUSTMENT REQUIRED —► �/ Z ❑ Yes LINo I\4 I - - PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0 No .: ) �;lJ LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet L 6 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ©inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ° S.F. 5"- S.F. 6"- —S.F. Class'AL S.F. ADDITIONAL REPAIRS 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: IA% -Z1- i — FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SU .VEY F• [M PROPERTY ADDRESS . *DO 4 A 1( 5T `b°IO2 24 - /(3 - o►r7 > 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ri R ElYQUIR e ED D go See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes 0—No WATER VALVE .`r if ADJUSTMENT REQUIRED — �0- -► ❑ Yes ❑"No vOk -- I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes © No A 5I11 �iZ6�L;F� LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Erg Feet ❑ 5.3 Feet ❑ Other _ _ DEPTH OF SIDEWALK ❑'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : 5 Date: /6-227. FORMED POURED COMPLETED CIS OF WATERL••SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 .&L-K Jr g� l� -z4 - 33 -d)QI ' - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A REQUIRED See reverse side for Defect Codes A-F I ❑Yes ( o — See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No WATER VALVE I V ADJUSTMENT RFQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED— A _ — ❑Yes I� No — 4,1 A 24LtL LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet i Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1'4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 4."- 74 j S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : t � � Date: /O " /f FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 46 i A> Y Sr f 3 - C.. 4Y c6gq -zh - /63 -Ole ' 77- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 3 REQUIRED See reverse side for Defect Codes A-F I ❑ Yes Ei No See below for Defect Code G TRIM VEGETATION REQUIRED * ❑Yes [no ox c"c( / WATER VALVE ADJUSTMENT REQ'D 4,v �,o( rtAcIA-k I ❑ Yes ❑`No PARKS DEPARTMENT REVIEW REQUIRED A ❑ Yes © No /CA )0.0 (I\ CGA"i LOCATION OF SIDEWALK 0-Front Yard ©'Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 173-8 Feet ,❑5.3 Feet ❑ Other DEPTH OF SIDEWALK Ef 4 inches L 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- /O4 S.F. 5"- �� S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : � K-1 Date: FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . Q .,... (6g13 - 24- .03 - oo C 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _A;v ❑ Yes No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED — ❑ Yes J --No WATER VALVE ADJUSTMENT REQUIRED 4' "� 4) ❑ Yes C.No ir I — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes EE1 -KX: \ _ — LOCATION OF SIDEWALK C3'f`ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0-5-Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- rirl,Q S.F. 5"- S.F. 6"- S.F. Class`A- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 21'gio No. of Squares with Patches _ CODE G - Ca-. Wt.(oli NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : !eS K.- Date: ✓?/- l9. — FORMED POURED COMPLETED — CEY OF WATERLOO -- SIDEWALK REPA➢1: SURVEY FORM PROPERTY ADDRESS lb? 4g'c,w $u I/7 I!,-3 - on- ' - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes Er ao See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ErNo — .` 4,7 WATER VALVE 3 ADJUSTMENT REQ'D 101 El Yes q-No PARKS DEPARTMENT REVIEW REQUIRED Yes 10 LOCATION OF SIDEWALK ❑ Front Yard Lide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ,�Other 5. I DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 2I,' ✓S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Cr—No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S Date: //e Z? (/ FORMED POURED COMPLETED CITY OF WATERL'•''• — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS co4, - git3 -24- - 3o4- - o©rj ' -� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A REQUIRED See reverse side for Defect Codes A-F I ❑ Yes ErN o See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ►vo -- WATER VALVE >0(�, I ADJUSTMENT REQ'DRE El Yes l�f No PARKS DEPARTMENT REVIEW REQUIRED — — — — d — ❑Yes �o _ LOCATION OF SIDEWALK c-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet C�5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Z14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-P 'e S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ErNO No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: ID .0,1 r FORMED POURED COMPLETED CITY OF WATE!".LOO SIDEWALK REPAIR SURVEY FO!M PROPERTY ADDRESS i3 -2'1 - 119 o3 - 76 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A- ❑Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No nt � WATER VALVE Tom" ADJUSTMENT REQUIRED ��, ❑ Yes ❑ No I PARKS DEPARTMENT /a9 r REVIEW REQUIRED 0 Yes ❑ No LOCATION OF SIDEWALK ❑ Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0-5-Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK i(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-5:46 S.F. 5"- S.F. 6 "- S,F. Class'A'- S.F. ADDITIONAL REPAIRS 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 r s Date: r� T7-/`1 FORMED POURED COMPLETED CITY S F WATERLS• / SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS r�1t'3 - Z4 - l>q - 003 ' 6 , PARCEL CODE CONTROL NQ. - CLEAN SIDEWALK Type of Defect � REQUIRED See reverse side for Defect Codes A-F 0-Yes ❑ No See below for Defect Code G I TRIM VEGETATION — �`� REQUIRED ❑Yes ❑ No -- t WATER VALVE —► ,r.'! I ADJUSTMENT REM) — �\ I ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No _ J LOCATION OF SIDEWALK ❑ Front Yard 121—ide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Ely5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK QR4inches ❑ 5 inches Eflinches AREA TO BE REPAIRED 4"- Z3&-°S.F. 5"- S.F. 6 "- cO O S.F. Class'A'- S.F. ADDITIONAL REPAIRS — 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. QP FIRST INSPECTION AND FORM MADE BY : h�S 4, Date: /G " 1 /7 FORMED POURED COMPLETED CITY OFWATEILOi` SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS s 0 7 d YN 6!a U rf '} — 3 i3 23 - ?'76. - 00I ' /7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED I `17;1 Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED 4-4211-40. — ❑ Yes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED 1 I (Yes ❑ No 'o 13r a .sit aV,zr s� . LOCATION OF SIDEWALK El Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'AL S.F. — ADDITIONAL REPAIRS — 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. S Date: ( v -2- 19 FORMED POURED COMPLETED CITY OFWATiERLOo SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3Z/ . P,fnt,,ol©f,- $9 f 3 - S- 271... - co N " PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes I No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED j I I ❑ Yes No — WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Pi No I I PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes la No ia C Br aAV10 Ulf LOCATION OF SIDEWALK X" Front Yard ❑ Side Yard ❑ Other -' WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '•'- S.F. 5"-_ S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes E1.No No. of Squares with Patches CODE G - NOTE:Areas marked with an "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: ] o -A -1 FORMED POURED COMPLETED CITY OF WATE .LO s SIDEWALK REPAIR SURVEY F••RM PROPERTY ADDRESS _ ' 1 O PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ' ❑ Yes I?(NO See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 2 No ' WATER VALVE ADJUSTMENT REQUIRED �( ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED • Yes C?'No LOCATION OF SIDEWALK "C(Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0'5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' - S.F. 5"- S.F. 6 "- S.F. Class'A- S.F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CEY OF WATERL•• - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 3 Graft) b.er- S %it -23 - ZS2 -oil PARCEL CODE CONTROL NO. 5 1 Z CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑ Yes 17 No — See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes N No110 — a WATER VALVE Y 4" ADJUSTMENT REQ'D — 1,04 ❑Yes No I (on c4 $ PARKS DEPARTMENT REVIEW REQUIRED 3 Yes ❑ No _ V/A —� Ji LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 'C-.1 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- _ S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS '— 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 ; es Date: iQ FORMED _ POURED COMPLETED CITY OF WATERLO. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - `r/ t')ev S4 . c°;? -Z3 - 252 - 007 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes L No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED `+ Yes ❑ No 4 WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ' No 1 \ PARKS DEPARTMENT REVIEW REQUIRED °iR t ❑ Yes iNo I I c 4s1®N€( S$ . LOCATION OF SIDEWALK J Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .5.3 Feet ❑ Other DEPTH OF SIDEWALK Xl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 'C 7 S.F. 5"- S.F. 6 "- S.F. Class'As- S.F. ADDITIONAL REPAIRS 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: )0- - FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS . 4 27 boa-Nowt- - :27- - if ` • ty' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes riNo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I I ❑ Yes OIo A WATER VALVE ADJUSTMENT REQUIRED �—Q—► ❑ Yes Ergo /♦N4 I - I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑-Pdb trA -1 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E(5.3 Feet ❑ Other DEPTH OF SIDEWALK E4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- H'i 5 S.F. 5"- S.F. 6 "- S.F. Class'As- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes f 1Jo No. of Squares with Patches CODE 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' FIRST INSPECTION AND FORM MADE BY : Lr S Date: / Q _ 17 FORMED POURED COMPLETED — CITY OF WATE, LOo SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /1'27 lirclt;\oheV �f . t3 -23 -2.cz. - a� 5_ ,z PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK REQUIRED Type of Defect /4 ❑ Yes 4'No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes y No t WATER VALVE ADJUSTMENT REQUIRED ~4-00- ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No S.) ' LOCATION OF SIDEWALK VI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet '6 5.3 Feet ❑ Other DEPTH OF SIDEWALK .4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ? c= S.F. 5"-_ S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 'L.No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : {.› Date: io _ 5t - 1 cx FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 44- 45-z, ig kArA c C - g'1s 5j Z,3 - 2C .- 623 ' ' ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ( o See reverse side for Defect Codes A-F TRIM VEGETATION I See below for Defect Code G I REQUIRED — I ❑ Yes ZiNo WATER VALVE11/4 I11 ,{ qq��Z ADJUSTMENT REQUIRED � � `�'� ` `T ❑ Yes [ I\lo 1,01 I - PARKS DEPARTMENT REVIEW REQUIRED ;f; 2-es ❑ No A ) ) *MO- LOCATION OF SIDEWALK 0-front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK Linches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-_ '° S.F. 5"- S.F. 6"- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes D'flo No. of Squares with Patches CODE 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 : r'"° le'- Date: 1 & '/ l — FORMED — POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SU VEY FSRM PROPERTY ADDRESS /CO ,hex 62aAbu.4 y ,5r 5 - L3- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No 1 WATER VALVE ADJUSTMENT REQUIRED �Q--► ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK ,❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK L(4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ', -S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: /c''i-/ FORMED POURED COMPLETED CITY OF WATE LO• SIDEWALK REPAIR SURVEY FO!PROPERTY ADDRESS /, 2 • e,e0,4 OicAy ✓J '7 .� -2 3- /: - 1-77r PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect — yes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED 1 I ❑ Yes ❑ No WATER VALVE ., ADJUSTMENT REQUIRED 44"' "'1 ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED / ' ❑ Yes ❑ No — LOCATION OF SIDEWALK 'Front Yard LI Side Yard ❑ Other -' WIDTH OF SIDEWALK D-4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ;<.` S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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. t : O" FIRST INSPECTION AND FORM MADE BY : KC )t) Date: i FORMED POURED COMPLETED CITY OF WATER OS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect REQUIRED See reverse side for Defect Codes A-F p Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ��' ❑Yes ❑ No ` If WATER VALVE N ~ —► ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes El No Pt le-L. LOCATION OF SIDEWALK -❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 2i 4 Feet ❑ 5 Feet ❑ 5,3 Feet ❑ Other DEPTH OF SIDEWALK L14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- - S.F.= 5"- S.F. 6"- S.F. Class'AP- S.F. ADDITIONAL REPAIRS 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: ''., { FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SUI'VEY FORM PROPERTY ADDRESS 3040 stRe_ S I ; '"2 3 CZ - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect D Yes NI No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED 0 Yes Xl No t WATER VALVE 41) ADJUSTMENT REQUIRED 0 Yes No 1,04 PARKS DEPARTMENT REVIEW REQUIRED • 0 Yes VI, No 5, 21 .s LOCATION OF SIDEWALK )0 Front Yard Lii Side Yard El Other WIDTH OF SIDEWALK El 4 Feet 0 5 Feet gl 5.3 Feet LI Other DEPTH OF SIDEWALK CI 4 inches 0 5 inches /4 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'Ai- S.F. ADDITIONAL REPAIRS CODE F - PATCHES El Yes 'IAN° No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : k_s Date: (") FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS '20 G r c m Si- . '8913 -?3 - 24z - 01c1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect . REQUIRED See reverse side for Defect Codes A-F ❑ Yes lNo See below for Defect Code G TRIM VEGETATION REQUIRED ''= ❑Yes lNo ` 3 WATER VALVE 1-4-400- = ADJUSTMENT REQ'D L ❑Yes lj No PARKS DEPARTMENT REVIEW REQUIRED - - - - - - ❑Yes [ °'.No j LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Ill Other �, H DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 6 inches — AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- 'r, . S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G NOTE ;Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /o-s- FORMED POURED COMPLETED CITY OF WATER:JO• SIDEWALK REPAIR. SURVEY FORM PROPERTY ADDRESS 4 24 5PoPt-,0L,*f — q9 l.3 - toy j PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A c, I REQUIRED See reverse side for Defect Codes A-F I ❑Yes Kricio — See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes Lo — "` 1 , 3 WATER VALVE i— —► 4i4 I ADJUSTMENT REQ'D — ;� ❑Yes Lilo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes L1"No — #c ( cr4 LOCATION OF SIDEWALK ❑ Front Yard ZSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑�5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches Z6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes , 1 No. of Squares with Patches — CODE 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 : ir-S CJ Date: (o✓?-17/ FORMED POURED COMPLETED CITY OF WA—TRH®* S DEWAL< REPA➢ SURVEY FORM PROPERTY ADDRESS SEMobilki `113 - 0020 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑Yes CEo See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ( No WATER VALVE `� ADJUSTMENT REQ'D — \ `J". ❑Yes L o PARKS DEPARTMENT REVIEW REQUIRED ❑Yes C'No sy fi..0,14) LOCATION OF SIDEWALK ❑ Front Yard 2'Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 14.3 Feet ❑/Other _ DEPTH OF SIDEWALK ❑ 4 inches El '6 in 5 inches Zches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- ,y S.F. Class S.F. ADDITIONAL REPAIRS 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 : �� ff Date: /p'1'/Y FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5(g , n3 -13 - - -)`f PARCEL CODE CONTROL NO. CLEAN SIDEWALK /� REQUIRED Type of Defect li ❑ Yes to _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes EIo - \ firWATER VALVE ADJUSTMENT EQUIRED f 4—► I ❑ Yes cNo ,Ok I - PARKS DEPARTMENT REVIEW REQUIRED, ❑ Yes L^^4o — — eCLc-c — — — gtv \ LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet - 3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches L inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S,F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 17 No No. of Squares with Patches CODE G - NOTE:Areas marked with an"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) iC-.� Date: /°-T`Ir FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS jr> Jith s.'1[ - Oo) PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑ Yes 1610 See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes El-No `t WATER VALVE ADJUSTMENT REQ'D — IJL\ ❑Yes In-No PARKS DEPARTMENT REVIEW REQUIRED Cr' ❑Yes ariNo LOCATION OF SIDEWALK f3Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2-5.3 Feet ❑ Other DEPTH OF SIDEWALK . '4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- =.V ' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes LJ'No No. of Squares with Patches _ — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .S VS Date: FORMED POURED COMPLETED CITY OF WATERL•}®SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 64) / , OI 9W f - !'3 -2 5 zo4 - 0 z, r PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect _A-( REQUIRED See reverse side for Defect Codes A-F I ❑Yes 6No — See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes I21Clo 1 ,1 WATER VALVE +� -► .r D ADJUSTMENT REQ'D — 11` ❑Yes ErIG PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ( to — _C- UGC — _A_ 4-- 4d) /ova LOCATION OF SIDEWALK Er ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [ .3 Feet 1 -Other 7. DEPTH OF SIDEWALK e4 inches ❑ 5 inches inches AREA TO BE REPAIRED 4"- ° S.F. 5"- S.F. S"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑Yes C?No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ( _ — FIRST INSPECTION AND FORM MADE BY : 7 ' Date: la ` -/ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS zoo eoed i PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED L/I Yes ❑ No -` I it WATER VALVE ADJUSTMENT REQ'D a ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED El Yes ❑ No -12 Cyr€„ LOCATION OF SIDEWALK 2-rout Yard Ctide Yard ❑ Other WIDTH OF SIDEWALK [ '4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-4S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : 14..T Date: t0.-i4--t9 FORMED POURED COMPLETED Clef OF !/SATE LO c SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS13� 6113 - 2 ' - i o . - OD? " PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect , fYes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G J REQUIRED ❑ Yes ❑ No — WATER VALVE ADJUSTMENT REQUIRED 4--T o/ 1 ❑ Yes ❑ No J I PARKS DEPARTMENT REVIEW REQUIRED cc I ❑ Yes ❑ No — C&I _ LOCATION OF SIDEWALK Cront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C(5.3 Feet ❑ Other DEPTH OF SIDEWALK 114 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-;'?65:9 S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS 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. �y FIRST INSPECTION AND FORM MADE BY : Date: /0-/4,,/ FORMED POURED COMPLETED CITY OFWATERLOO' SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . a r3 - 2�`�- 007 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 4 ❑ Yes [moo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I ❑ Yes Leo WATER VALVE z.`=Fi ADJUSTMENT REQUIRED 4— ❑ Yes JNo PARKS DEPARTMENT REVIEW REQUIRED Yes I KIo LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Inrg.3 Feet ❑ Other DEPTH OF SIDEWALK J2-11 inches ❑ 5 inches Cl 6 inches AREA TO BE REPAIRED 4"- '3'3. S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : l-3 Date: — 949 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SUI:VEY FORM PROPERTY r ADDRESS . , 6tiA r /Lr 113 -23 - Z33. - Qe) ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect '' ❑ Yes lM Iio _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED 1 ❑ Yes Crt-No ` WATER VALVE ADJUSTMENT REQUIRED C — �Q---► I ct ❑ Yes CYNo lr k A PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes io P�� cc,0 LOCATION OF SIDEWALK , Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C4'5.3 Feet ❑ Other DEPTH OF SIDEWALK 13.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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. j( FIRST INSPECTION AND FORM MADE BY : `7 ItT Date: ID- J ' FORMED POURED COMPLETED CITY OF WATERLOG SIDEWALK REPAIR SURVEY FOF M PROPERTY ADDRESS c),4 0 cosri 91t - 23 - 23t - c 11 ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes I No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes f?(No '' WATER VALVE 11/4 L ADJUSTMENT REQUIRED ~ � 1 ❑ Yes KNo PARKS DEPARTMENT REVIEW REQUIRED • Yes ❑ No A - A ' l _ C&r. rect_ LOCATION OF SIDEWALK VP ont Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet e173 Feet ❑ Other DEPTH OF SIDEWALK l f4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 133,E S.F. 5"- S.F. 6 "- S.F. Class TA'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes II,1~do No. of Squares with Patches CODE G NOTE :Areas marked with an "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: /6' 1" FORMED POURED COMPLETED CITY OF WATE CO RE PAIR EPAIR SURVEY FORM PROPERTY ADDRESS _ z 3 Z CEO ice' 23 b`3 lO r PARCEL CODE CONTROL NO. CLEAN SIDEWALK � � REQUIRED �- Type of Defect i,) ❑ Yes ,r] No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes 6No -- WATER VALVE ADJUSTMENT REQUIRED — ~ � - ❑ Yes Z No i A & PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ,E5 No Cehht LOCATION OF SIDEWALK font Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L'1 5.3 Feet ❑ Other DEPTH OF SIDEWALK [4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 963 S.F. 5"- S.F. 6 "- S.F. Class'IV- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes CJ-No No. of Squares with Patches CODE G - — NOTE :Areas marked with an "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: i0-/4/ FORMED POURED COMPLETED CITY OFWATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c ni? PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-Fes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No ` -Y2. a WATER VALVE ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED yv — l7 ❑Yes ❑ No / \ J Cr�� LOCATION OF SIDEWALK 24ront Yard ]LrSide Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK al:inches El 6 inches AREA TO BE REPAIRED 4."- S.F. 5" - S.F. 6 "- S.F. Class'Al- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /O 9`/( FORMED POURED COMPLETED CITY OF WATERLOSS - SIDE /*LX REPA1�' SURVEY FORM PROPERTY ADDRESS 50 I c ig- — V 113 - Z3 - co (.0 ' 10 7 PARCEL CODE CONTROL NO. '- CLEAN SIDEWALK Type of Defect i REQUIRED See reverse side for Defect Codes A-F i El- es ❑ No See below for Defect Code G TRIM VEGETATION — REQUIRED ❑Yes ❑ No Y I I WATER VALVE `-`=' I ADJUSTMENT REQD — a ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 2-2i— 1E5 ❑Yes ❑ No j — L1 tJCcldd LOCATION OF SIDEWALK ❑ Front Yard Eide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet ❑ Other — DEPTH OF SIDEWALK ,Z4 inches iJ inches ❑ 6 inches AREA TO BE REPAIRED 4"- ` S.F. 5"- ; S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. 5 FIRST INSPECTION AND FORM MADE BY : t Date: /49- -"/% FORMED POURED COMPLETED CITY OF WATERLOG. SI*'E°, U< REPAIR SURVEY FOF,,M PROPERTY ADDRESS . 3 d c (3 -D - 2-i1. PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes Ilo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑'No 4 WATER VALVE ADJUSTMENT REQUIRED '4(9 iI Yes C 10 PARKS DEPARTMENT REVIEW REQUIRED ❑A Yes 0-10 4,s C LOCATION OF SIDEWALK JFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2'5.3 Feet ❑ Other _ DEPTH OF SIDEWALK �4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- - S.F. 5"- S.F. 6"- S.F. Class'As- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ?AID No.of Squares with Patches _ CODE G - S 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 : -5 )L- Date: a__ _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FIIRM PROPERTY ADDRESS . Orl ce,,uvz g— �3 - 3- 3Z - 005 ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A, ❑ Yes ❑'E"No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED i ❑ Yes p.-No - t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [AV() PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes n No LI) \A- vv >i et Arid- LOCATION OF SIDEWALK 12-Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet fit.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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 : fl.5 Date: /t—7-79 POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SU'IVEY FSRM PROPERTY ADDRESS _ 51 Z- CAN"clL- -� I5 -Z3 - RA . I PARCEL CODE CONTROL NO. CLEAN SIDEWALK /J REQUIRED Type of Defect /'I ❑ Yes L 'NNo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes OiSlo WATER VALVE ADJUSTMENT REQUIRED ,29 I ❑ Yes PP'IZo I I PARKS DEPARTMENT REIEW REQUIRED in-7-Yes El No S( y� LOCATION OF SIDEWALK VlFront Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -,G 5.3 Feet ❑ Other DEPTH OF SIDEWALK 24 inches ❑ 5 inches ❑ 6 inches r AREA TO BE REPAIRED 4"- '>"F i' S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. p C FIRST INSPECTION AND FORM MADE BY : R S � Date: /6-I-1� FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK � REQUIRED i Type of Defect t ❑ Yes VI-No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED 1 ❑ Yes L(No WATER VALVE `.„. , ADJUSTMENT REQUIRED ~ � ,j[‘. ❑ Yes C/rNo I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes eNo _ A 4, _ \ 43 LOCATION OF SIDEWALK `❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [cY5.3 Feet ❑ Other DEPTH OF SIDEWALK ,21 inches C7'5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- , S.F. 5"- S.F. 6 "- S.F. Class'As- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Cl--No No.of Squares with Patches CODE G - "- NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 0`V-11 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . z3 c—c,JulzieL 5gt3 - 61174- IrvG ' 10 -7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect tt _ ❑ Yes CAC10 See reverse side for Defect Codes A-F TRIM VEGETATION --- I See below for Defect Code G I REQUIRED I I ❑ Yes Cho Ji WATER VALVE ADJUSTMENT REQUIRED 4-0—* Z3 ❑ Yes L-No PARKS DEPARTMENT REVIEW REQUIRED des C�No - - - - - - A 1 )41 LOCATION OF SIDEWALK Cront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 01.3 Feet ❑ Other DEPTH OF SIDEWALK - 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- &' •g S.F. 5"- S.F. 6"- S,F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes liNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : . ( Date: /O✓14 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPA SURVEY FORM PROPERTY ADDRESS 3 z7 'Ti3 - z3 - i3- - (xi d I PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect AC REQUIRED See reverse side for Defect Codes A-F ❑Yes RI-No See below for Defect Code G I - TRIM VEGETATION REQUIRED et ❑Yes Cho WATER VALVE t— --► �� (3 ADJUSTMENT REQ'D — ❑Yes ( o PARKS DEPARTMENT REVIEW REQUIRED ❑Yes If -No C tIL-- LOCATION OF SIDEWALK ❑ Front Yard grSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet ❑ Other "- DEPTH OF SIDEWALK 1KL4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- _S.F. Class'A- S.F. ADDITIONAL REPAIRS -. 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� I�'J Date: /0 (3- FORMED POURED COMPLETED CITY OF WATERLO SIDEWALK REPAIR SURVEY FOE'M PROPERTY ADDRESS WO 5X 57— 41 iS 2o& -60 -' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes E FNo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes LTNo WATER VALVE ADJUSTMENT REQUIRED ~ � ❑ Yes EilClo I PARKS DEPARTMENT -' REVIEW REQUIRED [I Yes 1=1'No cr1 i LOCATION OF SIDEWALK G''Front Yard • ide Yard ❑ Other fir/ WIDTH OF SIDEWALK ❑ 4 Feet ( Feet CJ< - ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ° S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes fi No No. of Squares with Patches CODE G - NOTE:Areas marked with an "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-C �1 Date: 10-9-1 9 FORMED POURED COMPLETED CITY OF .`,'ATERLOS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS oG C j qct lj -i;5 - 20 4 - o L- ' r'' _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F Ii' -Yes ❑ No _. See below for Defect Code G TRIM VEGETATION REQUIRED 4-Yes ❑ No i ` WATER VALVE -- --► ®� ADJUSTMENT REQ'D a 1,06ti) f ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No c,JEt- LOCATION OF SIDEWALK l nt Yard RSfde Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet l Feet ❑ Other DEPTH OF SIDEWALK l4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' e S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 KJ Date: /0"y 17 FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 406 craN 6 R ao4 -oj ) 6 , PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _A__ Yes Cl No See reverse side for Defect Codes A-F TRIM VEGETATION J See below for Defect Code G I REQUIRED I Yes C o k WATER VALVE ADJUSTMENT REQUIRED 4 ❑ Yes Ergo J I PARKS DEPARTMENT 50 REVIEW REQUIRED — — —� — • ( [� Yes Na -� c�e� 30 4,� eicr it LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '. ~l"S.F. 5"- S.F. 6 "- S.F. Class`A'- S.F. ADDITIONAL REPAIRS 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 : es- Kr Date: /0'9'l? FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY Fl.ab PROPERTY ADDRESS . 'I0 c &1 L .. _ i3 -23 - ate. - U/I . Z PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect — ❑ Yes I-No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED 4—► i0 LI Yes -❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes �No — 5.1) C LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C .3 Feet ❑ Other DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 1 S.F. 5"- S.F. 6"- S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes q 4Qo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 i<-J Date: ffl'9'/9J _ FORMED POURED COMPLETED — CITY OF WATERLOO) SIDEWALK REPAI SURVEY Or PROPERTY ADDRESS 1 C, t1 , S9 i (o C- o t� PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect 4C4C ❑ Yes C�No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I Yes io WATER VALVE ADJUSTMENT REQUIRED 4-7-5 ❑ Yes L 'No I PARKS DEPARTMENT REVIEW REQUIRED h ❑ Yes l2'P�o ° So LOCATION OF SIDEWALK ont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet e5.3 Feet ❑ Other DEPTH OF SIDEWALK Cam] 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS _ -- CODE F - PATCHES ❑ Yes I±No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: �® �: - ' ' d FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 2q cgrt.'i, '' ' - '� - 005 , PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes '❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes �o WATER VALVE — ADJUSTMENT REQUIRED 4t-Y ❑ Yes 0- !-o I I _ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C I4.Jo — C - -- - - - - I fib - -- ( LOCATION OF SIDEWALK l Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet t Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches EEI E inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- '` `' S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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. v FIRST INSPECTION AND FORM MADE BY : �`"`) Date: /D —I FORMED POURED _ COMPLETED — CITY OF WATERLOG SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - 43T C PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect � ❑ Yes 01 See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes 7 No WATER VALVE l ADJUSTMENTREQUIRED ~ —11. 417 ❑ Yes 2-No _ I PARKS DEPARTMENT REVIEW REQ91RED ❑ Yes ❑ No c a C Ecu t(Q. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- % S.F. 5"- S.F. 6 "- S.F. Class'AL S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No. of Squares with Patches _ - CODE G - • NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. nn FIRST INSPECTION AND FORM MADE BY : IDS l4� Date: /0-?�19 FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /C2c3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect -` „�.w_ ❑ Yes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ' ] Yes ❑ No WATER VALVE ADJUSTMENT/REQUIRED ❑ Yes i I No '' I — I PARKS DEPARTMENT REVIEW REQUIRED 1" - - 'w — / D Yes ❑ No — — > t\ [.47 LOCATION OF SIDEWALK Cl Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK rff 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ;E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ` ' _ S.F. 5"- S.F. 6 "- S.F. Class'A'- _ S.F. — ADDITIONAL REPAIRS 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: / -111 FORMED POURED COMPLETED _. CIS OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / t , PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of DefectIYes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ry'J Yes ❑ No 11 ADJUSTMENTEREQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED `5, 1 t'r14_ ❑ Yes ❑ No F l LOCATION OF SIDEWALK I 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK CI 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 1 q_S S.F. 5"- 2•c: S.F. 6"- S.F. Class IN- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 4, Date: 6 $ ° .' 1'I FORMED POURED COMPLETED CITY' OF WATERLOO SIDEWALK REPAIR SURVEY PROPERTY ADDRESS (02 ttitil/Jar - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A- , ❑ Yes eNo — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 10 tlf WATER VALVE ADJUSTMENT REQUIRED 4— s`` (7 ❑ Yes V o PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I'No — - — A c GA A 141 LOCATION OF SIDEWALK La"Frant Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet C5Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- r' > ` S.F. 5"- S.F. 6 "- S.F. Class'A- S.F. ADDITIONAL REPAIRS _ CODE F - PATCHES ❑ Yes IT1‹. No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : lT Date: le `7i FORMED POURED COMPLETED -- CITY SF WATERLOS SIDEWALK REPAIR SURVEY FIR PROPERTY ADDRESS /X( Gl zy l i)e J '113 — —02 1 — ©0f PARCEL CODE CONTROL NO. CLEAN SIDEWALK �— Type of Defect REQUIRED See reverse side for Defect Codes A-F rr'Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED Q Yes ❑ No I- WATER VALVE R ADJUSTMENT REQTD ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED El Yes ❑ No Cf/yS�tJiA- -- LOCATION OF SIDEWALK 4ront Yard I -Side Yard ❑ Other WIDTH OF SIDEWALK Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK finches 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '. S.F. 5" • S.F. 6 "- S.F. Class 3A'- S,F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Cl No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : ` ✓ Date: -7!(f 1 FORMED POURED COMPLETED CBS OF WATERLOO SIDEWALK REPA1F: SURVEY FORM PROPERTY ADDRESS Li 3 Cnrke5� `, `iI3 'Zu - )53 - rG1 1 Z.,A0 PARCEL CODE CONTROL NO. 644Ches}hH+ CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I I ❑ Yes ID No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes Cn Flo WATER VALVE ADJUSTMENT REQ'D — ❑ Yes I]`No PARKS DEPARTMENT REVIEW REQUIRED s. ❑ Yes E'No i j T j Sr.• LOCATION OF SIDEWALK 'Front Yard C1Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 11(5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches Zr6 inches AREA TO BE REPAIRED 4."- .2C+c S.F. 5"- S.F. 6 "- 129 o S.F. Class S.F. ADDITIONAL REPAIRS _ 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 : 1"Z 5 0 Date: /0 FORMED POURED COMPLETED CITY OF WATERLOO) SIDEWALK REPAIR SURVEY FORM • PROPERTY ADDRESS . to- LIT2 a f. Au+ .` -- Sal, 13 -29 - 155 ova 1 Zo • PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED ®"Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G EQ R VEGETATION REQUIRED ❑ Yes ❑ No t j/ WATER VALVE ADJUSTMENT REQUIRED \ ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 11 Yes ❑ No LOCATION OF SIDEWALK ®Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Li 4 Feet ❑ 5 Feet ` 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches ❑ 5 inches Cr6 inches AREA TO BE REPAIRED 4"-_634;,e S.F. 5"- S.F. 6 "- '443.0 S.F. Class`A7- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES LI Yes ❑ No No. of Squares with Patches _ CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ( '' 2 Date: FORMED POURED COMPLETED CITY OFWATERLOO) SIDEWALK REPAI 7.. SURVEY FS'RM PROPERTY ADDRESS . /00 L' v 411 - ! -2-: -- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _ _leYes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes ❑ No11/4 -' t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No Ie,Ok I - PARKS DEPARTMENT REVIEW REQUIRED El-Yes ❑ No CLfti LOCATION OF SIDEWALK ETFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK Winches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- " _ "' S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS 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: /c IC! FORMED POURED COMPLETED _ CITY OF WATERL* SIDEWALK REPAIR SURVEY FO•AM PROPERTY ADDRESS . /1X2 C(---47 y' .5'r PARCEL CODE CONTROL NO. CLEAN SIDEWALK -` REQUIRED Type of Defect `Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED -- � Q—► ❑ Yes ❑ No �j\ I PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes ❑ No CZ41 LOCATION OF SIDEWALK LI-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .-®' .3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- a S.F. 5"- S.F. 6 "- S.F. Class'As- S.F. ADDITIONAL REPAIRS 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: / FORMED POURED COMPLETED CITY OF WATERL� O SIDEWALK REPAIR SURVEY 'O Ml PROPERTY ADDRESS /00 ez.411 5r- ' 13 - e-r)Z-( PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect `Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes ❑ No WATER VALVE 11/4 if ADJUSTMENT REQUIRED I �� ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 41-7 LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -5.3 Feet ❑ Other DEPTH OF SIDEWALK 0-4-inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ` ' S.F. 5"-_ S.F. 6"- S.F. Class TA'- S.F. — ADDITIONAL REPAIRS 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 : . ) el Date: /C"-4.(` FORMED POURED COMPLETED _ CITY OF WATERLOtt SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS - 00 t4/ ST r PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑-Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT r REVIEW REQUIRED d--),4" ❑ Yes ❑ No LOCATION OF SIDEWALK L'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 21-513 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '' " I S.F. 5"- S.F. 6"- S.F. Class TAR- S.F. ADDITIONAL REPAIRS 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. �l FIRST INSPECTION AND FORM MADE BY : Date: FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY FO':M PROPERTY ADDRESS - T-cal:? c y — 6 -2+- 3c3 - 6x2 _ I PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes fiNo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes Flo WATER VALVE ADJUSTMENT REQUIRED `- ❑ Yes l❑-No a PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I❑"No 5 ( cuitct LOCATION OF SIDEWALK "Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,S 5.3 Feet ❑ Other DEPTH OF SIDEWALK C-E1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F.c27,a f 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ©'No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : l 3 4 Date: l°"71-# FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REP,AI": SURVEY FORM PROPERTY ADDRESS Tv /oS Ci. 4 -24 - - 1 1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes C10 See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes �'No WATER VALVE µ� �► r7G> ADJUSTMENT REQUIRED Z FA Yes R No PARKS DEPARTMENT REVIEW REQUIRED f�Yes ❑ No A LIci 6) e �{ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 115.3 Feet ❑ Other _ DEPTH OF SIDEWALK L' inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 016.° -S.F. 5"- S.F. 6"- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes LH 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 : Date: /0 •-1` FORMED POURED COMPLETED CITY OF WATERLO J SIDEWALK REPAIR SURVEY ,O M PROPERTY ADDRESS . _ 21 i -2 ? c-A}t W5 - Zr- 3c1- - Pig PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 4 ❑ Yes 0 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes a'No WATER VALVE ADJUSTMENT REQUIRED 4-0 'x 21. 1- `i, ❑ Yes ❑1 o I � I PARKS DEPARTMENT s? REVIEW REQUIRED �'� Yes ❑ No ( CL, 1? LOCATION OF SIDEWALK El-Front Yard ❑ Side Yard ❑ Other —' WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet if15.3 Feet ❑ Other DEPTH OF SIDEWALK Er44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4" S.F. 5"- S.F. 6 "- S.F. Class'AT- S.F— ADDITIONAL ADDITIONAL REPAIRS 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 : KT. Date: /r `ZZ4 I FORMED POURED COMPLETED _ CITY OF WATERLOO` SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS . gr 8 15 -24 -30 04.3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect ❑ Yes ONo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes l-No WATER VALVE ADJUSTMENT REQUIRED �V ❑ Yes k7-No _ PARKS DEPARTMENT REVIEWW REQUIRED ! es ❑ No - - - - - AA Sig LOCATION OF SIDEWALK EFront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 23 Feet ❑ Other DEPTH OF SIDEWALK l'nches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 46)16 S.F. 5"-_ S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes l"No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: J0-2)-(61 FORMED POURED COMPLETED CITY OF WATErRLOOD ..... SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - ?1,T CL AT-4 tii 3 - t/t - 3oz PARCEL CODE CONTROL NO. CLEAN SIDEWALK — A Type of Defect REQUIRED See reverse side for Defect Codes A-F I 0 Yes LA° See below for Defect Code G — I TRIM VEGETATION -7 REQUIRED J.s- 0 Yes El,-No I , --) r- WATER VALVE 0—> -, --/A __ I ADJUSTMENT REQ'D _ Ie 1\ ---' I 0 Yes EiNo I itj I PARKS DEPARTMENT '— REVIEW REQUIRED 0 Yes EINo 4- _ 141 1///1 5:3 15,1, \ \ D,A-41 ..-- ,-- LOCATION OF SIDEWALK D'Pront Yard ,n Side Yard 0 Other WIDTH OF SIDEWALK 0 4 Feet f-J5 Feet 0 5.3 Feet 0 Other — DEPTH OF SIDEWALK Erzfinches 10(5 inches 0 6 inches — AREA TO BE REPAIRED 4"- 99M S.F. 5"- 9Z-0 S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES 0 Yes fErNo No.of Squares with Patches — CODE G - NOTE :Areas marked with an"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 .41- Date: /0 - FORMED POURED COMPLETED CITY OF WATERLOG SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zoo eziC &4 y ,5 PARCEL CODE CONTROL NO. Type of Defect , CLEAN SIDEWALKREQUIRED See reverse side for Defect Codes A-F ❑ Yes El-No See below for Defect Code G TRIM VEGETATION `- REQUIRED �� ❑Yes L-Nb WATER VALVE l ADJUSTMENT REQ'D �♦\ El Yes a"ho PARKS DEPARTMENT REVIEW REQUIRED ❑Yes O-No c LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L 15,3 Feet ❑ Other _ DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 44"- ' p5 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes LYNo No. of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : o t I Date: /0 FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY Fit M PROPERTY ADDRESS 4!i_ cut,/ y; - 24 - (63 . - c2'O • PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A _ ❑ Yes •L lNo _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes C°14o WATER VALVE ADJUSTMENT REQUIRED ❑ Yes LiNo I - PARKS DEPARTMENT REVIEW REQUIRED ErYes ❑ No — c -0-1111 LOCATION OF SIDEWALK IT-Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2'5.3 Feet ❑ Other DEPTH OF SIDEWALK Et 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ''5i S.F. 5'- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes .I No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : > 4-1 Date: lU ZZ jQ FORMED POURED COMPLETED ,_ • CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS cLri--( - i - J' : -oe, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I -Q Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED -Yes ❑ No WATER VALVE fQ� ADJUSTMENT REQ'D ‘ 4 I ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED t ' ❑ Yes ❑ No LOCATION OF SIDEWALK 0-Front Yard 12 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E"5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ❑(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- Cbl,p S.F. 5"- S.F. 6"- S.F. Class'AL S.F. ADDITIONAL REPAIRS 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. p FIRST INSPECTION AND FORM MADE BY : f 3 Date: %a- ` i FORMED POURED COMPLETED CITY OF WATERLO'S SIP EWALK REPAIR SURVEY FORM PROPERTY ADDRESS 400 ,t K - oc4 = _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C- ❑ Yes fi No See reverse side for Defect Codes A F TRIM VEGETATION See below for Defect Code G I REQUIRED -- I I ❑ Yes 0-No t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 0-No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C'No LOCATION OF SIDEWALK )3front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .-15.3 Feet ❑ Other DEPTH OF SIDEWALK E 14 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 41o(41 .S.F. 5"-_ S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: /& zZ� i j FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 4,00 • &4 ST- f39i5 - - r5 - af( 56 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect E/Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No 't' WATER VALVE it ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 47 7 LOCATION OF SIDEWALK I ._Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK X,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "-Z49;1 S.F. 5"- S.F. 6"- S.F. Class 1AI- S.F. ADDITIONAL REPAIRS 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 : ifZ Date: e"°3-147 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWAL< REPAIR SURVEY FO i` PROPERTY ADDRESS 4�� ct. 59:3 -24 - 17` - oz ' PARCEL CODE CONTROL NO. -- CLEAN SIDEWALK Type of Defect / REQUIRED See reverse side for Defect Codes A-F I ❑Yes if No See below for Defect Code G TRIM VEGETATION I REQUIRED ❑Yes 0-No 11/4 t- WATER VALVE N,`• ��� ADJUSTMENT REQ'D s ♦ a I ❑ Yes ©'No PARKS DEPARTMENT REVIEW REQUIRED l�4 - - es ❑ No 14, q. LOCATION OF SIDEWALK L7 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 2'4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- cA",÷ S.F. 5"- S.F. 6"- _ S.F. Class'A'- S.F. ADDITIONAL REPAIRS _ 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 : vs Date: /o-7Z-19 FORMED POURED COMPLETED CITY OF WATERLOO S DEWA REPAIR'. SURVEY FO M PROPERTY ADDRESS 5b - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ®Yes ❑ No See below for Defect Code G TRIM VEGETATION _ I REQUIRED ❑Yes ❑'No WATER VALVE ADJUSTMENT REM) fir` ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No C�q . LOCATION OF SIDEWALK 12 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK if 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 00i o S.F. 5"- S.F. 6 "- S.F. Class'IN- S.F. ADDITIONAL REPAIRS 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: l " r3! FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F RM PROPERTY ADDRESS 21 2- C o!u PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect ❑ Yes Q No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ;A Yes ❑ No - g 11/4 WATER VALVE ADJUSTMENT REQUIRED ❑ Yes d No PARKS DEPARTMENT REVIEW REQUIRED • l�y� ❑ Yes ( No {�.. L LOCATION OF SIDEWALK t-f, 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 4"- S.F. 5"- S.F. 6"- S.F. Class'Al- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - — NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : '` Date: ,o cr-1`' FORMED POURED COMPLETED CITY OF WATERED. SIDEWALK REPAIR SURVEY FORM A PROPERTY ADDRESS . Sett -23 - 2sZ - Co PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F 14,40 = Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED Yes ❑ No a WATER VALVE ADJUSTMENT REQ'D El Yes ❑ No PARKS DEPARTMENT A � \�v\ REVIEW REQUIRED 112 / ( 'Yes ❑ No Clean watt( �. -7o CPS(..ey“- LOCATION OF SIDEWALK KI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 'q 5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches 0 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- )12•y S.F. 5"- _y3t G '.S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : 1.1s Date: /0.8.19 FORMED _ POURED COMPLETED CITY OF FIAT ERL011 SIDEWALK REPAIR SURVEY FOrp.M PROPERTY ADDRESS ? b'c_ C f SS`113 -23 - 2743 - o0Z PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes © No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G i REQUIRED i I ❑ Yes 1No — WATER VALVE 32 {_�) �p ADJUSTMENT REQUIRED 0i' D�11 i�laP'AC�G ❑ Yes ED No PARKS DEPARTMENT REVIEW REQUIRED '6 Yes ❑ No 5.3 LOCATION OF SIDEWALK 1S1 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet '2 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- =< 'S.F. 5"- S.F. 6"- _S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS 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 : 5 Date: )o-g i FORMED POURED COMPLETED CITY OF WATERL•O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS _ ?o c.I v3;0. - 3 ' 23 2c? - pf PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes T,_No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I I ❑ Yes Q No WATER VALVE ADJUSTMENT REQUIRED '- ❑ Yes t] No _ I — PARKS DEPARTMENT REVIEW REQUIRED 15.�. El Yes ` ] No 141 LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard `l;] Other i . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 1C(6 inches AREA TO BE REPAIRED 4"- S.F. 5"-- S.F. 6 "- f'.'; S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes -® No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: to•S-rQ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO _ PROPERTY ADDRESS 3? :` , " q J3 -23 - 274., 503 6'7-47 CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 'J \ i G El .B No _ See reverse side for De ect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED I ' Yes WATER VALVE \ ADJUSTMENT REQUIRED `• ❑ Yes No a I — PARKS DEPARTMENT REVIEW REQUIRED X Yes ❑ No �. i — 1 La(Vw0,S, • LOCATION OF SIDEWALK tn Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet XI 5.3 Feet ❑ Other DEPTH OF SIDEWALK '`I 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 7 S.F. 5"- S.F. 6 "- S.F. Class `A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - — NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ;4:5 Date: l -B-lc FORMED POURED COMPLETED _ CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 FLU . $q13 - 23 - 27(F, - ooi 4-5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect t I REQUIRED See reverse side for Defect Codes A-F I ❑ Yes Q No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes El No \t WATER VALVE .3 ADJUSTMENT REQ'D 1°'c ° ❑Yes l'No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No er S� LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- I "S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes 9ZNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R5 Date: /a•8-I 9 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 400 644 5 '577:- - Z - do- oii 41-- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 'Yes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes El No ,04 I _ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑�,4 Feet ❑ 5 Feet C .3 Feet ❑ Other DEPTH OF SIDEWALK Ld4 inches ❑ 5 inches LI 6 inches AREA TO BE REPAIRED 4"- <v'' _S.F. 5"- S.F. 6 "- S.F. Class'AT- S.F. — ADDITIONAL REPAIRS 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 nn DS Date: _ ,o- ( 19 FORMED POURED COMPLETED — CITY OF WATE L00 SIDEWALK REPAIR SURVEY F.RIVI PROPERTY ADDRESS 4a3 5i. 13 -3 - - 0,z. PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ffrcres ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED i ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No iyOk i PARKS DEPARTMENT REVIEW REQUIRED 4© / ❑ Yes ❑ No Cot-tkf1481 LOCATION OF SIDEWALK ❑- front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet - 5.3 Feet ❑ Other DEPTH OF SIDEWALK finches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- 2' y S.F. 5"- S.F. 6"- S.F. Class TA'- S.F. -- ADDITIONAL REPAIRS -- 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. y�-� l FIRST INSPECTION AND FORM MADE BY : -? .f"--' Date: (a"74 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ') ' Yes ❑ No See below for Defect Code G TRIM VEGETATION I REQUIRED ❑Yes ❑ No — t '1='_ WATER VALVE 4— "* ADJUSTMENT REQ'D — ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No LOCATION OF SIDEWALK .`E,Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet R5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ] a S.F. 5"- S.F. 6 "- _ S.F. Class'A'- S.F. ADDITIONAL REPAIRS — 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: J .r``, FORMED POURED COMPLETED CITY OF WATERED. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 445 44'4-L61,1' ;4 ' VI i3 -23 - 206- 0/5 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F I ❑Yes RI -0 See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes iVo N 44.5 j WATER VALVE ti5 ADJUSTMENT REQ'D ❑Yes 1 1-b-o PARKS DEPARTMENT REVIEW REQUIRED A- - -A- __ — ❑Yes I3Tf0 LOCATION OF SIDEWALK ❑ Front Yard Fide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4/Feet ❑ 5 Feet C1 5 3 Feet El Other DEPTH OF SIDEWALK B'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' ' S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes C. -Ido No. of Squares with Patches CODE G NOTE :Areas marked with an"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 e23 Date: %6 1_/ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPA : SURVEY FORM — PROPERTY ADDRESS 44 0 Cen—LcrtAf A J _ ci6 - 25- Zdg.- o( . fir r PARCEL CODE CONTROL NO. - CLEAN SIDEWALK REQUIRED Type of Defect El tires ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ NoI1/4 - WATER VALVE t Jl ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No — 40 c QLKrLai rS LOCATION OF SIDEWALKEnt Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet t5.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- > ' 5"- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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. ff FIRST INSPECTION AND FORM MADE BY : re-J IC T Date: l76 9- / — FORMED POURED COMPLETED — CITY OFWATE fLO• SIDEWALK REPAIR SURVEY FOB' PROPERTY ADDRESS '� Y' °- , :, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect AREQUIRED See reverse side for Defect Codes A-F ❑ Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes :El No 1` 1 JI WATER VALVE .. ADJUSTMENT REQUIRED \ I ❑ Yes [] No PARKS DEPARTMENT REVIEW REQUIRED Yes 0 No VglO LOCATION OF SIDEWALK .El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑15.3 Feet ❑ Other DEPTH OF SIDEWALK N 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- _ f S.F. 5"- S.F. 6 "- S.F. Class'IV- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes LI No No. of Squares with Patches _ CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS %g C t-u t.,31 ) 0 - iefg - Olo PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F Q Yes ❑ No — See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No —' t WATER VALVE ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED Z 15 ZD Yes ❑ No — LOCATION OF SIDEWALK J2-F`ront Yard Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .3 Feet ❑ Other DEPTH OF SIDEWALK 12-4 inches C5inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. ll q --- FIRST INSPECTION AND FORM MADE BY : 7 Date: /o 9 �! FORMED POURED COMPLETED _ CITYOF WATERLOO SIDEWALK REPA! SURVEY FORM PROPERTY ADDRESS j 3 cci-itRciti 13 - of-J- cvo - olt ' if PARCEL CODE CONTROL At4 Type of Defect (�`' I CLEAN SIDEWALK — REQUIRED See See reverse belowfor sideDefect for DefectCodeG Codes A-F I ' ❑ Yes 'No ti' TRIM VEGETATION REQUIRED ❑Yes d fNo --a—.� 3 WATER VALVE a \ ADJUSTMENT REQ'D ♦ I( ❑ Yes 2-No .--, PARKS DEPARTMENT — REVIEW REQUIRED --A - — — — '1 'Yes ❑ No �yrXi4 14 c ) — LOCATION OF SIDEWALK 12'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 44 Feet ❑ 5 Feet I15.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' ` : S.F. 5"- SF. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes L 4io No. of Squares with Patches CODE G - C 4/-ILEC ii0/1 — 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 : P1<) Date: /0 j J -19 FORMED POURED COMPLETED CITY O= WATE LO• - SIDEWALK REPAIR SURVEY =ORM PROPERTY ADDRESS ti �!��✓ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4 REQUIRED See reverse side for Defect Codes A-F I ❑Yes # 114o — See below for Defect Code G I TRIM VEGETATION REQUIRED ❑Yes -iNNo — `z WATER VALVE 5 z 3 I U ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 1;?No - - -. 1/%l (/i1 LOCATION OF SIDEWALK Pront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L -5 3 Feet ❑ Other DEPTH OF SIDEWALK CA4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- = i,`? S•F• 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 es Date: /0 '?--- 11 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO M PROPERTY ADDRESS , _ , L1c G.' [unrt6'4 6T M13 -23-29 - aD PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect [ 'Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No 1 WATER VALVE ADJUSTMENT REQUIRED (Ai ❑ Yes ❑ No I � I PARKS DEPARTMENT REVIEW REQUIRED S— ❑ Yes ❑ No LOCATION OF SIDEWALK lFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet B'5.3 Feet ❑ Other _ DEPTH OF SIDEWALK Zr4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' > `% `% S.F. 5"- S.F. 6 "- S.F. Class'AL S.F. -' ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 1/ c� FIRST INSPECTION AND FORM MADE BY : )2' Date: Icy`�/` l FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F! �r' M PROPERTY ADDRESS 7 2 Catti t A l -2 - 7,Z1 - cov PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect -i'Yes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No10'if — WATER VALVE ADJUSTMENT REQUIRED 4"' ❑ Yes CI No �s I — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No — 3 ' co,,4 n pi nt LOCATION OF SIDEWALKont Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet ❑ Other DEPTH OF SIDEWALK L -4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ''`_ S.F. 5"- S.F. 6 "- S,F. Class'A'- S.F. — ADDITIONAL REPAIRS 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 : ec Date: /0 c?-j(g — FORMED POURED COMPLETED — CITY F 'ATE _®Q SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (,z-7 Co t tAmbii r 6'13 - 23- 2-v4 - o2I PARCEL CODE CONTROL NO. �" CLEAN SIDEWALK Type of Defect /� REQUIRED See reverse side for Defect Codes A-F I ❑ Yes Et-No See below for Defect Code G TRIM VEGETATION REQUIRED J ❑Yes iNo WATER VALVE 1-77 a ADJUSTMENT REQD a ❑Yes /ff-No PARKS DEPARTMENT — REVIEW REQUIRED iKLYes ❑ No 5.11 � �� i* IfA C LOCATION OF SIDEWALK ?(Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 13 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- I f S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes liZyNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: / - 9 -1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5 Cod �12r 13 -z4 -f0 t - 013 :.- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect / — REQUIRED See reverse side for Defect Codes A-F I ❑Yes No See below for Defect Code G TRIM VEGETATION REQUIRED / "-) ❑Yes ,❑ No — ` 'f J WATER VALVE f —► 65 ADJUSTMENT Q'D — jF'f\ �I,` 5s\ ❑Yes J. No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No Co tt)60 LOCATION OF SIDEWALK ❑ Front Yard tide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .3 Feet ❑ Other — DEPTH OF SIDEWALK ell- nches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes yrNo No. of Squares with Patches CODE G - NOTE ;Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ; V3 Date: FORMED POURED COMPLETED CITY OF WAFTERLOS SIDEWALK REPAIR SURVEY F• M PROPERTY ADDRESS . / -C 0 i. - t3 - 2i6 - ®G� t_ -7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- REQUIRED Type of Defect ❑ Yes See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes kl E110 WATER VALVE `4 ADJUSTMENT REQUIRED C ❑ Yes LIo pe i — I PARKS DEPARTMENT -- REVIEW REQUIRED ❑ Yes Priqo a; LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 2-4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ziiinches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS 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 ; _DB ie,T Date: /a-/6,-I FORMED POURED COMPLETED CITY OF WATERL• , SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t 1'7 Go; 6 1L� '?I -23 -ZZ, . - Do PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes i r ilo _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes Z"No — WATER VALVE ADJUSTMENT REQUIRED - ( HI'7 I es ❑ No /416,y PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Vj{ U S/pe G0 E LOCATION OF SIDEWALK [_Front Yard CI Side Yard El Other WIDTH OF SIDEWALK I2': Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 2 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- C70,0 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. _ ADDITIONAL REPAIRS 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 : J g 1T Date: /a-/6-/ FORMED _ POURED COMPLETED _ ®CITY OF WATERL O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . ZeOp eo S° v� —Z30 . —DID—" PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- REQUIRED Type of Defect Iirsfes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I 4-7"Yes ❑ No t WATER VALVE ADJUSTMENT REQUIRED < 0-10. LI Yes ❑ No it ' ► PARKS DEPARTMENT REVIEW REQUIRED CL-�`4-70 ❑ Yes ❑ No LOCATION OF SIDEWALK .I 1-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [ Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK �4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- "® S.F. 5"- S.F. 6"- S.F. Class`A'- S.F. -- ADDITIONAL REPAIRS 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. �s FIRST INSPECTION AND FORM MADE BY : Date: Ia-r FORMED POURED COMPLETED CrrY OF WATERLOO - SIDEWAL< REPAP• SURVEY FORS,,; PROPERTY ADDRESS eLK co - 57 a Y PARCEL CODE CONTROL NO. _.. CLEAN SIDEWALK Type of Defect REQUIRED�� See reverse side for Defect Codes A-F 'Yes ❑ No See below for Defect Code G ( TRIM VEGETATION REQUIRED ^�-- L1 Yes ❑ No WATER VALVE ADJUSTMENT REQ'D — ❑Yes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED la Si u) _ _ ❑Yes ❑ No — LOCATION OF SIDEWALK 1Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2- .3 Feet ❑ Other _ DEPTH OF SIDEWALK ,Z 4 inches ❑ 5 inches ❑ 6 inches f AREA TO BE REPAIRED 4"- "-_S.F, 5 S.F.S,F. 6 S.F.SF Class A S.F.SF ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : _ Date: 'D -1'' -/9 FORMED POURED COMPLETED CITY OIFWATE LO SIDEWALK REPAI': SU =VD( FO'M PROPERTY ADDRESS . c2l`7 c Jo co_ PI13 -z - 20 -ow PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect G ❑ Yes �-No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED Yes ❑'No t WATER VALVE ADJUSTMENT REQUIRED 11 ❑ Yes C7o 01, I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes i''No G Co tUG LOCATION OF SIDEWALK U-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet El Other _ DEPTH OF SIDEWALK ❑ 4 inches inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- 14 8 S.F. 6"- S,F. Class 'A'- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes fl No No. of Squares with Patches CODE G - /j� 1 ji,cSC NOTE:Areas marked with an "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 0-I4 FORMED POURED COMPLETED CITY OF WATEr.LO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 " ce)tiee '- 537/ -Z3 - Zc.9 - too PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect '' ❑ Yes c- 1 Flo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes iglo - WATER VALVE ADJUSTMENT REQUIRED ) ❑ Yes Epiti PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C-1'1l0 - - 4 — — — — `7 PASS"A., CgAi6 f LOCATION OF SIDEWALK Ir t-ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK —eet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK = inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-_ S.F. 5"- S.F. 6 "- S.F. Class'A'- - � •S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Is No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : a XT Date: /o-9"l FORMED POURED COMPLETED _. — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO' PROPERTY ADDRESS 3 f'7 Ca -- 4 i5 =2,3 - 229 - 004 I v PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect Yes Colo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes R-No t WATER VALVE ADJUSTMENT REQUIRED c = ---► 3 l ❑ Yes PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Ei o -- - - - _ A 4A k4A II. 417 15.7 CoiJG�=�, LOCATION OF SIDEWALK LIFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK C7'4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK --f l-inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : A 1C Date: b9-"/_-19 FORMED POURED COMPLETED CITY •F WATERLOO) SIDEWALK REPAIR SURVEY -7ORM PROPERTY ADDRESS 3 z7 ca, 'o 1- 11 -2i - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4REQUIRED -� See reverse side for Defect Codes A-F I ' Yes L7 No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ,-] No _ \Are WATER VALVE ADJUSTMENT REQ'D — I�_ . ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No — A- 4-4- - - - -�°i t,2)6 coati; fL LOCATION OF SIDEWALK E 1Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK C(4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK - fiches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- � '9 S.F. 5"- S.F. 6 "- S.F. Class'A'- 'i 6°° S.F. ADDITIONAL REPAIRS — 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: /6)—Y-19 FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAI�": SURVEY FORM PROPERTY ADDRESS - 1.00 (ELK C759 13 -73 -201 - oo3 j PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect (es ❑ No See reverse side for Defect Codes A-F j See below for Defect Code G I TRIM VEGETATION REQUIRED I I Yes ❑ No t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No j I PARKS DEPARTMENT REVIEW REQUIRED G ❑ Yes ❑ No C AJGE�- LOCATION OF SIDEWALK iIont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK (-4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK LI inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- % L' S.F. 5"- S.F. 6"- S.F. Class'A`- S.F. ADDITIONAL REPAIRS 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 : gC Date: )0 %� FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS log 6,0 ►3 -ds3 - , 4 - or© .f PARCEL CODE CONTROL NO. CLEAN SIDEWALK A REQUIRED l No' Type of Defect ❑ Yes t See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED 1 I ❑ Yes o WATER VALVE ` ADJUSTMENT REQUIRED 40 q ❑ Yes ErNo igf PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I;1.No ..-. A 40 c coA)Ivc f- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK I Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK TAir ches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. r� FIRST INSPECTION AND FORM MADE BY : I.S K3 Date: /19-% l)FORMED POURED COMPLETED CITY OF WATE"LOO SIDEWALK REPAIR. SURVEY FAIR' PROPERTY ADDRESS 4) G006 �� 9t 3 73 zoo - oo� - 1 ; PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect , ❑ Yes o See reverse side for Defect Codes A-F -- See below for Defect Code G TRIM VEGETATION RED es ' ❑ No �''` WATER VALVE ADJUSTMENT REQUIRED -- 0"'� �1� ❑ Yes 3'No PARKS A REVIEWDEP REQUIRED ❑ Yes I r14o t Ca k-- LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK RFeet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ----inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- try -LI S.F. ADDITIONAL REPAIRS 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 : � P Date: /6-(a`79 FORMED POURED COMPLETED CITY OF WATE LO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - _ 4/7 Ce4,0a_ _ 1i3 -Z3 - zor PARCEL CODE CONTROL NO. CLEAN SIDEWALK 4 REQUIRED Type of Defect ❑ Yes to See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED 1 I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED 417 ❑ Yeso PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes o A 4.0 ,4' Co,U 5El_ LOCATION OF SIDEWALK '❑ Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK E14 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK -04. inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- YS.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes I No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. (� FIRST INSPECTION AND FORM MADE BY : V`S KJ- Date: / '1� FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 45 corv6Ek- 6 -2-3 -ao4 -000a PARCEL CODE CONTROL NO. — CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes fNo See reverse side for Defect Codes A-F r-- J See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes 12-Ito WATER VALVE � ADJUSTMENT REQUIRED < ❑ Yes Flo I � -- PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes C'1-No A A A) — — - - i24 Ci,4 ' LOCATION OF SIDEWALK Ofront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Feet ❑ 5 Feet ❑ 5.3 Feet LI Other _ DEPTH OF SIDEWALK 4=nches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- S.F. 5"- S.F. 6 "- — S.F. Class `A`- 79<�rr S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L!I No No. of Squares with Patches _ CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : I� Date: / ,P- f/ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 431 Co 6 - 23 - ZCq . - 00 5y PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes a No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes I o — WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Ig,ICIO PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes L No — ( 3,C / \ -- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other -" WIDTH OF SIDEWALK Ls;4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK - 4-inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- /404 S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L'flo No. of Squares with Patches CODE G - — NOTE:Areas marked with an"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 143— Date: jo-9 lf7 FORMED POURED COMPLETED CITY OF WATERLO SIDEWALK REPAIR SURVEY FS�R PROPERTY ADDRESS _ 44-1 Co,4i 'g 45 -z, - 00z_ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 'Yes ❑ No See reverse side for Defect Codes A-F -- I See below for Defect Code G I TRIM VEGETATION REQUIRED Yes ❑ No WATER VALVE -` ADJUSTMENT REQUIRED <� —► ❑ Yes ❑ No I v PARKS DEPARTMENT REVIEW REQUIRED 50 ❑ Yes ❑ No _ CO G. LOCATION OF SIDEWALK lfFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK C 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 2<lnches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ; -' ° S.F. 5"- S.F. 6 "- S,F. Class `A`- S.F. ADDITIONAL REPAIRS 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 — recorstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � Date: /0 FORMED POURED COMPLETED CITY OF WATT ERLO• SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS .5 C 0-e c P Scii3 -23 - 2SZ - c)G a ? PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ) 'Yes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I I ❑ Yes El No - WATER VALVE ADJUSTMENT REQUIRED ♦'Q. L� .?18 `'10 Yes ❑ No \ I C f—— I PARKS DEPARTMENT REVIEW REQUIRED r ❑ Yes ❑ No — t r.escev.f f I . LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet V 5.3 Feet ❑ Other DEPTH OF SIDEWALK b 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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: ID- FORMED POURED COMPLETED —. CITY OF WATER O• S DEW,`jL< REPA➢ • SURVEY FORM PROPERTY ADDRESS 30 Cerescevt� I ' -,13 - =3 - 2V2 - ocfl 1-13 PARCEL CODE CONTROL NO. CLEAN SIDEWALK -- Type of Defect _ r REQUIRED See reverse side for Defect Codes A-F ? I ❑ Yes tiZ1 No See below for Defect Code G I® TRIM VEGETATION cC---017 REQUIRED 6 ❑Yes gi No 5,a WATER VALVE ADJUSTMENT REQ'D v I ❑ Yes No u ®� . o PARKS DEPARTMENT 5. REVIEW REQUIRED - — — — _ — )'Yes CI No LOCATION OF SIDEWALK X1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [a5.3 Feet ❑ Other DEPTH OF SIDEWALK gj 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- I33.c: S.F. 5"- - 7- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes X No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f-5 Date: ®0 • ® �� FORMED POURED COMPLETED CITY OF WATERLO• ERLO• SIDEWALK REPAB SURVEY FORM PROPERTY ADDRESS 310. C,esce.;+ p i S' ;3 - 23 - 27a. - c i 74- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect T ❑ Yes _ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 10No K. WATER VALVE ADJUSTMENT REQUIRED ♦' r`= ❑ Yes ' No /j, I _ PARKS DEPARTMENT REVIEW REQUIRED VI Yes ❑ No — 0 C•resce0.3, PI . LOCATION OF SIDEWALK L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I3I 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S,F. Ciass'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 'RI No No. of Squares with Patches CODE G - NOTE:Areas marked with an"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: /o•g-i Ct _ FORMED POURED _ COMPLETED CITY OF W'A T ERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L-)( 5 nt-) -2A - )c - Oa(U .. . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED�� See reverse side for Defect Codes A-F [A es ❑ No See below for Defect Code G TRIM VEGETATION — _ REQUIRED es ❑ No is _Q WATER VALVE ° ` Jo3 ADJUSTMENT REQ'D ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED t?s ❑ Yes ❑ No teUrkl J LOCATION OF SIDEWALK (IYFront Yard [-Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1'5.3 Feet ❑ Other _ DEPTH OF SIDEWALK I inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- P71c7 / S.F. 5 S.F. 6 S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. �I q FIRST INSPECTION AND FORM MADE BY : /' Date: fo—/// FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAI" SURVEY FOR _ PROPERTY ADDRESS . (Pt, 5eiC "JA,JE ST _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect E�Yes ❑ No -- See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ~ '♦ ❑ Yes ❑ No r� I 1 PARKS DEPARTMENT REVIEW REQUIRED , ❑ Yes ❑ No re, -- - - - - - - �i.% -- ViMiE LOCATION OF SIDEWALK Z7'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Z'S Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E1'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "-a$. Q S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : / 5 Date: /0 -Z5-J7 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS :-try 4,, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F f7 Yes ❑ No See below for Defect Code G -.� TRIM VEGETATION REQUIRED SJ fYes ❑ No -` J WATER VALVE C' ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 1 ❑ Yes ❑ No - - w / ,f1 LOCATION OF SIDEWALK 1:1-Front Yard i]Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0`5 Feet []5.3 Feet ❑ Other DEPTH OF SIDEWALK 0'4 inches Q 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-48'W.° S.F. 5"- IQf,,O S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL.REPAIRS 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 : i2 r' Date: /a FORMED _ POURED COMPLETED CITY Y OF WATERLOS SIDEWALK REPAIR SURVEY FSR . ; l� PROPERTY ADDRESS . A l - 4Z 7 1,16= T -24- - a(Z, i' ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect f3.f ❑ Yes El-No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I ❑ Yes Ei No11/4 -- t WATER VALVE 4 ADJUSTMENT REQUIRED ) 12- � '2 ❑ Yes Efl o I PARKS DEPARTMENT REVIEW REQUIRED / . E Yes ❑ No A A A A JIA t/,ii V/A ,1 t 1' ' I - 5.3 �o ! \ — G" �f LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ll Other DEPTH OF SIDEWALK ,-a14 inches ❑ 5 inches El B inches 7 7 AREA TO BE REPAIRED 4"- S.F.(.37 5"- S.F. 6"- / '';L S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS 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 : e5 a Date: /o'Z3'1 FORMED POURED COMPLETED r.. CITY `F WATERLOOS !p SIDEWALK REPA ! SURVEY FORM PROPERTY ADDRESS AZ-- 4-Z- ,J �-� (/ /3 -24 - 1. - 6iL PARCEL CODE CONTROL NO. ‘e§` CLEAN SIDEWALK Type of Defect / - REQUIRED See reverse side for Defect Codes A-F ❑ Yes ElNo See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes l]4o \ At WATER VALVE 112- �` ®�J ADJUSTMENT,REQ'D — ,► � El Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes E'No LOCATION OF SIDEWALK LJ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Er 5,3 Feet ❑ Other DEPTH OF SIDEWALK _El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- a1 ,,I S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL_REPAIRS CODE F - PATCHES ❑Yes l /No No. of Squares with Patches -- CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : e) Date: /0 2 FORMED POURED COMPLETED CITY OF WATERLO. i i< SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4Z7 DAB �-a- 3° 13 - 241 - i 5 . - cc: ' . . PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect El Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED i C� Yes No — • WATER VALVE ADJUSTMENT REQUIRED f— � ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No - - —ire° - - — C nir S . LOCATION OF SIDEWALK IQ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet C 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ell inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 90010 S.F. 5"- S.F. 6"- S.F. Class!A'- __ S.F. _ ADDITIONAL REPAIRS 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 : iZ ? Date: rq/2s/PI FORMED POURED COMPLETED _ CITY OF WATERLO• UP 2 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . zi-z117 D1WE, PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No 11/4 WATER VALVE ADJUSTMENT REQUIRED < � `. ❑ Yes ❑ No a i _ PARKS DEPARTMENT REVIEW REQUIRED je>' ❑ Yes ❑ No Jaye S LOCATION OF SIDEWALK [Fr 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 4"- 90040 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : e)2 Date: t 4/23 FORMED POURED COMPLETED CITY OF WATERL•• SIDEWALK REPAIR SUIIVEY FORM - PROPERTY ADDRESS 5oO > � - L} - - DO`( PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Et Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes Q'No — WATER VALVE ADJUSTMENT REQUIRED 0—+ ❑ Yes ❑ No v04 I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No ) 3.5- LOCATION OF SIDEWALK 1]Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 1 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-7 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. _ ADDITIONAL REPAIRS 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: ;® FORMED POURED COMPLETED CITE OF WATERLOO SIDEWALK REPAIR SURVEY FPS' K/d PROPERTY ADDRESS 5Z c pay ; Si . 89 {3 -z+,' - 1SC. - oGCo 1' 9 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect A ❑ Yes E No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes El No 111/4 WATER VALVE `.A ADJUSTMENT REQUIRED ❑ Yes •No 01,04 PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes Li No Jo. 5.11 51, LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ® 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK f 4 inches ❑ 5 inches CJ 6 inches r AREA TO BE REPAIRED 4"- '3,16 S.F. 5"- S.F. 6"- S�° S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : P. 7 3 Date: it/93/i,9 FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . too 3L¢! ojvti-Areo,5 5T — PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ®'No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED i ❑ Yes C No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes EKNo PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes �o LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Ztther ; DEPTH OF SIDEWALK ill inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- _S.F. Class'A'- S.F. ADDITIONAL REPAIRS _ CODE F - PATCHES Comes ❑ No No. of Squares with Patches ( . CODE G - NOTE :Areas marked with an"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: R,-/e -r) FORMED POURED COMPLETED CITE OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS too t T z- -- 13 -23- 234.- ©// PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C�Yes ❑ No See reverse side for Defect Codes A-F — I See below for Defect Code G I T VEGETATION REQUIRED ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED `I Yes ❑ No _ I PARKS DEPARTMENT REVIEW REQUIRED • -J Yes ❑ No — — — 4a _ f 17/p FIV S LOCATION OF SIDEWALK E4cont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet LI-Other ,“ DEPTH OF SIDEWALK 2nches ❑ 5 inches Clinches AREA TO BE REPAIRED 4"- 135.® S.F. 5"- S.F. 6"- f�® S.F. Class IN- S.F. ADDITIONAL REPAIRS 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 : Dg Date: /67-140-1r FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SU VEY FORM PROPERTY ADDRESS . // ) 5913 -23 - 7,34 - 0Z3 1 4- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes ❑ No - WATER VALVE "` ADJUSTMENT REQUIRED ~ ``€ 1I ❑ Yes ❑ No I i PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No ._ Z.00' 4o'(0/0) 1 IMPS LOCATION OF SIDEWALK Z'front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet RI-Other 54 DEPTH OF SIDEWALK inches ❑ 5 inches Et inches AREA TO BE REPAIRED 4"- B64,o S.F. 5"- S.F. 6 "- 2l6,0 S.F. Class'AT- S.F. _. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /D /� /g FORMED POURED _ COMPLETED _ CITY OF ATERL®• SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS .r € r PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G REQUIRED El Yes II No t WATER VALVE ADJUSTMENT REQUIRED < ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED J2cJ TL-i111 • ❑ Yes ❑ No Ii . 1 � / 7 C LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches i 15 inches ❑ 6 inches AREA TO BE REPAIRED 4"- t�'� �' S.F. 5" S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: i,', F;3 FORMED POURED _ COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FSRM — PROPERTY ADDRESS Z06) .sti< Al b5 5T 5,/.5 -23 -43 - Oro PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect _ ❑ Yes ❑'No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑'No — WATER VALVE •� ADJUSTMENT REQUIRED ❑ Yes C4No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 1' LOCATION OF SIDEWALK E 1 ront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 11.3 Feet ❑ Other DEPTH OF SIDEWALK Cinches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : E4 ��'� Date: A7 4-I 7 FORMED POURED COMPLETED _ f�/CITE' OF '�`['ATE'LOO SIDEWALK REPAID. SURVEY FOR , PROPERTY ADDRESS Eco .etg eb. .57— 9l3 -i3- i33- l , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ces ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No _ ! 0 `t WATER VALVE N ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED (21 ❑Yes ❑ No J 1l/JCCLA) LOCATION OF SIDEWALK ❑ Front Yard Lf Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other _ DEPTH OF SIDEWALK -Er4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 4 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS _ CODE F - PATCHES ❑Yes Vi No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ILA KJ Date: /0.y(7 FORMED POURED COMPLETED CITY OF WATERLOO' SIDEWALK REPA - SURVEY FORM PROPERTY ADDRESS 12Z- -Rp 31(3 -v., - .37-). - ©13 , PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes C�ici0 — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes l -No _ '- WATER VALVE A ADJUSTMENT REQUIRED 4— t`.` —r ❑ Yes ID-No \ I _ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes LOCATION OF SIDEWALK Er-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet R'5.3 Feet ❑ Other DEPTH OF SIDEWALK 0-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- _ S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yeso No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. f� FIRST INSPECTION AND FORM MADE BY : (`� r- Date: /D-6? FORMED POURED COMPLETED — ��/CITY OF V�ATERLi•'• SIDEWALK REPAIR SURVEY FORM �'. PROPERTY ADDRESS - 2 ZY.- 6i - /33- b i .r - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A-t ( ❑ Yes 1No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED I ❑ Yes .L 1Jo , WATER VALVE m ADJUSTMENT REQUIRED W -�% ❑ Yes LI-No /11 _ I PARKS DEPARTMENT i REVIEW REQUIRED ❑ Yes Ilo \ 1 LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet l 'S.3 Feet ❑ Other DEPTH OF SIDEWALK E inches nches ❑ 6 inches r AREA TO BE REPAIRED 4"- - S.F. 5"- •- -= S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes eK No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. nn FIRST INSPECTION AND FORM MADE BY : Date: /g_9- FORMED POURED COMPLETED ®,CI Rt tl OF ATE e.Lt.• SIDEWALK REPAIR SURVEY FO•.M PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Nt Yes ❑ No -- See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED [ .Yes ❑ No t WATER VALVE ADJUSTMENT REQUIRED F "'� ❑ Yes ❑ No Iffif I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No '— LOCATION OF SIDEWALK Li Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches n 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY Fo PM PROPERTY ADDRESS & 16)1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect '��Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED Yes ❑ No WATER VALVE \ ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No ' • qi { { - LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet \O 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches Q 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ' Date: 1 FORMED POURED COMPLETED CITY OF WATE!.,L0 SIDEWALK REPAIR SURVEY Fe r:Mh PROPERTY ADDRESS . ,3C-0 .02- — eaof — 1> `Zi L3Z- &097 T 1 f' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect is ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No ►' WATER VALVE "` 6 ADJUSTMENT REQUIRED ❑ Yes ❑ No 404 I _ PARKS DEPARTMENT REVIEW REQUIRED �`v I ❑ Yes ❑ No ro oaf% LOCATION OF SIDEWALK i ont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet CJ 6.3 Feet ❑ Other DEPTH OF SIDEWALK K inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- -' - S.F. 5"- S.F. 6 "- S.F. Class'AL S.F. — ADDITIONAL REPAIRS 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 Date: I rb— 9 / FORMED POURED COMPLETED _. CITY OF WATERLO• SIDEWALK REPAIR SURVEY F011. PROPERTY ADDRESS _ .3 i E041;6:t PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes /No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes C1lo WATER VALVE ADJUSTMENT REQUIRED < r 1- ❑ Yes 11-No — PARKS DEPARTMENT • REVIEW REQUIRED ❑ Yes ;21% LOCATION OF SIDEWALK Front Yard El Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Feet ❑ Other _ — DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- --- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L 4 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 : 1"� Date: /6 ..9 --6.• FORMED POURED COMPLETED CITY OF W TE*LO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f(p fti.,),4145 y - 8?/3 -23 -232_2 2(0 - ! - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes Lb No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No +'- WATER VALVE L ADJUSTMENT,EQUIRED F } ❑ Yes ❑ No PARKS DEPARTMENT I REVIEW REQUIRED I ❑ Yes ti No — IL A 4,' LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C 3 Feet ❑ Other DEPTH OF SIDEWALK Diinches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- • S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS - CODE F - PATCHES ❑ Yes Li No No. of Squares with Patches - CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /c> ITT Date: /6)'9-.4 — FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOB PROPERTY ADDRESS I ' 5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes LcJ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED Yes �Jo 4` WATER VALVE `eI ADJUSTMENT REQUIRED 31,3 ❑ Yes Cr/No M S��' I PARKS DEPARTMENT kIrfo , REVIEW REQUIRED ❑ Yes E1 No FDIJ AIDS LOCATION OF SIDEWALK Er ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2(5.3 Feet ❑ Other DEPTH OF SIDEWALK Z4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- _. ` . S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes r'i No No. of Squares with Patches _ CODE G - V NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �f FIRST INSPECTION AND FORM MADE BY : I Date: 1 0 - 1-/ 1 FORMED _ POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3-L ' £Uhf, s S't 61l3 -23 - Z3._ t ik Wig, PARCEL CODE CONTROL-NO. - CLEAN SIDEWALK — Type of Defect it REQUIRED See reverse side for Defect Codes A-F I , `Yes ❑ No — See below for Defect Code G TRIM VEGETATION I REQUIRED ❑Yes ❑ No — WATER VALVE 2 ADJUSTMENT REQ'D — 14\ \.1 ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 17-Z-.1 es ❑ No — LOCATION OF SIDEWALK [Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet j-5.3 Feet ❑ Other DEPTH OF SIDEWALK 03 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- _ S.F. 5"- S.F. 6 "- S.F. Class'At- S.F. ADDITIONAL REPAIRS — 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 : P$ Date: /O-9/9 — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS . 40 t co 4-Aps q9)17 - 3- 2e ` ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK /� REQUIRED Type of Defect A ❑ Yes p-No See reverse side for Defect Codes A-F See below for Defect Code G EQ R I VEGETATION REQUIRED ❑ Yes [J-No 4 WATER VALVE �" ADJUSTMENT REQUIRED < ec' ❑ Yes -fNo 1 . I PARKS DEPARTMENT nn REVIEW REQUIRED 11"�I ❑ Yes 1No fr 1 - 1! P.) An, LOCATION OF SIDEWALK front Yard LI Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2-5:3 Feet ❑ Other _ DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches i AREA TO BE REPAIRED 4"- - - S.F. 5"- S.F. 6 "- S.F. Class'Ai- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 1No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : S h�/ -� Date: /O 'l FORMED POURED COMPLETED CITY OF WATET LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 4i f-hiJI $ — s - O i t- e. PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect it ❑ Yes ,fiNo — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes Q-No — ! s WATER VALVE "` Ir ADJUSTMENT REQUIRED � � 4/0 ❑ Yes p-No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I o — Lam' CDL 4 D5' LOCATION OF SIDEWALK Ofiont Yard ❑ Side Yard ❑ Other _. WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet f 15.3 Feet ❑ Other DEPTH OF SIDEWALK Inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S,F. 5"- .S.F. 6 "- S.F. Class'As- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ° No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: _ /0✓9/� FORMED POURED COMPLETED CITY OF WATERLo• SIDEWALK REPAI! SURVEY FORM PROPERTY ADDRESS . 4 ) PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ro See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes I.o 4 WATER VALVE ADJUSTMENT REQUIRED < 0-10. i j Yes Q7No T 4 PARKS DEPARTMENT REVIEW REQUIRED A ) 1,2 1..„i,ta_ ❑ Yes dNo 4,0 J. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet a'5`.3 Feet ❑ Other _ DEPTH OF SIDEWALK L 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : a-(; Date: f . /49-Y4 FORMED POURED COMPLETED CITY OF WATE LO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4/4 Oa VA ' -- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C ❑ Yes — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes o WATER VALVE 11/4 ADJUSTMENT REQUIRED 4 i4 ❑ Yes C10 — I PARKS DEPARTMENT REVIEW REQUIRED L -Yes ❑ No — C n 7, LOCATION OF SIDEWALK i Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Er5.3 Feet ❑ Other DEPTH OF SIDEWALK 2 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '``"_ X' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L'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 : pc � Date: FORMED POURED COMPLETED CITY OF WATERL.• SIDEWALK REPAIR SURVEY FO M PROPERTY ADDRESS . 4--Zo END ,/q 5 Zcil3 -,13- , - tor-5 PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes [-No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ` < 29 ❑ Yes CNo I I PARKS DEPARTMENT REVIEW REQUIRED [ es ❑ No - - - - A ",3 golJA-45 LOCATION OF SIDEWALK El-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .3 Feet ❑ Other DEPTH OF SIDEWALK 13v4 inches ❑ 5 inches ❑ 6 inches , AREA TO BE REPAIRED 4"- = ' S.F. 5"- _S.F. 6"- S.F. Class'At- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes IR'No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. cc Date: FIRST INSPECTION AND FORM MADE BY : I > Date: a--9 FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F•RIM PROPERTY ADDRESS . 4 z; 6�5113 -73 - 70 - and PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes IVo — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ YesV WATER VALVE ADJUSTMENT R QUIRED 4z3 ❑ Yes EIKNo I I _ PARKS DEPARTMENT REVIEW REQUIRED ❑ YesCI4o Sf LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard� El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet fl 5.3 Feet ❑ Other DEPTH OF SIDEWALK I1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class 'A'- _ S.F. — ADDITIONAL REPAIRS 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: 04-11 — FORMED POURED COMPLETED — CITY OF WATERLOO '� SIDEWALK REPAIR SURVEY FORM PROPERTY Y ADDRESS Foogad5 sc;11 2‘10 • PARCEL CODE CONTROL NO. CLEAN SIDEWALK /l REQUIRED Type of Defect ❑ Yes E t\lo See reverse side for Defect Codes A-F J See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes p`No \ WATER VALVE � f,�� ADJUSTMENT REQUIRED `j J ❑ Yes FNo PARKS DEPARTMENT REVIEWIE REQUIRED • i Yes ❑ No A A _ EOLJ'Ag LOCATION OF SIDEWALK El-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .B 5.3 Feet ❑ Other DEPTH OF SIDEWALK Z 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'N- S.F. ADDITIONAL REPAIRS 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: /� )49 FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY F$ . fi PROPERTY ADDRESS 433 6Alitra - - S ) 113 - , - 1.2S . - ©o1 a :</- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED RE �� Type of Defect A ❑ Yes Z1 iVo -� See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED 1 I ❑ Yes iN o WATER VALVE ADJUSTMENT REQUIRED F —* ❑ Yes H-No PARKS DEPARTMENT REVIEW REQUIRED es ❑ No AA LOCATION OF SIDEWALK eKrFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑,4✓Feet ❑ 5 Feet C 1-5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ` '% S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS 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 : K-- Date: le FORMED POURED COMPLETED — CITY OF WATERLO• SIDEWALK REPAI!; SURVEY FORM PROPERTY ADDRESS . / 3-7 EDwik, - 3 - goc - ac:6 PARCEL CODE CONTROL NO. CLEAN SIDEWALK /� REQUIRED Type of Defect ,4 C ❑ Yes K7 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes i to 11/4t WATER VALVE /(�'� ADJUSTMENT REQUIRED � `I ❑ Yes 17No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes V o J _A_c IA IP LOCATION OF SIDEWALK Cont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet j 5 3 Feet ❑ Other _ DEPTH OF SIDEWALK nches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 15 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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- 1�J Date: /b` )9 FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SU VEY F.RM PROPERTY ADDRESS 0e9 414 �i,4/J/lL-«.J PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No 721 WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No — Fk�KLr�l ST LOCATION OF SIDEWALK 1.,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK X4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '0S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /0-7-1 9 FORMED POURED COMPLETED _ CITY OF WA TERLO• SIDEWALK EPA I SURVEY FARM PROPERTY ADDRESS 00 &X rvi PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 'fl No WATER VALVE < E —•► ADJUSTMENT REQUIRED �� ❑ Yes 'al] No kr-ad,KI� I PARKS DEPARTMENT REVIEW REQUIRED Lf z Yes El No rvc,„0-, A. st LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes t No No. of Squares with Patches _ CODE G - NOTE:Areas marked with an "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: / FORMED POURED COMPLETED CITY OF G® A ERL0�• SIDEWALK REPAIR SURVEY EY 70i M PROPERTY ADDRESS . co aX- / . k L.._i/t! J PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect ❑ Yes -Ci No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes LI No WATER VALVE ADJUSTMENT REQUIRED -- FQ--► ❑ Yes Et No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑1'10 C — 4.0 R1\;JICsIN LOCATION OF SIDEWALK ❑"Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK U-4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK U-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '4"- `' `' S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS f;CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. ( -.// _ FIRST INSPECTION AND FORM MADE BY : r{ 'J Date: (0 3 f FORMED POURED COMPLETED CITY OF WATERLOS -- S DEW LK REPAIR SURVEY F•RM PROPERTY ADDRESS 3 2-3/1 F k,4/4 .-tiki t - ? - 4z - a PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F aYes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No �. �t� WATER VALVE � ADJUSTMENT REQ'D a ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No j LOCATION OF SIDEWALK EI Front Yard @'Side Yard ❑ Other WIDTH OF SIDEWALK E 4 Feet =-t 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK N 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 755.1 S.F. 5"- S.F. 6"- S.F. Class S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G NOTE :Areas marked with an"FR may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ;(. Date: """ 3®/9 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY '7ORNI PROPERTY ADDRESS -. .. I._' 'yam a - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect �a. : c-- ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED — 41-42)--111. I ❑ Yes '[ 7 No I _ I. \\\::\\\\\ I PARKS DEPARTMENT REVIEW REQUIRED �� ❑ Yes L No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet &'5.3 Feet ❑ Other DEPTH OF SIDEWALK KI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED f4"- S.F. 5"- S.F. 6"- — S.F. Class'As- S.F. ADDITIONAL REPAIRS 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: t c r? c FORMED POURED COMPLETED CITYOFWATERLO SIDEWALK REPAIR SURVEY FORM )l PROPERTY ADDRESS �. `'- i 3 -23 - `i `'PARCEL CODE CONTROL NO. CLEAN SIDEWALK r REQUIRED Type of Defect C ❑ Yes LI No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes E"No — WATER VALVE t l ADJUSTMENT REQUIRED Yes ❑.No - I ,04 I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C No r; LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ID 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK n 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '4"- - ' F S.F. 5"- S.F. 6"- S.F. Class 1A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes l0'No No. of Squares with Patches CODE G - NOTE:Areas marked with an "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: rc,/1/t — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FERN - PROPERTY ADDRESS- •PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Imo`Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ET Yes ❑ No — WATER VALVE ` ADJUSTMENT REQUIRED — ~ ` ` ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard -0 Other -=; — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Li Other = DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- - S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: f 1 ' FORMED POURED COMPLETED CITY OF WATERED• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS RA-1,74u,� 11113 -23 - ,'�� - Gam; PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect f + '% ❑ Yes ❑-No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED Yes E`No — ! * WATER VALVE Q1 4Z; ADJUSTMENT REQUIRED � ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED Yes 1]No 1 A4-.1 4.9/0,-) c raueLidt LOCATION OF SIDEWALK 1 iFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 4 inches 0`8 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 5 q-I S.F. 5"- 2 .C-' S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L7No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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: /° 3 1 9 FORMED POURED COMPLETED CITY OF WATERLOO) SIDEWALK REPAIR' SURVEY FOI*N1 PROPERTY ADDRESS ° it, 5ge 4'a: PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A 7") 4 ❑ Yes r No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes L .No WATER VALVE ADJUSTMENT REQUIRED — FQ--► ❑ Yes 'No !) I PARKS DEPARTMENT REVIEW REQUIRED 10/Yes ❑ No 5,5 _ �• i g� i SA- • LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet In 5.3 Feet ❑ Other DEPTH OF SIDEWALK inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. S.F. 6"- S.F. Class IN- S.F. ADDITIONAL REPAIRS 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: ,c.1;/I FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _ ❑ Yes Q No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I Yes 0 No t WATER VALVE ADJUSTMENT REQUIRED _. < CY+ ❑ Yes ti No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes `°II No lCi-,„ S4 LOCATION OF SIDEWALK °C] Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet b 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 'I] 4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED 4"- ': . , S.F. 5"-_ S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: c -f ti FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F.RM PROPERTY ADDRESS :x /-` r,110 v, C PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes RI No -- WATER VALVE `, E ADJUSTMENT REQUIRED 22�--�"• 1 v Yes No � i I PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes C1 No 3. 1 LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard '0 Other y _> WIDTH OF SIDEWALK \I 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 3 `; S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED 3/3 CITY OF WATERLO• SIDEWALK REPAIR SURVEY FOR', PROPERTY ADDRESS ‘s.‘1 >-c<,ig,I r n S+ . 0 t 29 PARCEL CODE CONTROL NO. Li 3 CLEAN SIDEWALK Type of Defect t`' . REQUIRED See reverse side for Defect Codes A-F I ❑ Yes 0 No See below for Defect Code G 1 `` TRIM VEGETATION REQUIRED , ❑Yes ''p No 1.1 1 .C' , WATER VALVE `om• ' --�$_ ADJUSTMENT REQ'D a c ❑Yes '0 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 1] No J LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard .b Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 'd 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑'6 inches AREA TO BE REPAIRED 4"- 6:2). S.F. 5"- S.F. 6= 1 Z'1,e S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERLOO 0 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS eZoo -k Fi.,�^ z / „5T-- - 1 i 1 - -#1 ' )C6 - -PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I EYYes ❑ No See below for Defect Code G TRIM VEGETATION — I REQUIRED _ ❑Yes ❑ No `; WATER VALVE F 4``"'� ADJUSTMENT REQ'D — i ❑Yes ❑ No I PARKS DEPARTMENT —REVIEW REQUIRED gli`a„') ❑Yes ❑ No 1 LOCATION OF SIDEWALK :fl Front Yard - Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet D-5.3 Feet ❑ Other — DEPTH OF SIDEWALK D 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4" S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 1 Date: <' 7 i FORMED _ POURED COMPLETED CITY OF WATERLo• SIDEWALK REPAIR SURVEY FORM 1 PROPERTY ADDRESS ZJC> ,5(LX iqxAiKGrr°' fit;r5 7-et -, (. , -t _ /5- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED -iJYes ❑ No WATER VALVE ` ADJUSTMENT REQUIRED < ❑ Yes ❑ No if jr PARKS DEPARTMENT REVIEW REQUIRED ./511'6 ❑ Yes ❑ No n (ir LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other � r$ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet D 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK Ci 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ;I."- -' S.F. 5"- S.F. 6"- S.F. Class'A°- S.F. _ ADDITIONAL REPAIRS 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. of — FIRST INSPECTION AND FORM MADE BY : ; Date: /C— Y FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS- 363 i ,6-1P-. - 619 PARCEL CODE CONTROL NO. —" CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes ❑"No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes INo WATER VALVE t ADJUSTMENT REQ'D El Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No s ' 1'/f l I • J L kca LOCATION OF SIDEWALK ❑ Front Yard Q Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C1 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- -- S.F. 5"- S.F. 6"- S.F. Class'A- S.F. ADDITIONAL REPAIRS _ 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: 'b FORMED POURED COMPLETED CITY F WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS`R 3 FRAM k,nI PARCEL CODE CONTROL NO, CLEAN SIDEWALK Type of Defect = REQUIRED See reverse side for Defect Codes A-F ❑Yes ❑ No See below for Defect Code G e TRIM VEGETATION REQUIRED ❑Yes ❑ No WATER VALVE 0—* Z7 ADJUSTMENT REQD \ ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes E'No J — LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet ❑'Other C 4 DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 0`6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- 'i S.F. Class S.F. ADDITIONAL REPAIRS 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. 1C FIRST INSPECTION AND FORM MADE BY : -� Date: /t��'�",1 FORMED _ POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS` -Do & 341-14 T: - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Q REQUIRED — See reverse side for Defect Codes A-F (Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes El No V WATER VALVE ADJUSTMENT REQ'D ❑Yes No _ tsu PARKS DEPARTMENT REVIEW REQUIRED — — i S2\ Yes No LOCATION OF SIDEWALK C Front Yard Lide Yard ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Li 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- _ 7' S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes t7I No No.of Squares with Patches CODE G - -- NOTE:Areas marked with an "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: 9-24 13 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS qcr C z PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect - REQUIRED See reverse side for Defect Codes A-F I ❑Yes El No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 1 No WATER VALVE 0-00' ADJUSTMENT REQ'D e" ❑Yes El No PARKS DEPARTMENT REVIEW REQUIRED - — — — U t ❑ Yes ❑ No — LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard 1 Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK i] 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: it, / FORMED POURED COMPLETED CITY OF 'bFATERLOO SIDEWALK REPAIR SURVEY FOR ` PROPERTY'ADDRESS' Arz.o. en)ti3 3s.A-- 3 .PARCEL CODE CONTROL NO. ret -�' CLEAN SIDEWALK Type of Defect . REQUIRED See reverse side for Defect Codes A-F I I ❑ Yes NI No See below for Defect Code G TRIM VEGETATION ... :...... REQUIRED ❑Yes IE No d' WATER VALVE F es► Y( ADJUSTMENT REM) — a tA -cc ❑Yes 1 No PARKS DEPARTMENT REVIEW REQUIRED �.. • ' ❑Yes T,,t,No KA '/1\ VA ( , ?��o LOCATION OF SIDEWALK Front Yard tp.Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 11 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ® 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class _ S.F. — ADDITIONAL REPAIRS 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 : t7 Date: 3 LQ �I 1 FORMED POURED COMPLETED 4.. 1 CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS' yy5 ?r® - - - (, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect c rs REQUIRED See reverse side for Defect Codes A-F � ®' ❑ Yes7 No See below for Defect Code G TRIM VEGETATION I - REQUIRED 5-. ❑Yes No t _ a WATER VALVE 0—* ADJUSTMENT REQ'D \ ❑Yes II No PARKS DEPARTMENT REVIEW REQUIRED 5,5 Yes No LOCATION OF SIDEWALK El'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches IA 6 inches AREA TO BE REPAIRED 4"- -17::,‘ S.F. 5"- S.F. 6'"- 'q2„L S.F. Class'A'- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 1E1.No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ; Date: it l 3 WI FORMED POURED COMPLETED CITY OF WA ERL • L OF Z SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS® .S 0 Si-. - - 5 - '0 PARCEL CODE (4/AL,.;U T s T. CONTROL NO. CLEAN SIDEWALK Type of Defect A G , REQUIRED See reverse side for Defect Codes A-F l I ❑Yes O..No See below for Defect Code G r �� — TRIM VEGETATION 'X, I REQUIRED ❑Yes ;❑ No _ i/l WATER VALVE ADJUSTMENT REQ'D — j a' El Yes 0 No '• A. �, PARKS DEPARTMENT 21$ 3y C �� REVIEW REQUIRED ❑Yes I2 No Hk ) - LOCATION OF SIDEWALK E1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet El Other — DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED 4"- 1= ` ° S.F. 5"- S.F. 6"- 53, S.F. Class'A- 3'NS S.F. ADDITIONAL REPAIRS 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: /L/3 if FORMED POURED COMPLETED CITY OF WATERLOO 3 0 r 2 - SIDEWALK REPAIR SURVEY Fri RM PROPERTY ADDRESS- S 5 i=,-c,m.Kt, .-, c ',4:,-- - 2 q- '5r - c ( ., z ---- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect n REQUIRED See reverse side for Defect Codes A-F `= ❑Yes 0 No See below for Defect Code G TRIM VEGETATION ;�� 3 �'-5 c � REQUIRED '� ,0: ❑Yes 0 No -` \ WATER VALVE ' 0—* (.:\c'''' _ ' ' -=. ''-'- ADJUSTMENT REQD - El Yes 0No 2 2- 0''� 5.c PARKS DEPARTMENT �,�� �4. , 13.E* �'.. 7' �� REVIEW REQUIRED _ s C, iv ❑Yes C7 No — ,, I `;.,. ) LOCATION OF SIDEWALK 0`Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0 Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED 4"- ,--,- S.F. 5"- S.F. 6"- it'-! q S.F. Class'A'- ° s S.F. ADDITIONAL REPAIRS 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: '''1 FORMED POURED COMPLETED CITY OF WATERLOti SIDEWALK REPAF! SURVEY FORM PROPERTY ADDRESS - /r 0 '3 i 4wed PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect El Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No _. WATER VALVE ADJUSTMENT REQUIRED ~ '� ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK GIFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet --- i 5.3 Feet ❑ Other DEPTH OF SIDEWALK a4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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' Date: FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /00 gk'k' iCyyl sT' - i1, - 1 Z 074' . PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 0.Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED < 1\ ❑ Yes ❑ No I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK K'front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK El 4 Feet El 5 Feet ❑'5.3 Feet ❑ Other DEPTH OF SIDEWALK 1014 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class`A'- S.F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . /00 lag illimet.Sew 5r -(( %='s' -0f - I E?^ °` PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No Ie,04 I — PARKS DEPARTMENT REVIEW REQUIRED �/ ❑ Yes ❑ No LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0"`5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: h'._7' r J — FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . /00 8 /�11,2050A.l PARCEL CODE CONTROL NO. — CLEAN SIDEWALK REQUIRED Type of Defect 0 Yes ❑ No _ See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes No WATER VALVE ` ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes ❑ No 4a,-$a:-; t Sa LOCATION OF SIDEWALK .❑'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0-5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' • S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - F'ATCHES ❑ 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: FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FO M PROPERTY ADDRESS /00 ,i•C iikada/LL .5 PARCEL CODE CONTROL NO. -- CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes d No WATER VALVE - ADJUSTMENT REQUIRED ❑ Yes LI No I I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑'No — LOCATION OF SIDEWALK Er Front Yard LI 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 4"- S.F. 5"- S.F. 6"- S,F. Class'A'- ADDITIONAL REPAIRS 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 : l• � Date: 1°6- . ' • — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /OQ L ,1l,4pp►,Soiti ,5t PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED I ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED < --11. ❑ Yes ❑ No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0 No — e LOCATION OF SIDEWALK [ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet iI5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 111-4i inches ❑ 5 inches ❑ 6 inches AREA TO B.E REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L3`�No No. of Squares with Patches CODE G - NOTE:Areas marked with an "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: 'l /1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS j ' d, ,i~z5r, 1_ de ; 'I- 7A,� - PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes ITNo See below for Defect Code G TRIM VEGETATION REQUIRED . (/ 1 Yes G No z t `-- WATER VALVE G I ADJUSTMENT REQ'D — ❑Yes ❑=`No PARKS DEPARTMENT — REVIEW REQUIRED — — — — — — — � ❑Yes .❑ No ilf LOCATION OF SIDEWALK O'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LI 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 2`4 inches ❑ 5 inches ❑ 6 inches v� AREA TO BE REPAIRED 4"- £- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: /r=A`/ FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAI SURVEY FORM PROPERTY ADDRESS too szk /174R1:6011 ST PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect _ REQUIRED See reverse side for Defect Codes A-F I E Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED >]Yes ❑ No ` WATER VALVE ADJUSTMENT REQ'D ❑Yes ❑ No — d I PARKS DEPARTMENT —9 REVIEW REQUIRED ❑Yes ❑ No 5 , I LOCATION OF SIDEWALK D-Front Yard Ei Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches LI 6 inches AREA TO BE REPAIRED 4."- ' �•5 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 n.9 Date: / FORMED . POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . /00 84-g -2-5 Z -tr11 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUI_2ED Type of Defect -0`Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQWRED I I Yes ❑ No11/4 At if — WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No Pe PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK LI Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -❑5.3 Feet ❑ Other DEPTH OF SIDEWALK �0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- _S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE : Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : _ �_ _ Date: /0 7- FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK EPAIR SURVEY FSRM PROPERTY ADDRESS n, `ifs, - 7 0 ! j PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑"Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes No t WATER VALVE — < `,._ % I tC 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 0.5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- )i ' S.F. 5"- S.F. 6"- S.F. Class S.F. ADDITIONAL REPAIRS 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: to' ?-/' FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F.-ARM PROPERTY ADDRESS 1 3S e `( i r!O PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ?T' ❑ yes {] No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes LINo — WATER VALVE ADJUSTMENT REQUIRED — ~ '♦ 2J ❑ Yes f]No )1,04 I PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes ❑No A i - LOCATION OF SIDEWALK 0•°Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ET 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- - S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : KS' Date: ,0_- 7- /9 FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS . _ /> �j f,'t w - °i 2 ds- ` - 6.1;t: ' - 3 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE ` ADJUSTMENT REQUIRED < 0—* \ka>`' ❑ Yes LNo PARKS DEPARTMENT REVIEW REQUIRED I ❑ Yes ❑ No �'B6I � r 1 a0 LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches i AREA TO BE REPAIRED 4"- `u S.F. 5"- S.F. 6"- S.F. Class `A'- S.F. ADDITIONAL REPAIRS 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: ` i FORMED POURED COMPLETED CITY OF ❑ A ERLO• SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS - 5 � 4_g i /3-z - 7g5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect El Yes El No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes El No — WATER VALVE ADJUSTMENT REQUIRED A-04. l<; ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No — al LOCATION OF SIDEWALK C7 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0h5;3 Feet El Other DEPTH OF SIDEWALK El 4 inches El 5 inches El 6 inches AREA TO BE REPAIRED 4"---' - S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : ✓' IS Date: P--7- L • FORMED POURED COMPLETED L CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ovo -zi6 ,14,wl50ni Sr/ /P � - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect =. REQUIRED See reverse side for Defect Codes A-F ❑Yes Ca No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes No ` WATER VALVE 4—* v ADJUSTMENT REQ'D a ❑Yes 'No PARKS DEPARTMENT - REVIEW REQUIRED c ❑Yes No lE:,, e , _ LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Cq5.3 Feet ❑ Other DEPTH OF SIDEWALK '0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' 5 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: is(- i l FORMED POURED COMPLETED CITY OF WATERL•'• / - SIDEWALK REPA!. SURVEY FORM f PROPERTY ADDRESS 202-Zr( , NadOrt1-Sr/WS iq t/ � - PARCEL CODE CONTROL NO. - CLEAN SIDEWALK — Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑ Yes ? No See below for Defect Code G TRIM VEGETATION I REQUIRED { ; . ❑Yes ❑-No t 7 '� WATER VALVE I ADJUSTMENT REQ'D — i ❑ Yes L No I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes J No LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Er 5.3 Feet ❑ Other — DEPTH OF SIDEWALK fl 4 inches ❑ 5 inches Ef 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes N No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : - Date: FORMED POURED COMPLETED CITY OF WA ERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c2b3 1-144150,07 si13 - r - 1. f, - toe " T37 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I I es ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No ` WATER VALVE 3 ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED - — qo — — — ❑ Yes ❑ No J to 0/4-jil LOCATION OF SIDEWALK l ont Yard Side Yard ❑ Other L�J WIDTH OF SIDEWALK ❑ 4 Feet 5/Feet C v.3 Feet ❑ Other DEPTH OF SIDEWALK Inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- 79I0 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: )V-Iit- FORMED POURED COMPLETED CITY OF WATE LO' SIDEWALK REPAIR SU*:VEY FORM PROPERTY ADDRESS . 07l 5" A' I;oi y -2I -/-9A - 611 - r_ PARCEL CODE CONTROL NO. CLEAN SIDEWALK [� REQUIRED Type of Defect /l ❑ Yes Ei to See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes [moo A WATER VALVE "`. ADJUSTMENT REQUIRED I 1�`. � � ❑ Yes Ci'No a I PARKS DEPARTMENT REVIEW REQUIRED E Yes ❑ No LOCATION OF SIDEWALK 11ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet LI'5Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- a'",o S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Z 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 : Date: la—l' "fi FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY 7ORM PROPERTY ADDRESS 21`f , ._, , PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Er Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I I `BYes ❑ No WATER VALVE t/ ADJUSTMENT REQUIRED 0...410. ❑ Yes ❑ No ,04 PARKS DEPARTMENT REVIEW REQUIRED 1/5 ❑ Yes ❑ No LOCATION OF SIDEWALK D Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Ei 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches LI 5 inches ❑ 6 inches r ✓, AREA TO BE REPAIRED 4"-2. .-5 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2 S Date: rcliy/i FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SU•NEY FORM PROPERTY ADDRESS .' . v r / vL4 %' /413 Z - 3° ° 7 40 PARCEL CODE CONTROL NO. CLEAN SIDEWALK A REQUIRED Type of Defect 1 ❑ Yes Ll'No See reverse side for Defect Codes A-F TRIM VEGETATION J See below for Defect Code G I REQUIRED J I ❑ Yes EJ1 o firWATER VALVE ADJUSTMENT REQUIRED FQ�� — J ❑ Yes ErNo /11 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes En"No LOCATION OF SIDEWALK L1 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet La'S Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- c2140 S.F. 5"- S.F. 6"- S.F. Class`A'- _ S.F. ADDITIONAL REPAIRS 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 : A Date: Jo 41'/9 — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REP A 1R SURVEY FORM PROPERTY ADDRESS • 3 f(o1c.t 6913 -e4 -3oa4- - 00 g 0,4( PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect C REQUIRED See reverse side for Defect Codes A-F I ❑ Yes Zo See below for Defect Code G - TRIM VEGETATION REQUIRED ❑Yes El/No WATER VALVE 3 (P C_)1 ADJUSTMENT REQ' ) ❑Yes p-No PARKS DEPARTMENT REVIEW REQUIRED — --C C C` — — C — — C El Yes o v/zi (0,0 c6d) LOCATION OF SIDEWALK VOront Yard Re Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet u b Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALKnches ❑ 5 inches ❑'I?inches AREA TO BE REPAIRED 4"- Z1-3•°S.F. 5"- S.F. 6 "- 50c S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : i� Date: !0 2 l FORMED POURED COMPLETED CITY OF % ATE LO• SIDEWALK REPAIR SURVEY FS*NI PROPERTY ADDRESS . 4 ! fo0_14 3 -24 - ! ;4 . - (4o 4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes i 1-No See reverse side for Defect Codes A-F TRIM VEGETATION — See below for Defect Code G REQUIRED ! I ❑ Yes 0-No WATER VALVE "` . ADJUSTMENT REQUIRED ~ �7 ❑ Yes l Eti o ! I PARKS DEPARTMENT REVIEW REQUIRED /� fees ❑ No Af 5:! 4,1 1 LOCATION OF SIDEWALK Er Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ©'Other .• ( DEPTH OF SIDEWALK I'inches ❑ 5 inches ❑ 6 inches `- AREA TO BE REPAIRED 4"- rib D S.F. 5"- S.F. 6"- S.F. Class 'A'- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - ; ziL ear( — NOTE :Areas marked with an"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?-S Date: / ' r2-17 FORMED POURED _ COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 500 456aG. /c aA 3 - j 5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes I] No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes I No WATER VALVE 1 ADJUSTMENT REQUIRED e --► Li Yes ❑ No /1,04 PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No C. J.1 LOCATION OF SIDEWALK .irFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0-5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK J2I 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 4.2` S.F. 5"- S.F. 6 "- S.F. Class'AT- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes al\I-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 : Date: /6 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO!M PROPERTY ADDRESS _ 'v° r ct,:; I:3 24 - 5.4) - ;E PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes Cl No — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes [I No 11/4 fir WATER VALVE ADJUSTMENT REQUIRED --► ❑ Yes ❑ No /1,0k PARKS DEPARTMENT REVIEW REQUIRED t ❑ Yes ❑ No — �"1 t LOCATION OF SIDEWALK []-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0'5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK O 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- _ " S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes -LNo No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : '`' Date: 1 FORMED POURED _ COMPLETED — CITY OF WATERLO• SIDEWAL< REPAIR SURVEY FORM PROPERTY ADDRESS `1 ;t 4{ 24- - 15°' - at') I Z4-5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A REQUIRED / See reverse side for Defect Codes A-F I ❑Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes QNo \t ��;���_ WATER VALVE 5� ADJUSTMENT REQ D ❑Yes p'No PARKS DEPARTMENT / REVIEW REQUIRED r I ❑Yes Lk No A 5.Z l J DkLiE LOCATION OF SIDEWALK ❑ Fi ont Yard Li Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 10'5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK L14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '16`c) S.F. 5"- S.F. 6 "- S.F. Class 1A1- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L "Nlo No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: G .t FORMED POURED _ COMPLETED CITY OF WATERLO• SIDEWALK RE!AI' SURVEY FOblA PROPERTY ADDRESS 00 6..t i.-MF1 V i7e PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 11No 1 WATER VALVE ADJUSTMENT REQUIRED f—Q---► ❑ Yes gl No Iej � I PARKS DEPARTMENT -` �' REVIEW REQUIRED ❑ Yes CNo VA LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other 4' DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes E2 No No. of Squares with Patches CODE G NOTE:Areas marked with an"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: FORMED POURED _ COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS __ 1- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes M No 4 WATER VALVE ADJUSTMENT REQUIRED 42:1-+ ❑ Yes LI No ri I l PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ID No . 1` , LOCATION OF SIDEWALK El'Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK i '4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED 4"- C s S.F. 5"- S.F. 6 "- • 0'S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES CI Yes ErNo No. of Squares with Patches CODE G - NOTE: Areas marked with an "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 47 Date: FORMED POURED COMPLETED CITY OF W TERLO S1 tE ALK REPAIR SURVEY Ft, :M PROPERTY ADDRESS t f3 - , - , - y; Al PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Lr es El No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I d Yes ❑ No WATER VALVE 2 ADJUSTMENT REQUIRED 33 ❑ Yes El No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK EE Front Yard El Side Yard El Other WIDTH OF SIDEWALK El 4 Feet C`SFeet ❑ 5.3 Feet El Other DEPTH OF SIDEWALK Lf 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes El No No. of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : _ 1" Date: 70 FORMED _ POURED COMPLETED CITY OF WATERLO. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `' - A S i 3-A-33 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes 1 No WATER VALVE ` ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED J Yes ❑ No IQ.Ar 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 4"- 1 ;( ' S.F. 5"- S.F. 6"- S.F. Class TN- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : r `'7 Date: =ti e to FORMED POURED COMPLETED CITY OF WATE LO SIDEWALK REPAIR SU VEY FORM PROPERTY ADDRESS Sa PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect Il Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED -41"' --110- ❑ Yes ❑ No I At4 ` I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet r1 5.3 Feet ❑ Other DEPTH OF SIDEWALK B'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 5"- S.F. 6"- SF. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes LEF No. of Squares with Patches CODE G - --- NOTE:Areas marked with an"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,�—a 4 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAII- SURVEY FORM PROPERTY ADDRESS L., C-A-r -23 - -33- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes p,No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes in No �t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes in No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes p No L LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C.5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 1p,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- R7,0 ' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. FIRST INSPECTION AND FORM MADE BY : F - t5 5 Date: ltp_a - i FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO MM PROPERTY ADDRESS ,, - Czn zv PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ( REQUIRED I I ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes rJ No I I ` PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 09No •Ze }i% V') LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ( 5.3 Feet ❑ Other DEPTH OF SIDEWALK P4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-_ _S.F. 5"-_ S.F. 6 "- _ S.F. Class'AT- — S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes El No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : P G7 Date: lC""Z—l -3 FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY Fe RM PROPERTY ADDRESS ': , -; 1 TT __ j r PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes Kb No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes 1'No t WATER VALVE ADJUSTMENT REQUIRED F 2` --�► 0Yes No n PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I No . LOCATION OF SIDEWALK J 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK I4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- a27 'S.F. 5"- S.F. 6"- S.F. Class'A- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: (X-7— -5 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPA - SURVEY FORM PROPERTY ADDRESS n a PARCEL CODE CONTROL NO, CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes 0 No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 0 No a WATER VALVE F -+ %A ADJUSTMENT REQD ❑Yes u No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ' 7 No i LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -0 5.3 Feet ❑ Other DEPTH OF SIDEWALK (i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A1- S,F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (--. L— PARCEL CODE CONTROL NO. CLEAN SIDEWALK '- REQUIRED Type of Defect ❑ Yes No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED Yes ) No t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ® No i I PARKS DEPARTMENT REVIEW REQUIRED t o ❑ Yes , I No LOCATION OF SIDEWALK ,Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK l] 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '?i3351 S.F. 5"- S.F. 6"- S.F. Class`A'- S.F. ADDITIONAL REPAIRS 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: k Z- FORMED POURED COMPLETED CITY OF WATERL•• SIDEWALK REPAIR S'iJRVEY FORM PROPERTY ADDRESS l\ (c., c.. . - �. ► � PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes © No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED i ❑ Yes 1E3 No t WATER VALVE ADJUSTMENT REQUIRED 41—(2)-410. ❑ Yes gt No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes l No A LOCATION OF SIDEWALK f Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Q'5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 023 k S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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. FIRST INSPECTION AND FORM MADE BY : b`) Date: FORMED POURED COMPLETED CITY OF WATERLO.. SIDEWALK REPAIli. SURVEY 17.0RM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Per REQUIRED Type of Defect ❑ Yes 0"No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED El Yes 0No WATER VALVE ADJUSTMENT REQUIRED 4— N --► t^`7 ❑ Yes -IL No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No L R LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ,0 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 10'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"--' 45 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Pi No No. of Squares with Patches - CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : 2,5 (gyp Date: (',5 /1 1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY F.,R — PROPERTY ADDRESS ' t3 = 48U- cx�Z 7` PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ® No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes No — WATER VALVE ADJUSTMENT REQUIRED T 4- 1 ❑ Yes LINO PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No .4 de.� LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0)5.3 Feet ❑ Other DEPTH OF SIDEWALK 7 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- Cji+4 S.F. 5"- S.F. 6 "- S.F. Class'A1- S.F. ADDITIONAL REPAIRS 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 : tz} Q P`7 Date: I L - FORMED POURED COMPLETED CITY OF WATERLOO) SIDEWALK REPAIR SURVEY FLOC': PROPERTY ADDRESS 111,2 4 A-3;4`0L.te 7/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect p Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED 1 ❑ Yes ❑ No WATER VALVE 3 ADJUSTMENT REQUIRED `'�''--► El Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED r l ❑ Yes ❑ No LOCATION OF SIDEWALK .®'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0-4 inches ii55 inches ❑ 6 inches AREA TO BE REPAIRED 4 "-2 S.F. 5"- _$c. ' ` S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. q 2 FIRST INSPECTION AND FORM MADE BY : 1?-7 Date: l ✓D "I? FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ! L r7=4. a �, 1 t, -�( - 4�` - / 'T _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect — ' -Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE if ADJUSTMENT REQUIRED — 4-0—* ❑ Yes ❑ No \k 110I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ,L 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ,Li 4 inches -L 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- - S.F. 5"- ›L-',C) S.F.' 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 Date: `r FORMED POURED COMPLETED CITY OF WATERLOO) SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS :3 5 k..3 -7 -1 -cx 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ES No See reverse side for Defect Codes A-F See below for Defect Code G EQ R I VEGETATIONREQUIRED ❑ Yes No 11/4 4 WATER VALVE ADJUSTMENT REQUIRED 411-- ---► ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 1t No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Eb Other DEPTH OF SIDEWALK ❑ 4 inches N 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- Alf) `S.F. 6 "- S.F. Class'AT- S.F. ADDITIONAL REPAIRS 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: I(-2)®Z FORMED POURED COMPLETED CITY OF WATER_®O SIDENNA-LK REPAIR SURVEY FOR PROPERTY ADDRESS 91117 4Og- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ©"Yes ❑ No See below for Defect Code G I TRIM VEGETATION REQUIRED ❑Yes ❑ No WATER VALVE d g 5 I ADJUSTMENT REQ'D �( I ❑Yes ❑ No vJ,c' PARKS DEPARTMENT C)a J ��✓ '07;` REVIEW REQUIRED ❑Yes ❑ No J Maf LOCATION OF SIDEWALK C_Front Yard r Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet E] 5 Feet CI 5.3 Feet El Other DEPTH OF SIDEWALK [ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-7"1.0 S.F. 5"- S.F. 6"- — S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS 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 : Date: 9 -,541) FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ..:5 '11 ',4 1`67, i3 - 2,\ - 353 - 010 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes No t WATER VALVE ADJUSTMENT REQUIRED 4-0—* ❑ Yes ❑ No 313E ,04 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK L 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- =' 'S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G NOTE : Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : , ,'r Date: q/Z /ici • FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FirR PROPERTY ADDRESS ' 363 L, — r Z( — PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect / REQUIRED See reverse side for Defect Codes A-F I ''.1Ef Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED Q Yes ❑ No WATER VALVE ADJUSTMENT REQ'D ❑Yes ❑ No e, *�' r PARKS DEPARTMENT v REVIEW REQUIRED t — — I — 5,2 Yes ❑ No J 2,0 S} LOCATION OF SIDEWALK ❑ Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C15.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 2 ' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: �r o,. FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FS!R.r PROPERTY ADDRESS ,:' 3o - �F r • PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect \- Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes ❑ No �t WATER VALVE ADJUSTMENT REQUIRED t-- ``,e --► ❑ Yes ❑ No — I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 1 LOCATION OF SIDEWALK D Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK 10 4 inches 0 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-7L1Z,G 'S.F. 5"-5,?.O 1 S.F. 6"- S.F. Class IN- S.F. ADDITIONAL REPAIRS 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: �� /r A FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SULI1VEY FSR .� PROPERTY ADDRESS ,ffa< t4F4Y677E -2 - 3 - OC'c PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I El Yes ElNo - WATER VALVE ADJUSTMENT REQUIRED pC)TK3� ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes El No — 5 L 1 - 3. J LOCATION OF SIDEWALK I'Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet I Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 10 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- -r___S.F. Class 1A'- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES El 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. FIRST INSPECTION AND FORM MADE BY : Date: (0/2,if FORMED POURED COMPLETED ,�, CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS q2 L, ;, g.; g. - - - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect _ REQUIRED See reverse side for Defect Codes A-F ❑Yes LI No See below for Defect Code G h` I TRIM VEGETATION REQUIRED ❑Yes 0No WATER VALVE ADJUSTMENT REQ'D - ❑Yes ❑ No 1 fi' egg`g PARKS DEPARTMENT 1:11® 70 '' REVIEW REQUIRED „ �'' ❑Yes Cl No 41 // ��� 1 •.) LOCATION OF SIDEWALK 'Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 1'Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- � S.F. Class'A'- ., S.F. ADDITIONAL REPAIRS 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: < /,,, FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS L- -eeof-T7E_ 24 - 00.4 PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect A 0 Yes El No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED Yes Erivo t WATER VALVE ADJUSTMENT REQUIRED 41) + IZ'Yes CI No PARKS DEPARTMENT REVIEW REQUIRED k 111 Yes 01Sio - 0 A- 1i A- r.7/14tzA, if""/ 1;of co4 A )(F1-70 ref\ \4\ 6(P ,+ uto lot* ( /1 c‘qss"A". 2 .5 q ‘.•-• LOCATION OF SIDEWALK QFront Yard 111 Side Yard 0 Other WIDTH OF SIDEWALK LI 4 Feet LI 5 Feet 0 5.3 Feet ii(Other DEPTH OF SIDEWALK E1 4 inches 0 5 inches 0 6 inches AREA TO BE REPAIRED 4"- S5. S.F. 5"- S.F. 6"- S.F. Class'A'- I 90,9 S.F.v ADDITIONAL REPAIRS CODE F - PATCHES El Yes feNo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : gc; Date: ' 7 -/C1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t7 - ‘„, t, A 1F-T/"e �'- 13 4- PARCEL CODE CONTROL NO. -- CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes CYNo '' WATER VALVE 1-7_52( ADJUSTMENT REQUIRED ~4� ❑ Yes ❑filo PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes 0-No „ "k, 16 1-1Z,-, y FIZtrvmssia, cA-P 6x'.5 -3°-3 LOCATION OF SIDEWALK I-front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ©"Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- T2•SVS.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes IJ'No No. of Squares with Patches CODE G - NOTE : Areas marked with an "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 Date: '‘' " -1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAi '; SURVEY =;O RM �t PROPERTY ADDRESS S1 i- i r -Z4- 310 - 610 :% PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect - s REQUIRED See reverse side for Defect Codes A-F El Yes l No See below for Defect Code G TRIM VEGETATION I REQUIRED ❑Yes 0-No WATER VALVE -- --► `5i5 ADJUSTMENT REQ'D — ❑Yes Er No 04 v 2' I PARKS DEPARTMENT .3� REVIEW REQUIRED ❑Yes O No fec 4, 1 =cri.0#ecq u=1(c?., -+3 tl/ .t= • LOCATION OF SIDEWALK El Front Yard ( Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet lit5 Feet ❑ 5.3 Feet ❑Other '1 i 4 DEPTH OF SIDEWALK Ei 4 inches ❑ 5 inches Ere.inches AREA TO BE REPAIRED 4"- [o3"- 'S.F. 5"- S.F. 6 "- ?-S'S S.F. Class'A'- S.F. ADDITIONAL REPAIRS .-. CODE F - PATCHES ❑ Yes I 11 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 : !� ' Date: /D •3 'l FORMED POURED COMPLETED CITY OF WAlERL•• SIDEWALK REPAIR SURVEY FO..M 2_4 PROPERTY ADDRESS i5 Gjy( - /3(t) z70 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No tJ/ C WATER VALVE ` e4—► ��J ADJUSTMENT REQUIRED ❑ Yes ❑ No Ie,04 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 11 c Y 3rd LOCATION OF SIDEWALK ❑ Front Yard Ei-§ide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK • 4 inches ❑ 5 inches [3 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- i, 6(4c-4 S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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. �,c-� FIRST INSPECTION AND FORM MADE BY : 1� es- Date: /° "3" 1 9 FORMED POURED COMPLETED CITY F WATER=•O SIDEWALK REPN' SURVEY FORM PROPERTY ADDRESS /100 8LX Liic/Ca -,t .5 91/3 - o/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F — I Yes ❑ No See below for Defect Code G �' TRIM VEGETATION REQUIRED ❑Yes ❑ No "` ` - WATER VALVE ♦' ADJUSTMENT REQD — I(1� I ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No l J _39$ ' LC/jC;OL LOCATION OF SIDEWALK -fl Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK .. - Feet ❑ 5 Feet ❑ 5.3 Feet [1Other 5 9 DEPTH OF SIDEWALK Kilinches ❑ 5 inches e'61nches AREA TO BE REPAIRED 4 S.F. 5"- S.F. 6 "- - S.F. Class'Ai- S.F. ADDITIONAL REPAIRS — 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. P-c FIRST INSPECTION AND FORM MADE BY : its- Date: 0 -7-1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY OR PROPERTY ADDRESS /00 5t (feat a.-1 ,5i: • PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION I See below for Defect Code G I REQUIRED I ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ` ~Q� ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED El Yes ❑ No LOCATION OF SIDEWALK :❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 2-i6-,r:.S.F. 5"- S.F. 6"- S.F. Class 1A1- _ S.F. ADDITIONAL REPAIRS 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. j)„ FIRST INSPECTION AND FORM MADE BY : Date: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 r; c°°i PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ( - REQUIRED See reverse side for Defect Codes A-F LI Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED 0-Yes ❑ No WATER VALVE _ ADJUSTMENT REQ'D 1� a I ❑Yes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes ❑ No ti J LOCATION OF SIDEWALK ®Front Yard Er Side Yard ❑ Other WIDTH OF SIDEWALK 0-4 Feet El 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑5 inches ❑ 6 inches i AREA TO BE REPAIRED 4"- - S.F. 5"- S.F. 6 "- S.F. Class'A- S.F. ADDITIONAL REPAIRS _ 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: f2._..? 0/! FORMED POURED COMPLETED CITY OF WATEJ‘iLOtt SIDEWALK REPAIR SURVEY Fs r'M PROPERTY ADDRESS . • // r - /1., / PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION J See below for Defect Code G I REQUIRED ❑ Yes No 4 WATER VALVE ADJUSTMENT REQUIRED ♦—Q--► ) ❑ Yes ❑ No )1 � J I PARKS DEPARTMENT REVIEW REQUIRED e ❑ Yes ❑ No / 1 .� ,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 4"- S.F. 5"- - S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 ; / FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO M - PROPERTY ADDRESS . (2U /f1.oL/i 1-7 F113 - 23 - gel.- t 7 �r PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect es ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED — ❑ Yes ❑ No I I I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No LOCATION OF SIDEWALK .ant Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK . -Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- -'-+<= u' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. �I _ FIRST INSPECTION AND FORM MADE BY : �" �) Date: /0 -7'�� FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SU{ VEY FO,DM PROPERTY ADDRESS / C-1w'Gail' 13 -z- Z j . - ®off , PARCEL CODE CONTROL NO. CLEAN SIDEWALK �] REQUIRED Type of Defect /C ❑ Yes ,a No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ( REQUIRED I Des 67. o WATER VALVE ` G ADJUSTMENT REQUIRED ❑ Yes ll-Nb I PARKS DEPARTMENT REVIEW REQUIRED -fl Yes ❑ No - - A AA)_ y�i- - - - Kr,/((tx (z /j f� G(/ OL#j LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK nr4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes -ET-No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. pj[ FIRST INSPECTION AND FORM MADE BY : f\/ IZT Date: /6- -i f FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SU :VEY FORM PROPERTY ADDRESS - !' ` Lo' € i PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect E Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No -' WATER VALVE ` ADJUSTMENT REQUIRED 0-40 fri ❑ Yes ❑ No - I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK ErFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK P 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Lt 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- j ; = S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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� Date: / ° FORMED POURED COMPLETED -- CITY OF WATERED 1 SIDEWALK REPAIR SURVEY FOB PROPERTY ADDRESS . I< 'L L-bu COW PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect -D- lames ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED [ 'es ❑ No t' WATER VALVE ADJUSTMENT REQUIRED 4-0 _ I ` 134 ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED (p9_/Z ❑ Yes ❑ No -- /. l LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK i Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALKches inches ❑ 6 inches AREA TO BE REPAIRED 4" _""S,F 5"- VS.F. 6"- S.F. Class'A'- S_F, ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /C-r Date: 10 2-' FORMED POURED COMPLETED CITY OF WATERLOS - SIDEWALK REPA9r" SURVEY FORM PROPERTY ADDRESS ceti6 -g3-sG) - 0(, 3 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK - Type of Defect RE�RED See reverse side for Defect Codes A-F Is ❑ No See below for Defect Code G TRIM VEGETATION REQIIRED dam' Yes ❑ No WATER VALVE <; 4' —► i ,rJ ADJUSTMENT REQ'D \ �✓ I ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED l64 - aa ❑Yes ❑ No LOCATION OF SIDEWALK ;YFront Yard fide Yard ❑ Other WIDTH OF SIDEWALK [A Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 'nches 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- vS.F. 5"- S.F. 6"- S.F. Class'Al- S.F. ADDITIONAL REPAIRS 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: /a"7 FORMED POURED COMPLETED CITY OF WATEr"LOO SIDEWALK REPAIR SURVEY FO PROPERTY ADDRESS / I.€- Jcii PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE \ ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ! ❑ Yes ❑ No LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑`4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑I inches ❑'5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- �� S.F. 5"- -S.F. 6"- S.F. Class'As- S.F. ADDITIONAL REPAIRS 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� ) P , Date: K FORMED POURED COMPLETED CITY OF ATERLOS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1./,��( - -- PARCEL CODE r CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑'Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No rc ` WATER VALVE �— � ADJUSTMENT REQ`D ❑Yes ❑ No PARKS DEPARTMENT — �� REVIEW REQUIRED t ❑Yes ❑ No LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 0 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other —_ DEPTH OF SIDEWALK 0 4 inches 0 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- 2g'o. S.F.` 5"- 110.0 " S.F. 6 S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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. 11-1 FIRST INSPECTION AND FORM MADE BY : T Date: E `( / FORMED POURED COMPLETED L , CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / 3 z5 L;v:c t,t„„ PARCEL CODE CONTROL NO. — I CLEAN SIDEWALK Type of Defect _ REQUIRED See reverse side for Defect Codes A-F 1 ❑Yes No See below for Defect Code G TRIM VEGETATION • REQUIRED ❑Yes l No c WATER VALVE `• 1 � ADJUSTMENT REQ'D a ❑Yes K]No PARKS DEPARTMENT REVIEW REQUIRED 5,1 ❑Yes 41 No J LOCATION OF SIDEWALK 1i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C1 5.3 Feet ❑ Other DEPTH OF SIDEWALK fR/4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ( 'S.F. 5"- S.F. 6 "- S.F. Class'Al- S.F. ADDITIONAL REPAIRS 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: rt - --1q FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SU!VEY FORM PROPERTY ADDRESS 3 z./de-A,J `77/, - Z:- 073 -0c7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect _ REQUIRED See reverse side for Defect Codes A-F I A Yes ❑ No See below for Defect Code G TRIM VEGETATION — REQUIRED ❑Yes ❑ No _ S WATER VALVE N 5 6 I -? ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED i ❑Yes ❑ No LOCATION OF SIDEWALK ffFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑,4 Feet ❑ 5 Feet 1 5.3 Feet ❑ Other Cif — DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- _ S.F. Class'A'- _ S,F. ADDITIONAL REPAIRS 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 7 Date: / FORMED POURED COMPLETED Crry OF WATERLOO - SJDEWAL< REPAI• SURVEY FORM PROPERTY ADDRESS ( ( lay'coi, 1 )3- - dor - col PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I !TYes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED 2/es ❑ No WATER VALVE �0�--► 0 ADJUSTMENT REQ'D ,►\ ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 60 ❑Yes ❑ No LOCATION OF SIDEWALK front Yard de Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet W5.3 Feet ❑ Other DEPTH OF SIDEWALK Z-4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- " : `'S.F. 5"- S.F. 6 "- S.F. Class'Al- S.F. ADDITIONAL REPAIRS CODE F - PATCHES El Yes ❑ No No. of Squares with Patches CODE G - _ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 16 Y Date: /6 f FORMED POURED COMPLETED CrY OF WATEr LOO SIDEWALK RE3A R SURVEY FSR.M - PROPERTY ADDRESS 6I 1 I/-)G ELiil PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No — 6C f WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No � � PARKS DEPARTMENT REVIEW REQUIRED 5-7- � ❑ Yes ❑ No LOCATION OF SIDEWALK !Front Yard El Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C 5.3 Feet ❑ Other DEPTH OF SIDEWALK I 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- `= `=S.F. 5"- S.F. 6 "- S,F. Class 'A'- S.F. — ADDITIONAL REPAIRS 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. j/_ FIRST INSPECTION AND FORM MADE BY : PS �`r Date: /6 -9 19 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FSR PROPERTY ADDRESS 6 152 tl,) jo -230 - od '7C'/1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK -' REQUIRED Type of Defect ❑ Yes 6No See reverse side for Defect Codes A-f= TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes VINo WATER VALVE ADJUSTMENT REQUIRED 6 1 ❑ Yes Vf o � Iv I IS. PARKS DEPARTMENT -' REVIEW REQUIRED ❑ Yes I�No Gl Ncau,.; LOCATION OF SIDEWALKront Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 13 Feet ❑ Other DEPTH OF SIDEWALK D 4 inches LI 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- ,5 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. q FIRST INSPECTION AND FORM MADE BY : N Date: / - /4`l FORMED POURED COMPLETED CITY GFWATE LOO - SIDEWALK REPAI~- SURVEY =OR ' PROPERTY ADDRESS (o Z6 G 1 act-icl PARCEL CODE CONTROL NO. - CLEAN SIDEWALK — Type of Defect k REQUIPED See reverse side for Defect Codes A-F I IlUirYes ❑ No See below for Defect Code G I TRIM VEGETATION REQUIRED -2 ❑Yes ❑ No J WATER VALVE 4...0...... 2C v ADJUSTMENT REQ'D — 11 T\ I ❑Yes ❑ No (G1/4. t I REVIEW REQUIRED DEPARTMENT N^ PARKS — — — — — - - ❑ Yes ❑ No _ _ il LOCATION OF SIDEWALK E l'rront Yard Side Yard ❑ Other WIDTH OF SIDEWALK K/4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other — DEPTH OF SIDEWALK Ln 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 4"--31b'`s S.F. 5"- S.F. 6"- S.F. Class'A'- 7`7i 47 S.F. ADDITIONAL REPAIRS — 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: lt)i+ /9 — FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FOR PROPERTY ADDRESS L of PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect % REQUIRED See reverse side for Defect Codes A-F 1 ❑Yes El No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 0 No WATER VALVE ~Q` ADJUSTMENT REQ'D ❑Yes No 1 PARKS DEPARTMENT REVIEW REQUIRED iz .5` I a ❑Yes li No LOCATION OF SIDEWALK -d Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ' 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- % S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: i /7 I i FORMED POURED COMPLETED CITY OF ATER'_�l�O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,3t7 l-o 4aJ Avg - PARCEL CODE CONTROL NO. ^- CLEAN SIDEWALK — Type of Defect REQUIRED See reverse side for Defect Codes A F .-0'Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No WATER VALVE F I ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No LOCATION OF SIDEWALK C].Front Yard El'Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet LI 5 Feet EEI.3 Feet ❑ Other — DEPTH OF SIDEWALK U 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- ' '°`‘S.F. 5"- S.F. 6 "- S.F. Class'Al- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"Fe may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : Date: (6 - t- FORMED POURED _ COMPLETED CITY OF ` 1ATERLOO - SIDEWALK REPAIR SU :VEY FORM PROPERTY ADDRESS 30'5 ept l i 13 - .,.5- - - PARCEL - PC/ z-;ff) - J PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes ❑ No See below for Defect Code G ITRIM VEGETATION "� REQUIRED ❑Yes O No ` ( WATER VALVE 1 -4— €,^ --► ADJUSTMENT REQ'D Ie1\ ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ..i 93,.2_5 (2) ❑Yes ❑ No i. _ / / �,� g5 ,� , c0.7_ Vic: .:r t ALI a:— LOCATION OF SIDEWALK ,Lf Front Yard ©Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches Ty inches ❑ 6 inches AREA TO BE REPAIRED 4"- ( .- 1`S.F. 5"- ?' --:='S.F. 6 "- S.F. Class'A'- _ SF. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Kir Date: zit-r°/ 1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ✓ 3I``' '-d 6 ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑`No -- See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes p'No WATER VALVE ADJUSTMENT REQUIRED 41-0—+ , ❑ Yes ❑ No i I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes El-No LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑`5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- - S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes n No No. of Squares with Patches CODE G - NOTE : Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: ` FORMED POURED COMPLETED — CITY OF WATERED• SIDEWALK REPAIR SURVEY FIRM PROPERTY ADDRESS &v. L.46 �.4a;E, i344-- tc62 - 005 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Erres ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION — I See below for Defect Code G I REQUIRED motes ❑ No t WATER VALVE ADJUSTMENT REQUIRED — `� ---► ❑ Yes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED ` / r ❑ Yes ❑ No ;Q(14. LOCATION OF SIDEWALK -I'?ont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LI 5.3 Feet ❑ Other DEPTH OF SIDEWALK C-4inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-d38.6 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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 S Date: _(O -/14 FORMED POURED COMPLETED CITY OF WATERED• S *EWALK REPAIR SURVEY FORM PROPERTY ADDRESS 400 61-K r o6 A-i A i/ �� !> -7i- y' - C ( ' PARCEL CODE CONTROL NO. - CLEAN SIDEWALK REQUIRED Type of Defect ( `Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes ❑ No WATER VALVE — ADJUSTMENT REQUIRED ❑ Yes ❑ No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK ❑.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 7 f5,3 Feet ❑ Other DEPTH OF SIDEWALK ©--4 inches Li 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-212.L S.F. 5"- S.F. 6"- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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 : k6:5_ Date: /© -1 FORMED POURED COMPLETED CITY OF A Y C RLO• _ SIDEWALK REPA ! SURVEY FSRM PROPERTY ADDRESS zJ t Lc 40'4 - o J t , ., PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 0 Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No 4 WATER VALVE ADJUSTMENT REQUIRED ~`yam 4l ❑ Yes No 404 — I I PARKS DEPARTMENT Ph REVIEW REQUIRED !cam ❑ Yes ❑ No r LOCATION OF SIDEWALK L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other — DEPTH OF SIDEWALK O 4 inches (] 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 " S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: /9 e 1// FORMED POURED COMPLETED CND OF WATERLAO SIDEWALK REPA SU'\/EY F•RM PROPERTY ADDRESS 414 L v , ci(3 -2 - !a, -it., 00(Q PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUITED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F ' See below for Defect Code G I TRIM VEGETATION REQUIRED ��❑lYes ❑ No — WATER VALVE ADJUSTMENT REQUIRED '1'I` ❑ Yes ❑ No I I PARKS DEPARTMENT REVIEW REQUIRED 4')t ❑ Yes ❑ No LOCATION OF SIDEWALK 46ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet e(5.3 Feet ❑ Other DEPTH OF SIDEWALK Cinches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F.3 ' 6 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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. J FIRST INSPECTION AND FORM MADE BY : l`' Date: jp.-(�7'I9 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FA-WM PROPERTY ADDRESS 4-GI& 1_06A 1 ?/1i -- -A -col PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes Q No See below for Defect Code G TRIM VEGETATION I REQUIRED ❑Yes a'ao ,t WATER VALVE �-- > +2-42 ADJUSTMENT REQ'D 1JL ► �,� ❑Yes p-No PARKS DEPARTMENT C? REVIEp REQUIRED - — A �di — — Yes ❑ No %1 57 DAKI L LOCATION OF SIDEWALK © Front Yard -I�Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet VI 5.3 Feet ❑ Other DEPTH OF SIDEWALK 21'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- �_ S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 0,1‘ No. of Squares with Patches CODE G NOTE :Areas marked with an"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' (9. FORMED POURED COMPLETED CITY OF WATERL•• SIDEWALK REPAIR SU VEY _ORM — PROPERTY ADDRESS I oe 4-ccrrd bp; -2' - r. z9 - oo sJ :PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _ ,ff'Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION — J See below for Defect Code G I REQUIRED Js ❑ No - WATER VALVE ` - ADJUSTMENT REQUIRED ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No to 6/4-id LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 8'5.3 Feet ❑ Other DEPTH OF SIDEWALK winches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ei‘ z S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: /6 11=1 j FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FIRM - PROPERTY ADDRESS S ZZ Lv ��►� Z4- /yz- ©©-t PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQU,4RED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No �t WATER VALVE ADJUSTMENT REQUIRED ` ❑ Yes ❑ No a I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 30 toC0,49 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El5 Feet l 3 Feet ❑ Other L i DEPTH OF SIDEWALK nches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 15`,Q S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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: /OF)1-f O FORMED POURED COMPLETED CITY OF WAT ERL®11 SIDEWALK REPAI SURVEY FORM PROPERTY ADDRESS �pC, ul 1, - &3 - otf3/ - DI` _ =V PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A. C7 El Yes ,.0-1To See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED I ❑ Yes 1- - WATER VALVE . ADJUSTMENT REQUIRED — t — s`_: _*, 52-5 ❑ Yes Leo PARKS DEPARTMENT REVIEW REQUIRED�IR El Yes E1 I to - C c 'k; • r� Lo6,660 LOCATION OF SIDEWALK 1Front Yard ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK El 4 Feet El 5 Feet ❑ 5.3 Feet Other .9-/y. DEPTH OF SIDEWALK El 4 inches El 5 inches -J inches AREA TO BE REPAIRED 4"-. S.F. 5"- S.F. 6 "- " S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes .211No No. of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /0 `7 l FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REP1,1R SURVEY RM PROPERTY ADDRESS �� Lc. -1 0)3 -24- - /z.-- Vol :f , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED * E Yes ElNo WATER VALVE ~V�� Z(O I J ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 01 ❑Yes ❑ No LOCATION OF SIDEWALK 13 Front Yard - Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet e5.3 Feet ❑ Other DEPTH OF SIDEWALK 1'14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 1)5 S.F. 5"- S.F. 6 "- S.F. Class'A- S.F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERLO• - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS s-6i C.0G - 7i3 _23 _g / - 06.3 PARCEL CODE .tlU CONTROL NO. - 4 t CLEAN SIDEWALK — Type of Defect REQUIREDIR� �� See reverse side for Defect Codes A-F I L.�'�es ❑ No See below for Defect Code G — TRIM VEGETATION N /--IREQUI ED N� Yes ❑ No — s "` / _ `� WATER VALVE FQ - J� f I v ADJUSTMENT REQ'D — Ie j�, = I ❑Yes ❑ No s \n PARKS DEPARTMENT �'t�` �l 14!' M l REVIEW REQUIRED ❑Yes ❑ No y'S / C / . 1%'\ �� // LOCATION OF SIDEWALK ❑ Front Yard L''Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet -Ell-Feet ❑ 5.3 Feet ❑ Other _ — DEPTH OF SIDEWALK 2-4-inches ❑ 5 inches Winches AREA TO BE REPAIRED 4"- 'TLC-. -eS.F. 5"- S.F. 6 "- E - S.F. Class IA`- _ S.F. ADDITIONAL REPAIRS 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 : Ps Date: jc0 sj, FORMED POURED COMPLETED CITY OF ATE LO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS &CO Ba< c I �. , ,7 PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes El No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 'No )1/4 lf WATER VALVE ADJUSTMENT REQUIRED ❑ Yes CT-No _ I I PARKS DEPARTMENT REVIEW REQUIRED ®Yes ❑ No LOCATION OF SIDEWALK GI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet d 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 5 "`S.F. 5"- S.F. 6 "- _S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 41 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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: FORMED POURED COMPLETED CITY OF e�ATERLO• -- SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS / (1 i L , .4'. A . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect nP` REQUIRED See reverse side for Defect Codes A-F I �Yes ❑ No See below for Defect Code G I TRIM VEGETATION REQUIRED ❑Yes 'E No — �^j.c1 r s WATER VALVE 4-0 __ _i ADJUSTMENT REQ'D — ❑Yes "El No I J^y n PARKS DEPARTMENT (,;,\'� , \, REVIEW REQUIRED — — — — — — ❑Yes 0 No i \ \ ) - LOCATION OF SIDEWALK '0. Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK L 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other -- DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ''> �d 'S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS _ CODE F - PATCHES ❑Yes lallo No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: r/, - i '1 FORMED POURED COMPLETED -- SIDEWALK REPA " SURVEY FORM PROPERTY ADDRESS _ 0i- / - - ict - 003 e' PARCEL CODE CONTROL NO. - i CLEAN SIDEWALK Type of Defect REQUI D See reverse side for Defect Codes A-F I Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED 1— ❑Yes ❑ No `[. ,► � WATER VALVE Q I ADJUSTMENT REQ'D ❑Yes ❑ No -- I PARKS DEPARTMENT crtREVIEW REQUIRED ` _ �9 ❑Yes ❑ No _ 1t LocAti LOCATION OF SIDEWALK el Front Yard ®Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Er.6.3 Feet ❑ Other DEPTH OF SIDEWALK 01 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '16&? S.F. 5"- S.F. 6 "- — S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: /t i'1 FORMED POURED COMPLETED CITY OF WA T ERL*• SIDEWALK REPAIR SUfki:VEY FO M - PROPERTY ADDRESS ' r. PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect - ❑ Yes 0 No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 0 No - WATER VALVE _ ADJUSTMENT REQUIRED ~ ❑ Yes 0 No � \ - PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0No q4R� /1 r�f I_e 1 1 lt. LOCATION OF SIDEWALK s0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Q 5.3 Feet ❑ Other DEPTH OF SIDEWALK a inches G 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 159 " 'S.F. 5"- '`' " ` S.F. 6"- S.F. Class'Ai- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes A-No No. of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: I FORMED POURED COMPLETED CITY OF WA tl ERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ROPERTY ADDRESS . 61() C4/(0/ -j — Sc 3 -Z - - (y( - 602- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect G ❑ Yes Ito See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes INo WATER VALVE '` / I ADJUSTMENT REQUIRED 4,1(0 ❑ Yes C?Illo /1,04 PARKS DEPARTMENT REVIEW REQUIRED / "A( ❑ Yes ElNo LOCATION OF SIDEWALK .'Front Yard ❑ Side Yard ❑ Other _/�V WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet KiOther DEPTH OF SIDEWALK ri 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- / S.F. 5"- S.F. 6 "- S.F. Class S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 1No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: )0✓11- FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK lEPAIR SURVEY FORM PROPERTY ADDRESS 6 t I _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect '. r_ ❑ Yes 0'No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 0 No WATER VALVE , ADJUSTMENT REQUIRED A— t -Kr= ❑ Yes b No I PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes LINO LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet '2 5.3 Feet ❑ Other DEPTH OF SIDEWALK n 4 inches EI 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-'13 "S.F. 5"- + S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes K7] No No. of Squares with Patches CODE G - — NOTE:Areas marked with an "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: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . (01§1 Lob,-tip PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C Yes L -I(do See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes L2' o WATER VALVE 4 // tt ADJUSTMENT RUIRED (� 7 ❑ Yes Lf No 1,01 PARKS DEPARTMENT • REVIEW REQUIRED E Yes J No Lo Llf LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet C7 Other _ 5,4 DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 4°)-1 S.F. 5"- S.F. 6"- S.F. Class IN- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes 1J No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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 0 1°1' FORMED POURED COMPLETED crrY OF WATERLO• SIDEWALK REPAIR SURVEY FO'; PROPERTY ADDRESS l I /_ t, ) Ell - 2 - 2?7 -62i r_ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes LJ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes LI No WATER VALVE♦„ ,, ADJUSTMENT REQUIRED — ❑ Yes n No PARKS DEPARTMENT REVIEW REQUIRED C 3`Yes ❑ No IC, ► 7, — • r a \`t - LOCATION OF SIDEWALK \El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet \III 5.3 Feet ❑ Other DEPTH OF SIDEWALK `Li-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 'l S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G - _. NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /0, l'6 FORMED POURED COMPLETED CITY OF WWA E"LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .8' 700 &-!L tc674/0 * E 277.- c?_55 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect __ ❑ Yes Cl No See reverse side for Defect Codes A F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes D No WATER VALVE t jl ADJUSTMENT REQUIRED ❑ Yes 07 No — I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No („_.cte -' LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches R5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- "S.F. 6 "- __S.F. Class!A- S.F. ADDITIONAL REPAIRS 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: ' FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS • . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect r`._,. REQUIRED See reverse side for Defect Codes A-F ❑ Yes El No See below for Defect Code G TRIM VEGETATION REQUIRED El Yes ElNo N 4 if WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK III Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches LI 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- ° S.F. 6 "- S,F. Class'As- S.F. .— ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes L No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ; `' Date: /( FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAI , SURVEY FORK — PROPERTY ADDRESS iito Ga 6 - 'Ik- tog - 6 ,� .✓ o CONTROL NO. PARCEL CODE —" CLEAN SIDEWALK„, REQUIRED / — Type of Defect C ❑ Yes Cli No See reverse side for Defect Codes la TRIM VEGETATION F REQUIRED See below for Defect Code G ❑ Yes If11No i WATER VALVE — 0 11 ADJUSTMENTpEQUIRED *AD ❑ Yes ❑ No ` ♦ PARKS DEPARTMENT REVIEW REQU)RED El Yes /❑ No — c Cie fa GooeJ LOCATION OF SIDEWALK kront 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 REPAI RED 4"-o1Jm� S.F. 5"- S.F. 6"- —S.F. Class'A'-v7"�L'_ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes [AO No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. co Date: )� �� FIRST INSPECTION AND FORM MADE BY FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . _ ir3 - -Io_e - as _ PARCEL CODE " CONTROL NO. I CLEAN SIDEWALK Type of Defect REQUIRED See reverse side forDefect Codes A-F U Yes ❑ No See below for Defect Code G I I TRIM VEGETATION! REQUIRED I ❑ Yes ❑ No `<-0 WATER VALVE Z�'� 72 , ADJUSTMENT REQUIRED 1 i ❑ Yes ❑ No I 1 I PARKS DEPARTMENT _ REVIEW REQUIRED ____1_ -- -__— _ l9 ' ALL 4" ❑ Yes ❑ No ..._ As, _ __ to GArj LOCATION OF SIDEWALK af-ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Cther Se 4 �O DEPTH OF SIDEWALK inches ❑ 5 inches - AREA TO BE REPAIRED 4 "- 9(0 0 S.F. 5��_ -- ---S.F. 6 "- S F. Class 'A'- ADDITIONAL REPAIRS ---— S.F. !. CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: `d_g-%�9 FORMED POURED COMPLETED CITY OF WATERL• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' M 1.3 -- 17- Z 4- - 00 b CONTROL NO. PARCEL CODE ea- ,� CLEAN SIDEWALK C k REQUIRED Type of Defect I � `.. ❑Yes Cho �` See reverse side for Defect Codes A-F 1 TRIM VEGETATIONSee below for Defect Code G I REQUIRED — ❑Yes ago —� ^ WATER VALVE ADJUSTMENT REQ'D �... k..:� .♦ �35 I � i ❑Yes Q-No PARKS DEPARTMENT 111,,, : -- REVIEW REQUIRED t' ; ❑Yes Cho — / i x>,4 ( 6" LOCATION OF SIDEWALK 2I'FrontYard Side Yard ❑ Other y WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet El Other `7 �' — DEPTH OF SIDEWALK /4 inches ❑ 5 inches inches �� S.F. 6 "- �'�/. S.F. Class'A'- 3•� S.F. AREA TO BE REPAIRED 4"- ��� S.F. 5 - — ADDITIONAL REPAIRS r CODE F - PATCHES ❑Yes [ No No. of Squares with Patches CODE G - NOTE :Areas marked with an. may panels.e repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk10 �� i� FIRST INSPECTION AND FORM MADE BY 04 KS Date: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAI•. SURVEY F•R . PROPERTY ADDRESS a A, a^. �lostr '53l3 — �3- Z3 — OG2 : : PARCEL.CODE ``_` CONTROL NO. CLEAN SIDEWALK Type of Defect G REQUIRED ' See reverse side for Defect Codes A-F ❑ Yes fNo I See below for Defect Code G — TRIM VEGETATION REQUIRED I I ❑ Yes LIN,- O — WATER VALVE 4 iff F0 ADJUSTMENT REQUIRED I�3 Li Yes No — I I PARKS DEPARTMENT REVIEW REQUIRED C c ❑ Yes .moo L is",z. LOCATION OF SIDEWALK iront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 3 Feet ❑ Other DEPTH OF SIDEWALK inches 0 5 inches 0 6 inches AREA TO BE REPAIRED 4 OCi'( S. .F 5"- S.F. 6 "- --_—S.F. Class'A'_ ADDITIONAL REPAIRS -- — S.F. �- CODE F - PATCHES 0 Yes -al ___ — No. of Squares with Patches CODE G - — NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired reconstruction of full sidewalk panels. by — FIRST INSPECTION AND FORM MADE BY : 0 0 4- Date: , �1 — FORMED POURED COMPLETED CITY OF WATERLO SIDEWALK REPAIR SURVEY FOR PROPERTY ADDRESS . o /! ,4,J kio PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect XYes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED 2/Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 30,/ t*4,k2 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2"-5.3 Feet ❑ Other DEPTH OF SIDEWALK 2/4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-WI'` S.F. 5"- S.F. 6"- S.F. Class'A'- _ S.F. ADDITIONAL REPAIRS 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 4a Date: /0--/4- 9 FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FIIRIVI PROPERTY ADDRESS . to-64-A.) g913 - z -. !e, - a'! - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C ❑ Yes Cho See reverse side for Defect Codes A-F TRIM VEGETATION J See below for Defect Code G I REQUIRED I ❑ Yes l 1No - WATER VALVE ADJUSTMENT REQUIRED �? ❑ Yes Lilo I J PARKS DEPARTMENT REVIEW REQUI5ED ID Yes ViNo t% (�� ,�•l,�y L�� 1) ragdr-o�C.�,4�/_ LOCATION OF SIDEWALK [front Yard ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other 4 i DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- q'e S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes no No. of Squares with Patches CODE G NOTE: Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : L �� Date: I0-f&- 1 FORMED POURED COMPLETED CITY OF WATERLOO ERLOO SIDEWALK REPAIR SURVEY FS — PROPERTY ADDRESS 1.3 to C, 7 [3 23 - - 0 7A PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _ ,- ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REED I I Yes ❑ No `tit WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No I l I PARKS DEPARTMENT REVIEW REQUIRED 9 ❑ Yes ❑ No �, - z 1 toy ' LOCATION OF SIDEWALK .Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1213 Feet ❑ Other DEPTH OF SIDEWALK I nches Kr5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 3 S.F. 5"- (o("i°S.F. 6 "- S.F. Class'As- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : 11 g k Date: /t16-fil FORMED POURED COMPLETED _ CITY OF WATERLO• SIDEWALK REPAIR SU*VEY FORM PROPERTY ADDRESS g/7 l 046-Z3- Z2g - p►q PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ,J'1es ❑ No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No -- WATER VALVE ADJUSTMENT REQUIRED Yes ❑ No I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No - - 38, LOCATION OF SIDEWALK 13-front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet D-5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑-4-inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- __ S.F. 5"- S.F. 6 "- S,F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - • NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /0-46` R FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOR PROPERTY ADDRESS . '3 q Lo6,4 69 r -'2 3 - 22.8 .- o I < a y PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect j'�C _ ❑ Yes o See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I 1 ❑ Yes 0--NO WATER VALVE ~Q� ADJUSTMENT REQUIRED � 1 ❑ Yes El-No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 1 o Ills Cc") LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK C 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 '4 inches 215 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 46P S.F. 5"- 16,4 S.F. 6"- S.F. Class'AL S.F. ADDITIONAL REPAIRS c_oadeltilod CODE F - PATCHES ❑ Yes 124 No. of Squares with Patches CODE G - NOTE:Areas marked with an"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< Date: /0—/6--i7 FORMED POURED COMPLETED CITY OF WATE L®. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS if+J Lowl 13 -2- - 2Z - ot3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect � ❑ Yes 12-No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes D-No -- WATER VALVE ` ADJUSTMENT REQUIRED 4—Q-- 7P- ❑ Yes p-No — I PARKS DEPARTMENT i REVIEW REQUIRED ❑ Yes E'No A w-L LOCATION OF SIDEWALK al--Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet �.3 Feet ❑ Other DEPTH OF SIDEWALK , 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class TA'- S.F. — ADDITIONAL REPAIRS 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 : f1I3 ief Date: /0 /P-H FORMED POURED COMPLETED CITY OF WATERL.• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . •' $ 113 -23 -214, . - 1-4 .dam%'.;,- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F �� Yes Na See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes .®'No 11/4 JI j WATER VALVE ADJUSTMENT REQUIRED �(� I ❑ Yes .B'No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes n No A — — — — _ ei( Lo( t) LOCATION OF SIDEWALK LFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1:3 -3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches Ellinches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- J7 0 S.F. 6 "- S.F. Class W- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1) J Date: /o4H H- FORMED POURED COMPLETED CITY OF WAAERL•O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'i C P64(J - 510 - 13 - 2 - 3 ZZ PARCEL CODE CONTROL NO. ' CLEAN SIDEWALK A REQUIRED Type of Defect P See reverse side for Defect Codes A-F I ❑Yes L 'No See below for Defect Code G °- TRIM VEGETATION REQUIRED ❑Yes KNo 1 WATER VALVE ADJUSTMENT REQ'D \ ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 6 No Le(Ad LOCATION OF SIDEWALK ❑ Front Yard I4de Yard ❑ Other WIDTH OF SIDEWALK Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- 4C,0 S.F. ADDITIONAL REPAIRS 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 : O G Date: ic--1 G--(q FORMED POURED _ COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS etbe ivkibR`t` .5.T PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect A-F REQUIRED below for Defect Code G L I � ❑Yes No *NI I TRIM VEGETATION REQUIRED ❑Yes 0 No F P � WATER VALVE <<t I ADJUSTMENT REQ'D v r I ❑Yes 0 No ..r PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No `1 LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LL 5.3 Feet ❑ Other DEPTH OF SIDEWALK :.4 inches L;5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- a5 S.F. 6 "- S.F. Class'A'- SF. ADDITIONAL REPAIRS 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: i i (> ig 0, y FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAI-r': SURVEY FOR - PROPERTY ADDRESS . 5- SEAL gr (VT' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes L ^No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED Mies ❑ No WATER VALVE ADJUSTMENT REQUIRED A— _+. ( ❑ Yes No 1,04 PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes ❑-No (,;;l LOCATION OF SIDEWALK [3- ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 115.3 Feet ❑ Other DEPTH OF SIDEWALK Er4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 2 7. 0 1/S.F. 5"- S.F. 6 "- S,F. Class'A'- S.F. — ADDITIONAL REPAIRS 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. c� FIRST INSPECTION AND FORM MADE BY ks Date: ICU- _7-'// FORMED POURED COMPLETED I CI �®F AT RLO• SIDEWALK REPAIR SURVEY FIRM PROPERTY ADDRESS - 5 ®, ti'� PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes . No See reverse side for Defect Codes A-F TRIM VEGETATION -- I See below for Defect Code G I REQUIRED ❑ Yes -0No 11/4* WATER VALVE ADJUSTMENT REQUIRED ~ .--* 60C ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 4'No 5.1 afrA ,r, C Uv.V, LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK , 7 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-_ '14 S.F. 5"- S.F. 6 "- S,F. Class'AL S.F. ADDITIONAL REPAIRS 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 : Date: ; l Z fig FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . ,5-72 11:':' PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 0 Yes Er IClo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED 0 Yes RI-No WATER VALVE ADJUSTMENT REQUIRED 0 Yes 111\lo 1(04 PARKS DEPARTMENT REVIEW REQUIRED 0 Yes Et-No A ic,4 i. LOCATION OF SIDEWALK '0 Front Yard 0 Side Yard El Other WIDTH OF SIDEWALK 0 4 Feet 0 5 Feet Er5.3 Feet 0 Other DEPTH OF SIDEWALK 24 inches 0 5 inches 0 6 inches AREA TO BE REPAIRED 4"- 5* /S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES 0 Yes Et1Jo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f5 KT Date: /6-3-19 FORMED POURED COMPLETED CITY rWATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 65- Atka-Scree( c3 -2. - 26 - Oi -7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A REQUIRED See reverse side for Defect Codes A-F ❑Yes L"No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 0 No p. t WATER VALVE � � �, T ADJUSTMENT REQ'D ❑Yes i No PARKS DEPARTMENT 94_ A REVIEW REQUIRED EfYes ❑ No 4.4 MIAOW-Si -` LOCATION OF SIDEWALK ❑."Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .E]`5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- gy.b S.F. 5"- S.F. 6"- S.F. Class'A'- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes "LJ No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. R _FIRST INSPECTION AND FORM MADE BY : ' ` Date: /0 '3'1cy FORMED POURED COMPLETED CITY OF ATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' 2/ 04�1., ra-k ac,75 -23 - 4 ! -0o9 = U7 - PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect `� a REQUIRED See reverse side for Defect Codes A-F ' ❑Yes 01‘Io See below for Defect Code G 3 I TRIM VEGETATION REQUIRED ❑Yes ©No — Gr1 �7( -- } WATER VALVE o:1"-+ ADJUSTMENT REQ D \ ( ❑Yes LINo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ ?Jo LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Er5.3 Feet ❑ Other DEPTH OF SIDEWALK 131 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS '- CODE F - PATCHES ❑Yes lI No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. l7� FIRST INSPECTION AND FORM MADE BY : I Date: 0-3 FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FtSqM PROPERTY ADDRESS S 2: 0,:1\be,r r S k t-. — '7 3113 - 23- `135.- Oo �'._~ 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect '' ❑ Yes ❑ No See reverse side for Defect Codes A-F I TRIM VEGETATION — See below for Defect Code G REQUIRED ❑ Yes Q No _ WATER VALVE 11/4* ADJUSTMENT REQUIRED .41.-0--41. ❑ Yes Q No PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes `fl No S.1 - - c.6 _ - - - - I \ LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- - ,) S.F. 5"- S.F. 6 - S.F. Class'A'- S.F. — ADDITIONAL REPAIRS — 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 : i- -, Date: a c /_'S 1 r,:g FORMED POURED COMPLETED CITY OF WATERLO. SIDEWALK REPAIR StPIVEY FOB'M _ PROPERTY ADDRESS _ - 63 Mi-ra- f,°4 PARCEL CODE CONTROL NO. CLEAN SIDEWAK - L Type of Defect REQUIRED See reverse side for Defect Codes A-F ,i Yes ❑ No _ See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes ❑ No — WATER VALVE : ` --► ADJUSTMENT REQUIRED — I 1 ��'� ❑ Yes ❑ No — PARKS DEPARTMENT L. REVIEW REQUIRED jar ❑ Yes ❑ No LOCATION OF SIDEWALK C7 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 013 Feet ❑ Other DEPTH OF SIDEWALK ,Q"4 inches —. ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- c-L, S,F, 5"- S.F, 6"- S.F. Class 'A'- S.F. _ ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - — NOTE :Areas marked with an "F"may be repaired by patching.Ali other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � Date: /6 ".-5"%j' FORMED POURED COMPLETED _ CTYOFWATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS e i-ltf (; 4?( y` l� - 23 - 4'5( - OO(PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect El Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No WATER VALVE jl ADJUSTMENT REQUIRED 4.-, —► �{ ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED A � ❑ Yes ❑ No LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ri5-.3 Feet ❑ Other DEPTH OF SIDEWALK 0-4-inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '',c, S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : Imo? Date: /0 -3' lq FORMED POURED COMPLETED CITY OF ATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7< z k- g 9i 9 35 PARCEL CODE CONTROL NO, CLEAN SIDEWALK — REQUIRED Type of Defect See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes C7No — 1`4 JI WATER VALVE ADJUSTMENT REQUIRED �a—+ ❑ Yes LI No I 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ' No LOCATION OF SIDEWALK _Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 'Ell 5.3 Feet Cl Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 52 S.F. 5"- _S.F. 6"- S.F. Class 'A'- S.F. _ ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes n,No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : '� Date: _ ' t x °� FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /0/0 7' eD t3 -Z3 d - ct ( PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑Yes IXP No See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G REQUIRED ❑Yes w No WATER VALVE ADJUSTMENT REQ'D ~ I 1 ❑Yes , No PARKS DEPARTMENT REVIEW REQUIRED 4,- 1, Yes ❑ No I A LOCATION OF SIDEWALK F Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- �� f S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. -` ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes N.No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : = 5 Date: CD FORMED POURED COMPLETED CITY OF WATERL .r SIDEWALK REPAIR SLIPVEy FORM — PROPERTY ADDRESS 13 Nt ej� y sr �� 1 -0-3- 3L - — PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F r''Yes ❑ No I See below for Defect Code G TRIM VEGETATION I REQUIRED [ Yes ❑ No _ 0, WATER VALVE ��— ► ADJUSTMENT REQUIRED "� 1 ❑ Yes , No I ff I PARKS DEPARTMENT o REVIEW REQUIRED / 6... tom. C�4,s ❑ Yes ENO _ ________________T__r \ _________________________________ C L ®1 - r k LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet . b5.3 Feet ❑ Other DEPTH OF SIDEWALK C`i'4 inches ❑5 inches K6 iig ches AREA TO BE REPAIRED 4 37- 1-'S.F. 5 S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS _ _ CODE F - PATCHES ❑ Yes iI No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: Ira® Z - t FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESSsT- - y3� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED J =Yes ❑ No "` � WATER VALVE t--Q ADJUSTMENT REQUIRED ❑ Yes El No PARKS DEPARTMENT REVIEW REQUIRED la j ,J ❑ Yes id-No � s LOCATION OF SIDEWALK Pi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 73 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK N4 inches Q5 inches O 6 inches AREA TO BE REPAIRED 4 "- 3 , S F 5"- `j.0 "- - S.F. 6S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : (2-5 .T`)(j Date: FORMED POURED COMPLETED CITY OF WATERLOO S ,E ALK REPAIR SU 'VEY FO*'.i PROPERTY ADDRESS /0(0 .t5oe /4 t. i 3r- - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A• C-' ❑ Yes ill No See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes No — WATER VALVE t'' ADJUSTMENT REQUIRED 41- ! E \{a c oin IDS\ ❑ Yes /0 No s \ Lv CI{�2.5 1 PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No 0 LOCATION OF SIDEWALK ,d Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet CI Other ' DEPTH OF SIDEWALK M 4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- 102a(9 S.F. Class IN- S.F. _ ADDITIONAL REPAIRS — 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: '°f Pi ' FORMED POURED COMPLETED 6• 1 h CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOI.M PROPERTY ADDRESS l: ± °'' I�'c c (2 k' " FA i `i- C - , ►3 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 3 REQUIRED See reverse side for Defect Codes A-F ❑ Yes ET No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes CT No WATER VALVE �-- —► ADJUSTMENT REQUIRED /� gi7 ❑ Yes El-No l PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0-No LOCATION OF SIDEWALK L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2 .3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-2 e 'S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes El-No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 3 [� Date: 0('30 -// • FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' fi e,e`f 57— _ S'`!1' -Z'i - '351 - c: ( 1 ,: . l PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A F Yes ❑ No See below for Defect Code G TRIM VEGETATION - ,v REQUIRED L ❑Yes ❑ No t WATER VALVE 4-0—* (-) ram, ADJUSTMENT REQ'D ❑Yes ❑ No I PARKS DEPARTMENT - REVIEW REQUIRED 5 o' `i Le ❑Yes ❑ No fTZ,,,\\Dt.cr y S�ceek LOCATION OF SIDEWALK 4 Front Yard 1 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 144 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED 4."- _'c ' 'S.F. 5"- S.F. 6"- S30. 'S.F. Class'A'- _ S.F. _ ADDITIONAL REPAIRS 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 z <, Date: ci /Z-;IM — FORMED POURED COMPLETED ~ I CITY' OF WATERLOO z/ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ea h4aistf y.=E13 - 7w - s - 332 PARCEL CODE CONTROL ND. Type of Defect CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F W Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No WATER VALVE `� 'dAV``''`G a ADJUSTMENT REQ`D ,► a ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 15 ❑Yes ❑ No E .2,;e LOCATION OF SIDEWALK Front Yard ❑`Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 1 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0.4 inches ❑ 5 inches 0.6 inches AREA TO BE REPAIRED 4" S.F. 5"- S.F. 6"- _ S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ci;-; PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ;A' r REQUIRED See reverse side for Defect Codes A-F I ❑Yes 0 No See below for Defect Code G TRIM VEGETATION REQUIRED , ' ❑Yes `.© No WATER VALVE ADJUSTMENT REQ'D • ❑Yes '0 No 4 PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes 0 No • LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Q 5 3 Feet ❑ Other DEPTH OF SIDEWALK 0'4 inches ❑ 5 inches El inches AREA TO BE REPAIRED 4."- S.F. 5"- S.F. 6"- S,F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"Fe may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: `( 5 it _. FORMED POURED COMPLETED CITY OF WATERLOO) SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS r 1 ✓�4t3 - - 34-7 - 6(1 30 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes El No See below for Defect Code G TRIM VEGETATION REQUIRED * ❑Yes ❑ No 1 .Z` WATER VALVE 4-0-10 ADJUSTMENT REQ'D ❑ Yes D No PARKS DEPARTMENT REVIEW REQUIRED - — — — — — — ❑Yes I] No I S.2' ,) LOCATION OF SIDEWALK ❑ Front Yard 2'Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L "5.3 Feet 1] Other DEPTH OF SIDEWALK D 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: `i'(z s fici FORMED POURED COMPLETED CITY OF ATERL•S SIDEWALK REPAIR SU!VEY FORM.' PROPERTY ADDRESS ` 4'/2 /9uI berr, Si- , — PARCEL CODE CONTROL NO. - S �n� -47 T CLEAN SIDEWALK — Type of Defect t4°2 --- REQUIRED ES See reverse side for Defect Codes A-F /Ca,1 ] ❑Yes Q No See below for Defect Code G '.v TRIM VEGETATION — 5,0 ] � REQUIRED ❑Yes 0 No r WATER VALVE f— —► 5.1 ] m., ADJUSTMENT REQ'D/e ` .f • ❑Yes bNo — `�- PARKS DEPARTMENT — " REVIEW REQUIRED ❑Yes 0 No ,,. I C, — kt11,1 -o Sic LOCATION OF SIDEWALK EZ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet b.5.3 Feet ❑ Other — DEPTH OF SIDEWALK Ei 4 inches ❑ 5 inches Q'•6 inches AREA TO BE REPAIRED 4"- aGt4r1S.F. 5"- S.F. 6"- 3 .(°S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes \s l No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ''-, Date: t 9 i z/i 9 — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY =ORM PROPERTY ADDRESS 5/0 - 4Lrue 4t 81>3 -2-4 - - 017 �4 - PARCEL CODE CONTROL NO. n A y CLEAN SIDEWALK Type of Defect i v' >s REQUIRED See reverse side for Defect Codes A-F I ❑Yes ❑-Na See below for Defect Code G I TRIM VEGETATION _ REQUIRED ❑Yes L I No — _` �" WATER VALVE (o - 5(0- l a ADJUSTMENT�REQ'D L�l N ❑Yes o w PARKS DEPARTMENT r - REVIEW REQUIRED ta f, l� - - ft - - A - - � �\ x ❑Yes ( to c n �f14 t 1 �� Z •�' 5,oxC.I,.(Ng y SzXG.O: 31.2 14.1 it All 4,7 W7,7_3 41.2 LOCATION OF SIDEWALK VI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet at5fher G• ( f, S" DEPTH OF SIDEWALK gJ 4 inches ❑ 5 inches EI 6 inches AREA TO BE REPAIRED 4"- y/`1.0'S.F. 5"- S.F. 6 "- 105:7 S.F. Class'A'- .3(6).4 S.F. ADDITIONAL REPAIRS 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 Ks- Date: -Z3 -l�I FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 �vtw�lit► � ' _ v Til -Z4 - 3 C9 - PARCEL CODE CONTROL NO. — CLEAN SIDEWALK REQUIRED Type of Defect — f ❑ Yes ED No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED _ I I ❑ Yes ❑No WATER VALVE — ADJUSTMENT REQUIRED ?F ` ❑ Yes [ No I I _ PARKS DEPARTMENT N4 REVIEW REQUIRED ❑ Yes El No "- h �%1 SAS=/zs•o — p m 4,7 0 so0,4,= 23.5 lilt,' 4,7,i 1o,3'48.4 ^A" 4,6X3,( =73.5 WT LOCATION OF SIDEWALK I Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet Other DEPTH OF SIDEWALK El 4 inches El 5 inches El 6 inches AREA TO BE REPAIRED 4"- 25.O S.F. 5"-_ S.F. 6 "- S.F. Class'A'- 5A °S.F. — ADDITIONAL REPAIRS L CODE F - PATCHES ❑Yes EI-No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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 _ A Date: 9`Z /9 FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS z ? c2L7 ram. — r37 - t PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes 0 No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes C` No WATER VALVE — �—a—► - I-� ADJUSTMENT REQ'D / \ I ❑Yes No PARKS DEPARTMENT p REVIEW REQUIRED \ 4 ❑ Yes Q No J LL-L LOCATION OF SIDEWALK ❑ Front Yard p Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet M 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 111 6 inches AREA TO BE REPAIRED 4"- S.F. 5"-_ S.F. 6"- S.F. Class'At- S.F. — ADDITIONAL REPAIRS 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 : 5 Date: 10®2- - 9 FORMED POURED COMPLETED CITY OF (ATERLO. _ SIDEG AL< REPAIR SURVEY FOR RROPERT(ADDRESS 2 Z E E 0 M u ,_l ;c. 'E , — e 5 I. 3 -2,3-4-3 L_- c72...-Z_ , 4�5 PARCEL CODE CONTROL NO. — CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F 1 ❑ Yes 13 No See below for Defect Code G — TRIM VEGETATION REQUIRED i ❑Yes C'No ` }' WATER VALVE -4--Q—► r ADJUSTMENT REQ'D — Ln .' _) 4 ❑Yes l? No I _J PARKS DEPARTMENT REVIEW REQUIRED ❑Yes p No _ j LOCATION OF SIDEWALK ❑ Front Yard )J Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other — DEPTH OF SIDEWALK ? 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- °al'S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes Ip No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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.5 (KI� > 5 Date: l -Z k, T FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOR,. PROPERTY ADDRESS 34-& PARCEL CODE CONTROL NO.- CLEAN SIDEWALK REQUIRED Type of Defect See reverse side for Defect Codes A-F 0 Yes in No See below for Defect Code G TRIM VEGETATION REQUIRED 0 Yes iiNo - WATER VALVE 41--01 ADJUSTMENT REQ'D 0 Yes --Li No PARKS DEPARTMENT REVIEW REQUIRED 0 Yes in No iii c}, LOCATION OF SIDEWALK LI Front Yard .0 Side Yard LI Other WIDTH OF SIDEWALK LI 4 Feet 0 5 Feet tl 5,3 Feet LI Other DEPTH OF SIDEWALK 04 inches 0 5 inches D 6 inches AREA TO BE REPAIRED 4"- 3°' 'S.F. 5"- S.F. 6 "- S.F. Class'At- S.F. ADDITIONAL REPAIRS CODE F - PATCHES 0 Yes NI No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching,All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY Date: 10 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAI,- SURVEY FORM PROPERTY ADDRESS = Li C; .ez! PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F REQUIRED See below for Defect Code G ❑Yes fo TRIM VEGETATION REQUIRED g, ❑Yes El No WATER VALVE ADJUSTMENT REQ'D ❑Yes El No 5 PARKS DEPARTMENT REVIEW REQUIRED - - - - - _ ._ — ❑Yes 'No LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches X 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- d 2' S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes `f No q No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOr M PROPERTY ADDRESS . ' 36 6t,e4 all< A PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 1 ❑ Yes ? No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes [J No 11/4t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ONo !2 ..yL® I!f f® /f y LOCATION OF SIDEWALK LI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IS 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- � S.F. 5"- S.F. 6 "- S.F. Class'A'- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes fl No No.of Squares with Patches CODE G - NOTE:Areas marked with an "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. (3I i'- FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ; 8' 13 -2 - 4z7 - e09 '` PARCEL CODE CONTROL NO. CLEAN SIDEWALK _. Type of Defect REQUIRED See reverse side for Defect Codes A-F 1 ,- 'Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No o � — WATER VALVE ,a 1 ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT ._ REVIEW REQUIRED ' — — 69. � _ — ❑Yes ❑ No NY L,4-f fr, LOCATION OF SIDEWALK ID-Front Yard Ergide Yard ❑ Other WIDTH OF SIDEWALK -i14 Feet 0'5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK JD-4 inches ❑ 5 inches ❑ 6 inches i AREA TO BE REPAIRED 4."- ` % S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : kt-S ll Date: / '� FORMED POURED COMPLETED '— CITY OF WATERLOO SIDEWALK REPAIR SURVEY PROPERTY ADDRESS - 30 9 a)( 1 i-5 "r'.. -k% - 007 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect /%' ❑ Yes ,[]`No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes El-No WATER VALVE 7 ADJUSTMENT REQUIRED 0 ❑ Yes E-No vo. PARKS DEPARTMENT REVIEW REQUIRED LJ Yes ❑ No 3,C LOCATION OF SIDEWALK 12`Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK R-2(Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK I"14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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 : t s' Date: AD-3" FORMED _ POURED COMPLETED CITY OF WATERED* SIDEWALK REPAIR SURVEY Fay M PROPERTY ADDRESS 369 o 4iL 13 -23 27.- OCAp ..' PARCEL CODE CONTROL NO. CLEAN SIDEWALK rI REQUIRED Type of Defect 25 ❑ Yes C7"No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes E to — WATER VALVE ADJUSTMENT REQUIRED '50`1 ❑ Yes Et—No I j I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes [INo _ t A i; ' 4 c9-aS 041z- LOCATION OF SIDEWALK E(Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK E 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- T'' °�' S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS 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: /o -5 -i FORMED POURED COMPLETED CITY OF WATERLOO) SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ; 3 2. O{�}l�- 13 - - 4.1i. - 04- PARCEL CODE CONTROL NO. CLEAN SIDEWALK — A REQUIRED Type of Defect ❑ Yes E1iNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes -CT No WATER VALVE ADJUSTMENT REQUIRED ~ _ 1-1 ❑ Yes No I PARKS DEPARTMENT — I A REVIEW REQUIRED ❑ Yes El - - - - - - - Q. yI Ofc LOCATION OF SIDEWALK O'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK L 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK f4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 34'1 VS.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. — ADDITIONAL REPAIRS 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 : } k Date: 110 - ' I i FORMED POURED COMPLETED CITY ri,F 'ATE L0 SIDEWALK REPAIR SURVEY FOR . PROPERTY ADDRESS L., ✓ 3- y30- C92Z_ 35,E PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED o See reverse side for Defect Codes A-F I g [2 Yes ❑ No _ See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑ No t WATER VALVE � —► ADJUSTMENT REQ'D 44 ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No 3,3' a ,Eke LOCATION OF SIDEWALK El Front Yard `ii Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet Er 5.3 Feet ❑ Other DEPTH OF SIDEWALK N 4 inches "-f] 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-it$ ,( S.F. 5"- 4040 S.F. 6"- S.F. Class'Al- — S.F. ADDITIONAL REPAIRS - — 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: P 1 3 J 9 FORMED POURED COMPLETED CITY' OF WATERL•, SIDEWALK REPAIR SURVEY PIORM PROPERTY ADDRESS _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No t WATER VALVE ADJUSTMENT REQUIRED F `,E ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 140 ❑ Yes ❑ No rx r LOCATION OF SIDEWALK 9„IqlFront Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ya4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- `l S.F. 5"- I' S.F. 6 "- S.F. Class'Al- S.F. ADDITIONAL REPAIRS 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: 6 h FORMED _ POURED COMPLETED CITY OF W T'C I LOO SIDEWALK REPAIR SURVEY FORM RM - PROPERTY ADDRESS .r Li 12- . C S _ ✓ m - 23 - 142 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect `I 1 Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes ❑ No - WATER VALVE ADJUSTMENT REQUIRED F D ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED Li0 El Yes ❑ No d LOCATION OF SIDEWALK '1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK [24 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 64 inches I] 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ''2°C S.F. 5" x S.F. 6"- S.F. Class'A'- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes LI No No. of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ``` Date: P`3/3 I I ` FORMED POURED COMPLETED L. CITY OF WiksTERL c* SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect .fl Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED 1 :Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ~0 ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No - / c E`er LOCATION OF SIDEWALK C 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 15 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK C7 4 inches `[mil 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 5 2 c' S.F. 5"- -i g 0 VS.F. 6"- S.F. Class'As- _ S.F. ADDITIONAL REPAIRS 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: ®6 b f I FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS it c - / 1T3 - 2 -07 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes D`No — �t�► WATER VALVE 4-I ADJUSTMENT REQD — a ❑Yes Et No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Ili-No o 'z — LOCATION OF SIDEWALK ®Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0-5 Feet ❑ 5,3 Feet ❑ Other DEPTH OF SIDEWALK 2-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- .` S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — 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: 16 FORMED POURED COMPLETED - CITY OF WATELO• SIDEWALK REPAI SURVEY F•RM PROPERTY ADDRESS 5 7 4:AK_ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C Cl Yes rrElo See reverse side for Defect Codes A-F TRIM VEGETATION I See below for Defect Code G I REQUIRED I ❑ Yes io WATER VALVE ADJUSTMENT REQUIRED 07 ❑ Yes ; o I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Il No C LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard other7� WIDTH OF SIDEWALK Ieet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A- S.F. ADDITIONAL REPAIRS 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. /l� FIRST INSPECTION AND FORM MADE BY : (� � Date: / 7-l/q FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS >-i; 6; 5 f , - 3 -2 <' - ) 3572 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I 3Yes ❑ No See below for Defect Code G — I TRIM VEGETATION REQUIRED ❑Yes ❑ No WATER VALVE 0 ,---- 1..46— -0. of 't✓' I ; ADJUSTMENT REQ'D — I ❑Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED l 9 1 ❑Yes ❑ No ej 1 \ —) y � _ o4e_ LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Li 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK —El 4 inches 0 5 inches 7 0-6 inches;, AREA TO BE REPAIRED 4"- 1,cZS f:'B.F. 5"- S.F. 6"- cLO/S.F. Class'A'- _ _ S.F. ADDITIONAL REPAIRS — 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 ; 16 -; 1U Date: 0 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SU VEY F•RM PROPERTY ADDRESS v/kt_ - 60 Z_ 5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK _ REQUIRED Type of Defect �, ❑ Yes C‘o See reverse side for Defect Codes A-F TRIM VEGETATION _ I See below for Defect Code G I REQ - Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [i io PARKS DEPARTMENT REVIEW REQUIRED es ❑ No _ _ _ _ kA - — — KAA 4,0 bAt LOCATION OF SIDEWALK II-Font Yard LI Side Yard ❑ Other WIDTH OF SIDEWALK C4/4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑,,enches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- a - S.F. 5 S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .� Date: (O FORMED POURED COMPLETED CITE" OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i00 &Y e: PAW 4i% SS t3 -e3-48 - ,3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes No WATE t i` VALVE ADJUSTMENT REQUIRED — ~©-4. ❑ Yes ® No +rw144-`"° "' '� I PARKS DEPARTMENT ` >C� ` s"'S y} REVIEW REQUIRED cttrD •k ❑ Yes ® No N 41.0 5.0`6r•1) E • Zak LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other i DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ® 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class'A'- 236-47 vS.F. ADDITIONAL REPAIRS PAv r V G WITH CteS = 5 DETEC.Tf`N6LE wAteNrNG /4. 0 s,F. ✓ — 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 : ?'5 ‘C3';'› Date: 3- 2-4 I46. FORMED POURED COMPLETED CITY OF WATERLOO [ lz SIDEWALK REPAIR SURVEY FORM i - PROPERTY ADDRESS . V (,off% -Ito E , 1. (1 v r3 -2 - (Gr - !l ,/.= PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes E No See reverse side for Defect Codes A-F TRIM VEGETATION i` See below for Defect Code G I REQUIRED I I ❑ Yes �io WATER VALVE 1 4( ADJUSTMENT REQUIRED Yes C�`"No PARKS DEPARTMENT REVIEW REQUIRED . �9 Yes [r No — — — — — — CC-✓ — — — fOrr F C �i • ` / irt ici'''''?0-`1.'c \ n -7 Ow 4 n�1E 4-I • LOCATION OF SIDEWALK Cl Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet <D'Other DEPTH OF SIDEWALK EI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- (1O°`a S.F. 5"- S.F. 6"- S.F. Class'A'- i2 i° S.F. ADDITIONAL REPAIRS CODE F - PATCHES El Yes ❑ No No. of Squares with Patches CODE G - NOTE : Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ;-<- l , Date: 'Z'f-l FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t oa-1i o 6, P/blz( 112) -25 - tc+ - ot / . ,} PARCEL CODE CONTROL NO. CLEAN SIDEWALK ,1 REQUIRED Type of Defect ti ❑ Yes ❑ No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No WATER VALVE _ �rn� ADJUSTMENT REQUIRED -- ❑ Yes ❑ No �� , _ PARKS DEPARTMENT P f- • REVIEW REQUIRED v- li'ci ❑ Yes ❑ No — — —4. --A — A a =+ — 4 A C (- to,8+�fs��-f-r4' /M r cItil et Kr,4 ... I ^ A, ,432,10,5z - t`A LIoN( 's It I, , iN f' :1 3or•L Q.3 0 6',C6:z, f / Via:4'/ ci ''A`,i,otit.4-k- ci:‘, 4.'10c37 i?,,J c ,itru-.) Yu. E , 3 gmil;o,_2I+-5 1 LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ElOther BACK. )" WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet El 5.3 Feet 0 Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "-1`IC,4,'7S.F. 5"- S.F. 6 "- S.F. Class'A'- " s - S.F. — ADDITIONAL REPAIRS CODE F - PATCHES Yes ❑ No No. of Squares with Patches 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 : Irk ' 1L Date: 9 '4 -/ FORMED POURED COMPLETED 6- CITY OF ti ATERL•O !j/py gy�p / ,,)v �2 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2?c1 E . ,c .. z/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect — 1\ ,C_ 112 4 1„ _- REQUIRED — See reverse side for Defect Codes A-F 4-, 1 - ❑Yes 0 No See below for Defect Code G �„ .0 +3, ' 1 TRIM VEGETATION LoS''1:i' REQUIRED PcSg. 1.5 ❑Yes Ei No SS \'- ` WATER VALVE f—Q--► _ ADJUSTMENT REQ'D 1 a ❑Yes 0 No K�,k1.%+� tg CV v".,'�;°' Uiw!:o �, v PARKS DEPARTMENT � �o�,- i°/ 2 ~�L S c'1,5'^ „6 REVIEW REQUIRED — — • � +"‘ , ^^ygrA"'ti,L"` ., 4,ti ~ .Yes ❑ No. a ., 1 J _ E . o.rV, A.re LOCATION OF SIDEWALK Front Yard 1 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0 Other DEPTH OF SIDEWALK Cr4 inches ❑ 5 inches 16 inches AREA TO BE REPAIRED 4"-14 I--T S.F. 5"- _S.F. 6"- S.F.3'1°7 . Class'A'- /14 . 'S.F. — ADDITIONAL REPAIRS 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: - 7' FORMED" POURED COMPLETED f CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS °' 2 2 R 6_ - Pat fi4, .Y r q - f O a. ' fi _rr PARCEL CODE CONTROL NO. I _ a^ 3 4 ff'`'A CLEAN SIDEWALK Type of Defect a, C ueS 2? 3 z s — y.z�t.�� 3s REQUIRED See reverse side for Defect Codes A-F'+,-—x 1i ❑ Yes C] No See below for Defect Code G ,"3`�t9 3'g 11. ` 3.ar�2 2® TRIM VEGETATION s.2' 0 7 REQUIRED uf.'=3.2xep 1' 1t = ❑ Yes El No if':3.2',1q.3°2 • :: if'`:`3 2'4 40 3'a2 „:T-.,"'1 ` t, y -3.2R1?3'. j� — 4 ®— .3,2''/4•2 i L WATER VALVE 4 23 Y,a y"3 - ADJUSTMENT REQ'D t if "=zs�x�s % ❑Yes No ,q• �, �, _�• ,�5.o -:.tr�z �'=.ate — GJ .- a� 4''''�. •+`�`}` w ''Z' ,2 , ,q•'o� •30' PARKS DEPARTMENT ''t y� .+ 1 n° ,try 7,' c ;g ky. co 4fr ,a 'I a0,5go ;4 q 2.' 1,1 �i'• a' ��' '1' o .} + ti•';° �' , REVIEW REQUIRED — v), �� 1v eI. R ta.., " ,., so 4i `4— >4. U'° L9 y CAL\ >� 1"_. �,'" r 1,9° '1,1 `}, !:1,U 4`�1.` ❑Yes ❑ No i/' $ ': - ' Cam '\r ki LTi :1 10, • .r LOCATION OF SIDEWALK 'l Front Yard 1LI Side Yard ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet ❑ 5.3 Feet l Other DEPTH OF SIDEWALK d 4 inches ❑ 5 inches l 6 inches AREA TO BE REPAIRED 4"-.(9'.h ` S.F. 5"- S.F. 6"- i g °3 'S.F. Class'A'- 2.�/ ' S.F. ADDITIONAL REPAIRS 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 : Date: to/7 Vi"+ FORMED POURED COMPLETED CITY OF WATERL011 SIDEWALK REPAIR SURVEY FtIaM PROPERTY ADDRESS _,� 5LK PAel< 4VL - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect `\: [1 Yes 1 i No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes No �t 3 = , WATER VALVE Z ,,,c, ADJUSTMENT REQUIRED € b Ptt'�E49 (�Je. -- © C7 Yes ti] No ‘,04 I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 'I] No \\\\ j • 1'J _ LOCATION OF SIDEWALK r Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 'Li Other •L DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches L 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- of -S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS �- 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: _-�I 2// FORMED _ POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS g2,5 E P.,r :,,-t — . / !t -2L? - 3 - OOLi ' PARCEL CODE CO:II:77 NO. �c:1\ �vet- CLEAN SIDEWALK Type of Defect I - REQUIRED — See reverse side for Defect Codes A F r I CI Yes fl No See below for Defect Code G j/ I TRIM VEGETATION ,J REQUIRED _ ❑Yes 0 No ' WATER VALVE �N ' ADJUSTMENT REM) — cy CI Yes Yes No �,0 4- I �-- PARKS DEPARTMENT \�)\° REVIEW REQUIRED — �,, ❑ Yes E No J/ 0 — LOCATION OF SIDEWALK D Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet I iOther DEPTH OF SIDEWALK 1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- Z°E3.0 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes El No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: fr i , — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS &-c l e- k - - 354- -cam.5 414-v 5t1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes CINo See below for Defect Code G TRIM VEGETATION REQUIRED "' ❑Yes No t - :. v\ WATER VALVE 4.4D I 4- ADJUSTMENT REQ'D a El Yes No owl .1 PARKS DEPARTMENT REVIEW REQUIRED "1. ❑Yes [ No Jr7e-4 (/4 LOCATION OF SIDEWALK ® Front Yard CS-Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet f5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches IN 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- I' B.q 'S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : R-5 Date: 9-Z-4 - E 9 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c 1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect — REQUIRED See reverse side for Defect Codes A-F 6 ❑ Yes I24Io See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 0 No WATER VALVE �— --► ADJUSTMENT REQ'D I \ ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED -- '9 ❑Yes I11 No ' TA 1 ' LOCATION OF SIDEWALK .Front Yard ® Side Yard ❑ Other — — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [ .5.3 Feet LI Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- E S.F. 5"- S.F. 6 "- _S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : Oe7 Date: 5 ° 9 FORMED POURED COMPLETED CITY OF WATELU•0 SIDEWALK REPAID, SURVEY FORM PROPERTY ADDRESS ZOO P_x Rb PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect • REQUIRED See reverse side for Defect Codes A-F I "Yes ❑ No See below for Defect Code G TRIM VEGETATION I REQUIRED 0 Yes ❑ No WATER VALVE -41"' ADJUSTMENT REQ'D �� I -- ❑ Yes ❑ No - mac. PARKS DEPARTMENT REVIEW REQUIRED /( 1 Cy 4/3 +�? K- _ — — �� C7 Yes ❑ No OM- J LOCATION OF SIDEWALK ii Front Yard ❑`Side Yard ❑ Other _ WIDTH OF SIDEWALK E1 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches i AREA TO BE REPAIRED 4"- I f LI e`i S.F. 5"- S.F. 6"- _ S.F. Class'A'- _ S.F. ADDITIONAL REPAIRS 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 c to Date: FORMED POURED COMPLETED CITY OF ATERLS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 1 ,K c - V i I \ -2J _gc ooci PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes O No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 0 No 1 1 I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ID No lY LOCATION OF SIDEWALK D Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LI 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'AL S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ,EI No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: ;"r 7 Al — FORMED POURED COMPLETED CITY OF WATERLO. SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .Z - d o C 5 ,,, PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION -- J See below for Defect Code G J REQUIRED ❑ Yes I No WATER VALVE ADJUSTMENT REQUIRED J J II Yes LINo PARKS DEPARTMENT REVIEW REQUIRED Gass"A" ❑ Yes AN No r a 3 1 t'P_ `f_ LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other _ — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 05.3 Feet ❑ Other DEPTH OF SIDEWALK 1E1`4 inches Q 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- I S.F. 5"- S.F. 6"- S.F. Class TA'- I '.3-7`7S.F. ADDITIONAL REPAIRS 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: FORMED POURED COMPLETED CITY OF WATERL•n -- SIDEWALK REPAIR SURVEY FORY. PROPERTY ADDRESS _ °� GtrK IC 913 -Z3 - 0/5 PARCEL CODE CONTROL NO. \_ CLEAN SIDEWALK Type of Defect ¢) i C-`' ?O REQUIRED See reverse side for Defect Codes A-F ❑Yes NC7 No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 0 No "`tit WATER VALVE < —* ADJUSTMENT REQ'D — Itl\ ❑ Yes EtNo PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes CI No — 4aac9Lvasg/ 54 LOCATION OF SIDEWALK `Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- /3' ,`/ S.F. Class'A'- S.F. ADDITIONAL REPAIRS — 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 ; Z 5 Date: '0 - -t 1 FORMED POURED COMPLETED CITY OFWATE L0• SIDE A_K REPAIR SURVEY FORS'. PROPERTY ADDRESS ! ? — . 2.(ir — F ,. _ a e./7/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 1 Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I El Yes ❑ No A WATER VALVE ADJUSTMENT REQUIRED Zi ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No r LOCATION OF SIDEWALK O"Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0-5.3 Feet ❑ Other DEPTH OF SIDEWALK 0"4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-?(7,5.c S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 � 1 / J Date: / °�' 5 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPA SUl':VEY FOr' PROPERTY ADDRESS - _ cZ'z' hiv 11 -2t - i n `57Z, PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ,B'Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes ❑ Notif -- WATER VALVE ADJUSTMENT REQUIRED ♦' "'� 'i 2`v ❑ Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED 50' i °r , ❑ Yes CI No t l LOCATION OF SIDEWALK VI-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet DI 5.3 Feet ❑ Other DEPTH OF SIDEWALK 2--4 inches ❑`5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-212oC 'S.F. 5"- 5J-C"/S.F. 6 "- _ S.F. Class'AT- S.F. ADDITIONAL REPAIRS 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: Jo '3 FORMED POURED COMPLETED �.. CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / 4-)am✓i y 1l5 -24-- /03 - oj, _33j _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect -El-Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes ❑ No �r A WATER VALVE ` ADJUSTMENT REQUIRED — I /1,04 ❑ Yes ❑ No I i PARKS DEPARTMENT — REVIEW REQUIRED Eyes ❑ No 30 LOCATION OF SIDEWALK R-wont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet kfTS Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches -E inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- ' ® -S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches - CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : (c KT Date: ro_ l 9" FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F•FD M PROPERTY ADDRESS 531-ite amucy T li?? - 4- 103 - 0/a 374- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect es ❑ No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ( REQUIRED ❑ Yes ❑ No -, WATER VALVE ADJUSTMENT REQUIRED N El Yes ❑ No 1 I _ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No _ 3e) 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 4"- 1,5°,1)°S.F. 5"- S.F. 6"- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. r FIRST INSPECTION AND FORM MADE BY : /`� K Date: /b 23_l" FORMED POURED COMPLETED _- — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS .' /CO et- Ou/Aiey r. --_ _ ..._ _ a9! 3 -z. - /o - 613 >7 � PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED — Type of Defect —g'(es ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes ❑ No — WATER VALVE jI ADJUSTMENT REQUIRED -0—► ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No Pcugy LOCATION OF SIDEWALK L1ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑'5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK finches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 3 o S.F. 5"- S.F. 6"- S,F. Class'A'- S.F. ADDITIONAL REPAIRS 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. jj�� v� — FIRST INSPECTION AND FORM MADE BY : / 5 1S Date: 7 ' Z ` 1 I" FORMED POURED COMPLETED CITY OF WATERLOG SIDEWALK REPAIR SURVEY FSRM PROPERTY ADDRESS /CV 4 Ju U j 5T= gi 13 -Z4- - 1E7 - 0aC:PARCEL CODE CONTROL NO, CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F [ es ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED i-es ❑ No — 1` �I WATER VALVE ADJUSTMENT REQUIRED Nk ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No 59' &l ib,/C I LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Li Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK -Er4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 1 S,F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : it5 �� Date: /0 5`f FORMED POURED COMPLETED -- CITY OF WATERL®' SIDEWALK REPAIR SURVEY FOAM PROPERTY ADDRESS (ao att`,W,y _ <=113 -g4 - 1©y -004 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect C Yes lrNo See reverse side for Defect Codes A-F TRIM VEGETATION _ I See below for Defect Code G I REQUIRED 1 I ❑ Yes 10 WATER VALVE ADJUSTMENT REQUIRED ~ —* t o C Yes IrNo NIT PARKS DEPARTMENT REVIEW REQUIRED C Yes ElNo A- A- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches hot AREA TO BE REPAIRED 4"- 4 S.F. 5"- S.F. 6 "- S.F. Class S.F. -- ADDITIONAL REPAIRS 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: /v 23 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY ,oRA A - PROPERTY ADDRESS . (Z/ 0-qa/C j 3'1(3 - c)i5 ,37 PARCEL CODE CONTROL NO. CLEAN SIDEWALK — REQUIRED Type of Defect , }'Yes ❑ No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes El No — kk WATER VALVE ADJUSTMENT REQUIRED �f ❑ Yes ❑ No I PARKS DEPARTMENT go rut`.rfi-- REVIEW REQUIRED ❑ Yes ❑ No ea Z` - - — — atokty LOCATION OF SIDEWALK Er Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ,E1''5Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK Cinches -winches ❑ 6 inches AREA TO BE REPAIRED 4"- 3°0.°.S.F. 5"- (0D.0S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 / tJ Date: /0-'2-37 I/ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAI m'. SURVEY FS F PROPERTY ADDRESS (z7 4:00ilc'( 53113 -z1" - (aS - 014 ?" PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect -Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No If - I PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes ❑ No (� LOCATION OF SIDEWALK E front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet r' Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK inches 5t 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ©''S.F. 5"- (00.0-S.F. 6"- S.F. Class TA'- S.F. ADDITIONAL REPAIRS _ CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /0 -Z3--19 FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /735 Za tic) 3m — P113 - 355- roc,Z 3 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect A REQUIRED — ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes Ill No t WATER VALVE — ADJUSTMENT REQUIRED 4-0—* kYes ❑ No PARKS DEPARTMENT REVIEW REQUIRED s ivot ( l Yes ❑ No 0%, vim ///t/A 41 4tl' ' A;6- LOCATION OF SIDEWALK $J Front Yard El Side Yard El Other WIDTH OF SIDEWALK 4 Feet Ig] 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- Cr40 S.F. 5"- -0 S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : \J- Date: -G "/ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i743 aNgpyct . (09/3 -/lam- 055 -/ of PARCEL CODE CONTROL NO. G CLEAN SIDEWALK Type of Defect i REQUIRED See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIMREQUIRED VEGETATION — ! ❑ Yes No `t v WATER VALVE 411-0 `-10- VI -7 ADJUSTMENT REQD a I yi ❑Yes [ l No PARKS DEPARTMENT REVIEW REQUIRED 0 A _ _ ❑ Yes No ;77 �giiu$O u1 Dg LOCATION OF SIDEWALK JFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches cr 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- /Z.l7 S.F. 5"- 33. S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 5a CUT= 4 CODE F - PATCHES ❑ Yes EX No No. of Squares with Patches — CODE G - NOTE : Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : kIG Date: S -I y FORMED POURED COMPLETED COT( OF WATERLOO 1 or 2 SIDEWALK REPAIR SURVEY *,RM PROPERTY ADDRESS /OC tkg $T 4 tiJ- i -23 - zsyl .- coi-f _ .? PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I 7/Yes 0 No11/4 WATER VALVE 1 ADJUSTMENT REQUIRED I6-122 A1� ❑ Yes ;l� No ,04 PARKS DEPARTMENT REVIEW REQUIRED 11 Yes El No b 5.3' `'� LOCATION OF SIDEWALK ®_Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .xC'I 5.3 Feet ❑ Other DEPTH OF SIDEWALK [ :4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' _ `7S.F. 5"- S.F. 6"- S.F. Class 'A'- S.F. _ ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No. of Squares with Patches — CODE G - NOTE :Areas marked with an "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: `'°•cT "II FORMED POURED COMPLETED CITY OF WATERLOO Z SIDEWALK REPAIR SURVEY Fal M PROPERTY ADDRESS - iC o J3'LK 4 6/j/ S .3i 1 -23 -2M. -D04 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect , REQ Ye ED ❑No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes ET-No t WATER VALVE ADJUSTMENT REQUIRED Of� ElYes ©INo PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes El-No 4,1 L.J z,J LOCATION OF SIDEWALK !Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK A.. Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches L`6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- -=• 'S,F. Class 'AL S.F. ADDITIONAL REPAIRS 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 : _ !(3-- Date: 0-9-l/p FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FOR PROPERTY ADDRESS ' )6 5 34. 11.00s . . V.113 z3 - ZS! - DogPARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect i* REQUIRED See reverse side for Defect Codes A-F I ❑Yes 6 No _ See below for Defect Code G I TRIM VEGETATION REQUIRED ❑Yes I ] No — / WATER VALVE �— N ADJUSTMENT REQ'D 1 ❑Yes iZ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes RI No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK .flg 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- = =' S.F. 5"- S.F. 6"- S.F. Class IA'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES LI Yes ❑ No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : la Date: - -I FORMED POURED COMPLETED CITY OF WA TERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ✓ ilk, • 12Z s+. 4 ►.)oAS sr. - 23 -284, . - Doi ZtRe,. PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes { ! No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes K No WATER VALVE ADJUSTMENT REQUIRED >Q--► � � ❑ Yes `-'D No I PARKS DEPARTMENT REVIEW REQUIRED C Yes ❑ No 5+. av1s t . LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK Xi inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 53.5✓S.F, 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: i 0 y - 19 FORMED POURED COMPLETED CITY OF WATERLO ti — SIDEWALK REPAIR SURVEY FORM ��tJ PROPERTY ADDRESS 11to-•; z 51-. ,#itiaAc SI-. — -23 - z sq - C 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED — )Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 7No %T I — 1 PARKS DEPARTMENT / V I-9" REVIEW REQUIRED T-1 \1:\ a,z, Yes ❑ No T:4q ST , LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard 2 Other UAe, WIDTH OF SIDEWALK J41 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches NI 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- `IC.g 'S.F. Class 'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes [allo No. of Squares with Patches — CODE G - NOTE :Areas marked with an"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: l o • 4-(`� FORMED POURED COMPLETED CITY OF 'ATER.LO• SIDEWALK REPAIR SURVEY EO!' M PROPERTY ADDRESS 1J 54 s c 4 . 913 - 23 - 2a3.-OoS r }` PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes II No See reverse side for Defect Codes A See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes I°No 10' WATER VALVE ADJUSTMENT REQUIRED ❑ Yes NJ No \ PARKS DEPARTMENT REVIEW REQUIRED ++ Yes ❑ No 54 , 16Q.‘c S-(- LOCATION OF SIDEWALK ( Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Cl 5 Feet u 5.3 Feet ❑ Other DEPTH OF SIDEWALK .64 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- =` ` ` S.F. 5"- S.F. 6 "- S.F. Class'Al- S.F. ADDITIONAL REPAIRS 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: 'o -s 9 FORMED POURED COMPLETED CITY OF WATERL*J SIDEWALK REPAirl SURVEY FORM 1�PROPERTY Y ADDRESS - !3c 54 , A I ba:,s 34 . SC017 -Z3 - ZK4 . ' 662 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes Ili No _ See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes 121 No — \ WATER VALVE ADJUSTMENT REQUIRED Q. ❑ Yes ©No / I - - I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes El No 5.1' S+. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I f5.3 Feet ❑ Other DEPTH OF SIDEWALK 1114 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- =' S.F. 5"- S.F. 6"- S.F.— Class'A'- S.F. _. ADDITIONAL REPAIRS 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 : 25 Date: /)`9'19 FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FIRM PROPERTY ADDRESS /SO S i; /k t' �ar3 - 2 - z xy . - vU2 t PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect t ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes -10 No WATER VALVE �0=1— ADJUSTMENT REQUIRED ❑ Yes Q No PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes q No 1(7/41 LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard k 1 Other 'g A P, WIDTH OF SIDEWALK K4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches -K6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- ' `i S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : 1'o-s Date: Jo •cr-t FORMED POURED COMPLETED CITY OF MERLOS - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS :J 3 5+, bans , (113 - ? EZ - ®0 3 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes XI No See below for Defect Code G TRIM VEGETATION I REQUIRED ❑Yes 11 No — WATER VALVE -4— t ADJUSTMENT REQ'D —' ❑Yes CNo PARKS DEPARTMENT REVIEW REQUIRED — — — ❑Yes No 5*. Atkocte, s �! . LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 3,5.3 Feet ❑ Other DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' S.F. 5"- S.F. 6 "- S.F. Class'Ai- S.F. ADDITIONAL REPAIRS — 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: Jo- - / FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SU VEY FIRM PROPERTY ADDRESS )3. 5.(4 ,,mi ✓- 1'2 -24 -/w7, .- ( ( PARCEL CODE CONTROL NO. CLEAN SIDEWALK 1 REQUIRED Type of Defect j` ❑ Yes El No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED J I ❑ Yes i iNo tif WATER VALVE ADJUSTMENT REQUIRED ❑ Yes L] No Nsr J — I PARKS DEPARTMENT REVIEW REQUIRED -5-Yes ❑ No A 'TJ LOCATION OF SIDEWALK l 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 4"-c9'7 r S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes I I No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : KT Date: l U- 2--?-1? FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - 3'31 ,a — • t t3 - 24 - t97 - °07 r PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect �, " REQUIRED See reverse side for Defect Codes A-F `9� ❑ Yes lNo See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes [TN A — 11 WATER VALVE � ADJUSTMENT REQ'D _ a if I ❑Yes C -No PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes Z1io LOCATION OF SIDEWALK ❑ Front Yard E1Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I t 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 04 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4" 94,1' S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑Yes ❑'No No.of Squares with Patches CODE G - /VI q)AJ( »{'(.AJ L - — Nat) RiAl 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: /a f? FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4001Z _ 13 -A - /5`F -el() :3 =-} 1yr" PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect tl REQUIRED See reverse side for Defect Codes A-F I ❑Yes fl No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes ❑`No ` I �! WATER VALVE ADJUSTMENT REM)— ♦ a ❑Yes fl No PARKS DEPARTMENT REVIEW REQUIRED i Yes ❑ No cc fir LOCATION OF SIDEWALK ❑Y Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®"5.3 Feet ❑ Other DEPTH OF SIDEWALK E4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- (247 ` S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes EI1 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. t FIRST INSPECTION AND FORM MADE BY ; Date: /C" FORMED POURED COMPLETED CITY OF WATT ERLS S SIDEWALK REPAIR. SURVEY Fe PROPERTY ADDRESS r P r f• r' . o PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _A ❑ Yes 13 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes Q No — WATER VALVE ADJUSTMENT REQUIRED FQ—* I ❑ Yes ©"No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes II-No — — A Ali — — — — 0,4 LOCATION OF SIDEWALK 0--Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ET5.3 Feet ❑ Other DEPTH OF SIDEWALK II "inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S). ( S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes ❑-No No. of Squares with Patches CODE G - — NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: /0—2,3-I 1 FORMED POURED COMPLETED _„ CITY OF WAY ERLOI SIDEWALK REPAI! SURVEY FORM PROPERTY ADDRESS • `t % X. ;,-! -04 37 �. PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 11 ❑ Yes El No See reverse side for Defect Codes A-F TRIM VEGETATION — I See below for Defect Code G I REQUIRED I I ❑ Yes ❑'No ', WATER VALVE I if ADJUSTMENT REQUIRED `- El Yes Er No a _ I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes -E No A LOCATION OF SIDEWALK EfFront Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK Cf"4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 53-0 ' S.F. 5"- S.F. 6 "- S.F. Class 'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No. of Squares with Patches CODE G - NOTE :Areas marked with an "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: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOr.M PROPERTY ADDRESS 4 5,44,6,i' r 9 11 - - I rt�'3 - 003 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect — ❑ Yes I No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I I ❑ Yes ❑"hloif - WATER VALVE ADJUSTMENT REQUIRED /� 4?(,) ❑ Yes ET No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ©-No — I; LOCATION OF SIDEWALK ©Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 1;15 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 21-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '' S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ©"No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : (5 -' Date: /c r 7 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAI ' SURVEY FORM PROPERTY ADDRESS . ` 16 ,;a , 11 -2y- - I(17 - 394- PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes E1 Jo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED LYes ❑ No WATER VALVE `„ ADJUSTMENT REQUIRED ~ —+ ❑ Yes ❑r to _ I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑'No LOCATION OF SIDEWALK i Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet LI-5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,II 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-_ S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes [a1 Jo No. of Squares with Patches CODE G - NOTE :Areas marked with an "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: FORMED POURED COMPLETED CITY OF WATERLS• SIDEWALK REPAIR SURVEY FO'M PROPERTY ADDRESS 11/9 rti; • PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A ❑ Yes 0-No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes WATER VALVE , F ADJUSTMENT REQUIRED 4 F —+ 4)9 ❑ Yes Li No 1� PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes E-No — _ _ A LOCATION OF SIDEWALK ['Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet D"5.3 Feet ❑ Other DEPTH OF SIDEWALK ©`4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 2(9,5 S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. — ADDITIONAL REPAIRS 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 : 1C't, Date: Z5-7'1 FORMED POURED COMPLETED CITY OF WATERLSO SIDEWALK RE AIR SURVEY FIRM PROPERTY ADDRESS ✓ 51-4!o;a..) PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK REQUIRED Type of Defect i ❑ Yes LI No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes 0 No WATER VALVE ♦� �� ADJUSTMENT REQUIRED 42 Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes L] No 11,0 LOCATION OF SIDEWALK CI-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Et 5.3 Feet ❑ Other DEPTH OF SIDEWALK ( 44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- yM±S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes allo No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. rr J FIRST INSPECTION AND FORM MADE BY : f�T Jam. Date: /6" Z3—f 9 FORMED POURED COMPLETED CITY OF WATE LOO SIDEWALK REPAIR SURVEY FORM .r /V PROPERTY ADDRESS 7ii- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes El-No _ See below for Defect Code G TRIM VEGETATION REQUIRED Cl Yes L1iNo — I. ` WATER VALVE 4-0 4 J 3 . ADJUSTMENT REQ'D — Of,04I ❑Yes allo PARKS DEPARTMENT REVIEW REQUIRED — 4A - - - - Yes No _ r '/i >i LOCATION OF SIDEWALK Q'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0 Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '° S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes C No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : g-< - Date: 1p s 24-1 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ! °>i =� o�e g?i3 -.23 - 4361, - o 7 G' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ! Yes ❑ No See below for Defect Code G v�I TRIM VEGETATION REQUIRED 4 Yes ❑ No le WATER VALVE 411— -10- ADJUSTMENT REQ'D v ❑Yes ❑ No °o PARKS DEPARTMENT 12 6' L TA L REVIEW REQUIRED El Yes ❑ No RAls_R.orAJ5 TIL I 1 Tfl I4/JA,c. k,r}i_L Foos, cone. 1-1-10 LOCATION OF SIDEWALK Et Front Yard V Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 13] 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- 931.a "S.F. 5"- »7.�'S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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: 10/ , I FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS < 7 5" t PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED — ❑ Yes p No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes IN No WATER VALVE t--Q—* ADJUSTMENT REQUIRED ❑ Yes l No '04 I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No iq 1 _5kiG Cain LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other _. DEPTH OF SIDEWALK ❑ 4 inches liSt inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- aes ! 'S.F. 6"-• S.F. Class 'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes El.No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : -) ' Date: t(' ---Z FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS V /00 Ave $(i 642446R — C.) C5- - -i-T? -o 0 4-0 > PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes ® No See below for Defect Code G I TRIM VEGETATION REQUIRED ❑Yes fa No WATER VALVE �—Q—► I ADJUSTMENT REQ'D ❑Yes No J I PARKS DEPARTMENT REVIEW REQUIRED Z ❑Yes I No 5-tci LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet l>Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 16 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- I Ii Class'A'- S.F. ADDITIONAL REPAIRS 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 : 5 Date: I ®� ®� FORMED _ POURED COMPLETED CITY OF 'F€,'ATER_®® SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / > ��`�,�-�-t� � 5� t _ PARCEL CODE CONTROL NO. ._ CLEAN SIDEWALK -- Type of Defect _ REQUIRED See reverse side for Defect Codes A-F I ❑Yes No See below for Defect Code G TRIM VEGETATION REQUIRED -f El Yes t1 No — d1 3 WATER VALVE —► ADJUSTMENT REQ'D • ❑Yes 1 No \�� PARKS DEPARTMENT — REVIEW REQUIRED (s `, ❑Yes p No SYc LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet E 5 Feet ❑ 5.3 Feet [Other 6'' DEPTH OF SIDEWALK LS 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4."- a C a'/S.F. 5 S.F. 6 S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes EI No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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%› t'5'-)5 Date: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / 29,3 - C> -t,I - A_^ 9 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A REQUIRED -� See reverse side for Defect Codes A-F ❑Yes ® No See below for Defect Code G I TRIM VEGETATION REQUIRED ❑Yes 111 No WATER VALVE ADJUSTMENT REQ'D ❑ Yes 0 No I PARKS DEPARTMENT REVIEW REQUIRED r;rz ,.O ❑Yes 0 No Sic ., c v e �k . LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Li 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK '0 4 inches ❑ 5 inches '-L7 6 inches AREA TO BE REPAIRED 4"-2 L Z S.F. 5"- S.F. 6"- 1U• S.F, Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes Li No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. [ i j FIRST INSPECTION AND FORM MADE BY : -} Date: FORMED POURED COMPLETED CITY OF WATERtOs41 SIDEWALK REPAIR SU VEY FORM PROPERTY ADDRESS c>rgo —GL 0 PARCEL CODE CONTROL NO. Nl CLEAN SIDEWALK Type of Defect s - REQUIRED See reverse side for Defect Codes A-F 1 ❑Yes Q'No See below for Defect Code G 4 ti I TRIM VEGETATION REQUIRED ❑Yes E1 No Z WATER VALVE f --► N ADJUSTMENT REQ'D ��►� ' ' ❑Yes fNo a PARKS DEPARTMENT REVIEW REQUIRED C.- — — 5.l ❑ Yes [ No :° A LOCATION OF SIDEWALK 1.Front Yard K. Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Q 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK C I'4 inches ❑ 5 inches Q.6 inches AREA TO BE REPAIRED 4"- lA S.F. 5"- S.F. 6 "- 66,y S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 : ~› Z-. `1 Date: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM I PROPERTY ADDRESS 360 jcc vvct e ,Sr-,er- ...., Cn13-2 - LI81 - 001 - PARCEL CODE CONTROL NO. Z5,(a.„:7,o c)?R ap {..UA`! �' i t,, 18.®' 7. `_l N� s„,„,„ vicar Ciass'A - &o xR ".'.\ `- i ..`0 t12 '` CLEAN SIDEWALK Z�.1�iY e�t34. ..;,�; REQUIRED Type of Defect A ;r -_ ���� ' ,,k See reverse side for Defect Codes A F I ❑Yes ❑ No See below for Defect Code G TRIM VEGETATION I "=6c`x6, 'zly 4 pc ;rs REQUIRED ',ca.c'_ o �,�+. ❑Yes ❑ No 6o'x8.0: . .o ti� ��. 'ss WATER VALVE ©_+ i ADJUSTMENT REQ'D \ ❑Yes ❑ No all s 6,,:s,q'<(.�.3`=Mo.r i ` C\ass"A'? PARKS DEPARTMENT Qarv.0) Ii.I'i8.1 s9�•y ' REVIEW REQUIRED t.ck , , Yes ❑ No ,253xSp c124,•5 yyx.5 e:Z?.5 Z�.3x S,Ccli(a.5 \ r 14 tc / 6" .• Li LOCATION OF SIDEWALK sE l Front Yard `n Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ;06 inches AREA TO BE REPAIRED 4"- I24•5 S.F. 5"-— S.F. 6"- 41111•Z 4.F. Class'A'- 106•4 S.F. ADDITIONAL REPAIRS 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: 7(2 r ; FORMED POURED COMPLETED CITY OF WATERLOO O SIDEWALK REPAIR SURVEY FORM rt3 PROPERTY ADDRESS .30C SIc0,w,c t kce PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A . C- REQUIRED See reverse side for Defect Codes A-F ❑ Yes N° See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes L No 4,9 WATER VALVE N ,� 1.9i N\ ADJUSTMENT REQUIRED J. �,� �� n!' �`�� �$' }� N. �� a� , b' ❑ Yes ❑ No 1�• 'ry s A 0% ,sF ® ,a +' ad rd. a° ��e;�ti ��,' �} ,- a+ a ", I PARKS DEPARTMENT a �• ti , • rti P ,;h ,��' :� ,` REVIEW REQUIRED 4 ❑ NOa f, G h a '� y _ _ �',��.a'- v Uu`'�\� ti Yes 7.14,f-, :ir ,/, ! KA 17 , alc-,1 ' / - \`';',1 :14;11::n 1,;(01/Y4-ii:/P' i'i.,01 / ' ;-P---1 ''''''' — 44 LOCATION OF SIDEWALK f Front Yard �� ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Li Other DEPTH OF SIDEWALK L3 4 inches ❑ 5 inches E(6 inches f AREA TO BE REPAIRED 4'- 93. -4'"S.F. 5"- S.F. 6 "- il 3 ' ' � S.F. Class A = 1.5 S.F. ADDITIONAL REPAIRS 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: I FORMED POURED COMPLETED — CiTY OF WATERLOS � �, Sl ikEWALK REPAIR SURVEYF`I I,\iM _ PROPERTY ADDRESS / 30(3 c,.,,4 i t r . ,_, ✓ YA 1 - J?, - 1-{q k.- CC L CONTROL NO. PARCEL CODE CLEAN SIDEWALK REQUIRED Type of Defect C ❑ Yes U No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED Yes O No "� WATER VALVE A1'Po• o ADJUSTMENT REQUIRED a a�a�fb J if.. ‘4, % es, ❑ Yes Q No ��,�' .tt �ft, c* ,;. 1ti' f, cL ri, I,.,4 PARKS DEPARTMENT n ^' }, tv .. REVIEW REQUIRED D k •, a"' � a•a1 ,q\ ? . A y 4.-' " . Yes ❑ No > - t• •S "�, N. A mo 11 0°- — ! o _ w _ — — ' ,, ION r:/1// /-'. 7 16 (7 / 6 LOCATION OF SIDEWALK ]Front Yard ❑ Side Yard ❑ Other ' �U IN o WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0 Other _ DEPTH OF SIDEWALK Igt 4 inches ❑ 5 inches d 6 inches ✓� AREA TO BE REPAIRED 4 - 4°4'9 S.F. 5"- S.F. 6"- /y40.2-S,F. Class'Ai- 5'af',9 S.F. — ADDITIONAL REPAIRS 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 : sk. `4 S Date: 2 1�19 FORMED POURED COMPLETED CITY OF W,`A TE L.O SIDEWALK WALK REPAIR SU . R9 Ey FORM PROPERTY ADDRESS r 3 25 . cu ci,F_ PARCEL CODE CONTROL NO. - Type of Defect 4, CLEAN SIDEWALK See reverse side for Defect Codes A-F REQUIRED See below for Defect Code G \\. I El Yes No 4¢�`�� '�� 1 .4-. TRIM VEGETATION u P�;5-61 4 REQUIRED lo, ❑Yes No 1 y ' ♦"a—► WATER VALVE ri / I ADJUSTMENT REQ'D ❑ Yes No , 7 r_. ,-,... -` " �� /' PARKS DEPARTMENT �" T �s < *6 REVIEW REQUIRED = v 3ar_ — _ ,O°'� Yes No v c AMItinedi,r' 7 Li I •f _ 'r �'_ Z. .3 'd S¢r-ee+ LOCATION OF SIDEWALK ❑ Front Yard ElSide Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet El Other DEPTH OF SIDEWALK '4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-:`f2,.n S F. 5"- S.F. 6 "- S.F. Class'A'- .278s2'S.F. ADDITIONAL REPAIRS 'CAI u LT Top �- CODE F - PATCHES i.:'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 : I2- FORMED POURED COMPLETED CITY OF ' :ATERLS0 SIDEWALK REPAIR SURVEY FORM 4 PROPERTY ADDRESS 409 61.X 6 ' Mgt ; 61- - — t ; -zi - a - Yo PARCEL CODE CO TROL NO.1 ='is" ' 'CL CLEAN SIDEWALK `\ `� 2 REQUIRED Type of Defect ';•C1 " ❑Yes LI No "at See reverse side for Defect Codes A-F I See below for Defect Code G ,, -',-.02 TRIM VEGETATION r ;ass "A =r3,3'�-3z.0 `_' REQUIRED 4x3.L,p1¢. ` ❑Yes C No �t 5 q = .z.4 -- _.. 1f' s°./1.44 '4� �S'.� -C C t'a s' ' 22 s 's ► , WATER VALVE .-1 a `I 5,1`�'`� °1'�.� ` C ADJUSTMENT REQ'D 4 �— s � � -� i ���- � ❑Yes [].No 1 x I 1 `V # PARKS DEPARTMENT ����� REVIEW REQUIRED - No L C\ ss A' '' ;I ' • ' • r / / f / , / / 32.4 J am \� / J/ ".4 , r LOCATION OF SIDEWALK 0 Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet DI Other DEPTH OF SIDEWALK C/1 4 inches ❑ 5 inches ❑ 6 inches kr `�'•' S.F. AREA TO BE REPAIRED 4"- 2 7.� S.F. 5"- S.F. 6"- S.F. Class'A'- ' ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes 'LJ No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ; ?3 Date: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAJ SURVEY FORM PROPERTY'ADDRESS P g3 ,at .�esa^� .t PARCEL CODE CONTfOL NO. , — .°� . Type of Defect A, t CLEAN SIDEWALK — See reverse side for Defect Codes A-F REQUIRED See below for Defect Code G I - '-`,` ❑Yes ❑ No TRIM VEGETATION REQUIRED bass'R"�t"�.y�'i,9-7.,- , \�r1 ❑Yes fl r i 3.c^' No �; FQ—► �. �.a==<i�•r': `l WATER VALVE a'� �� tg.c oar n=22., Lii ADJUSTMENT REQ'D r a �- A �. El Yes C7 No n -� ,_` 1\" A' i'Y AU.,,4' a;; PARKS DEPARTMENT ? \e` s'' u'' `' ` , CI: REVIEW REQUIRED is ci ,, �o •.�' — — ,o- ., �,, -; ❑Yes ( — No / i1 $ LOCATION OF SIDEWALK Ll Front Yard C_f Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5,3 Feet E Other DEPTH OF SIDEWALK IE inches ❑ 5 inches 0-6 inches AREA TO BE REPAIRED 4"-t 6 2.5 S.F. 5"- i 3'1, 1' vita, v; S.F. 6 - 7 S.F. Class'A'- �� ®I '''S.F. ADDITIONAL REPAIRS ''✓A v c-T -r c,P REPAIR_ _ vt. so a �14.2 s.F, DE Tc.c r#ALE w tot��ch1Cs = I2.e6 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 Date: -f; `, 3 -- FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5ce) 3tk 61Vc Mtn2C sr t el) - /� COopi NTROL CODE NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes ❑''No See reverse side for Defect Codes A-F I TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes 2 NNo t WATER VALVE ADJUSTMENT REQUIRED 44-0..+ ❑ Yes ©`No PARKS DEPARTMENT REVIEW REQUIRED cp1.4o C Yes Cfi`No — — 1(A" 5:501;1 A,s (c1.� LOCATION OF SIDEWALK iatront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet tether DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ' _ S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes LYf 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 : c Date: 9- Z11-t9 FORMED POURED COMPLETED CITY OF WATERL O SIDEWALK REPAk SUTVEy FORM PROPERTY ADDRESS _Teo ea e 4 6 5r ,' I - - - ex4PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK -- See reverse side for Defect Codes A-F J .T, R ❑ Yes See below for Defect Code G E No TRIM VEGETATION REQUIRED 4 ❑Yes ®`No Is so 111 WATER VALVE ♦ ADJUSTMENT REQ'D ( 7 Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑`No LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Cllther DEPTH OF SIDEWALK -0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4" 1 S.F. 5"- S.F. 6 "- S.F. Class ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.AU other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: - - FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS s5 G1_ -YCif4 ' �Z= -- -zS - d6)f �O PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑Yes I2 No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑Yes ®-No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Imo i I PARKS DEPARTMENT REVIEW REQUIRED ie ❑ Yes 0No -C- A 11,3x ,�= — — A A `�o ®` k ?-1 �. Ctiritit0 LOCATION OF SIDEWALK ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ®`Other DEPTH OF SIDEWALK Cl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4" ` S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES Yes "I ❑ No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : L s 1 Date: FORMED POURED COMPLETED CITY OF WATERLOO zyz, SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4:00 5jcii/v/02E: 57-- , - - 10 ! -009 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect CI Yes DI No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED Li Yes No t WATER VALVE ADJUSTMENT REQUIRED LI Yes 121-No PARKS DEPARTMENT REVIEW REQUIRED tifit N45) 0 Yes ZiNo I — — — — — biLltv) "41' 73 /11.0 Cv e. LOCATION OF SIDEWALK front Yard El Side Yard El Other WIDTH OF SIDEWALK 0 4 Feet El 5 Feet GI 5.3 Feet er6ther DEPTH OF SIDEWALK C7 4 inches 0 5 inches C7 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class 'A'- ADDITIONAL REPAIRS CODE F - PATCHES El Yes I1 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Kr Date: 9-- FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ./ 5-co 5 ci 41410, gl i 3 -.Z - fo i - l 1_° PARCEL CODE CONTROL NO. ' iii X'A x ei- a. Nil- `, `��g r CLEAN SIDEWALK Type of Defect 1�,. REQUIRED 4. S r- See reverse side for Defect Codes A F 'r- c 7 ❑Yes L?No — See below for Defect Code G d�s-Q . J ems„ TRIM VEGETATION �`1 REQUIRED 5. -L s- ❑Yes 2-No �. t,1 .4_ �7 a' ,�, WATER VALVE — � Q-- —► 5 4 e ✓l a, ADJUSTMENT REQ'D o®. ‘4., Li [ IVo - PARKS DEPARTMENT o REVIEW REQUIRED — ❑Yes L o _ Slcei e LOCATION OF SIDEWALK 0 Front Yard DrSide Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 0 Other DEPTH OF SIDEWALK 1]4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-27 -1 S F. 5"- S.F. 6"- S.F. Class'A' '' S.F. - . ADDITIONAL REPAIRS -- CODE F - PATCHES ❑Yes 15-No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : K 1 Date: 'Z+--l'21 FORMED POURED COMPLETED C OF WATER_Cil SIDEWALK REPAIR SURVEY FORM f 1 PROPERTY ADDRESS ' Z` -2i - 7izl - C!t) Z!- Z- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK -- REQUIRED See reverse side for Defect Codes A-F ❑ Yes ❑ No See below for Defect Code G _ TRIM VEGETATION REQUIRED ❑Yes ❑ No fif WATER VALVE `� ADJUSTMENT REQ'D i♦ ❑Yes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED — — _ ❑Yes ❑ No 5-iicAlv42t LOCATION OF SIDEWALK C1 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 4"- S.F. 5"- S.F, 6 "- S.F. Class'A- S.F. ADDITIONAL REPAIRS l//+) LT To CODE F - PATCHES El Yes T, ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: 19 FORMED POURED COMPLETED — CITY OF WATER O• SIDEWALK REPAIR SURVEY OR 1 /7 PROPERTY ADDRESS 1 S WA-n4.0,P 1 t1) -24 -361 - 910 1-1 Z- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect %1� ,L REQUIRED See reverse side for Defect Codes A-F I ❑Yes 0 iNo See below for Defect Code G I TRIM VEGETATION REQUIRED ❑Yes GrNo v I WATER VALVE N I - ADJUSTMENT REQ'D ❑Yes 12'No I PARKS DEPARTMENT ,v) REVIEW REQUIRED � %L5 •!�,��• ry�0 ��? ❑Yes L No 1 i 9 fd PE10C9 ;k ' �,/ k ic li otii, 0,61,ess:.00a,i c.,,r, , . ,A, - —) LOCATION OF SIDEWALK ❑ Front Yard Er—Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ©`5 Feet ❑ 5.3 Feet lather DEPTH OF SIDEWALK 4 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 2Z6,.O S.F. 5"- S.F. 6 "- S.F. Class'A'- 073• . S.F. — ADDITIONAL REPAIRS -- CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. r FIRST INSPECTION AND FORM MADE BY : 1C) /LT Date: tg-23 -19 FORMED POURED COMPLETED CITY OF WATE L.0 SIDEWALK REPA➢ 1- SU VEy FORM PROPERTY ADDRESS 3 f OMPo t/E 413 3 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F See below for Defect Code G ❑Yes No® TRIM VEGETATION — \ REQUIRED ❑Yes El No 1�t 4-- *--► WATER VALVE ADJUSTMENT REQ'D ❑Yes a No C9 PARKS DEPARTMENT REVIEW REQUIRED 4 • - ❑Yes In No LOCATION OF SIDEWALK Front Yard 1 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet l ? 5.3 Feet ❑ Other DEPTH OF SIDEWALK IL'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"-rnA/S S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS 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 bV27 Date: 10- `l FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .' ZOG Oil 7 ,rjkjP5UAi AV ' c.:c 4— PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect (fl Yes ❑ No See reverse side for Defect Codes A-F { r� TRIM VEGETATION See below for Defect Code G IV1 REQUIRED n ciYes No WATER VALVE ADJUSTMENT REQUIRED 41-0-10. c�' ❑ Yes ❑ No j I PARKS DEPARTMENT REVIEW REQUIRED f f Yes ❑ No LOCATION OF SIDEWALK L'1.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- c26 5-g© S.F. 5"- S.F. 6" S.F. Class'A'- _ S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes c #No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: ID-z e l y FORMED POURED COMPLETED • CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / t ! I -2? A -1-; ?7 1 ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect _ REQUIRED See reverse side for Defect Codes A-F ❑Yes ih No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes No WATER VALVE 43 ` ADJUSTMENT REQ'D j► a ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes N'0 No J — LOCATION OF SIDEWALK 14 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES 'p'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: FORMED POURED COMPLETED _. CITY OF WATERLOO O SIDEWALK REPAIR SURVEY Fa' PROPERTY ADDRESS .,60c T csA.65.c-vZ ‘;F _ s?) — q?l, 41( PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect 7 Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED I ❑ Yes ❑ No 11/4 At WATER VALVE ADJUSTMENT REQUIRED 42)-÷ ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 1-13 EYes CI No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet i] 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ci 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 3:19 S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : r Date: it., I 1/ FORMED POURED COMPLETED CITY OF kiVATER.L.0 SIDEWALK REPAI SURVEY 1 n PROPERTY ADDRESS` Z-1 &. 1\-F ►--ta a-k v3S PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect Yes ❑ No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED 'Yes ❑ No — Jt WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes I ':No 1 -'wvF c LOCATION OF SIDEWALK f I Front Yard ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®'5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches ❑ 6 inches r AREA TO BE REPAIRED 4"- 3 i6S.O S.F. 5"-_ S.F. 6 "- S.F. Class'A- S.F. ADDITIONAL REPAIRS 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 : "S 3 Date: - FORMED _ POURED COMPLETED CITY OF WA E LO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .e/ <' I rt - - 3 `f3 - 01 ' PARCEL CODE CONTROL NO. i CLEANREQUIREDSIDEWALK Type of Defect A See reverse side for Defect Codes A-F ❑ Yes 3 No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes 'ID'No T VL — ADJUSTMENT VE REQUIRED CI Yes CI,No PARKS DEPARTMENT REVIEW REQUIRED Li F i ❑ Yes 1 ,No 7/1 t--E) ¢mil�I e 1S � • LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK D 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ,d S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes I No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .- Date: IC FORMED POURED COMPLETED CITY OF @SATE' LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ./ 221 T !i G 0n. ,_sa,z Ave . — ?)91^ -2 3 z_ _ -cog _ (14 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect -iA ❑ Yes {] No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes '6 No -- WATER VALVE ADJUSTMENT REQUIRED — ❑ Yes I] No I I — s I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No — LOCATION OF SIDEWALK LI Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet VI 5.3 Feet ❑ Other DEPTH OF SIDEWALK d 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 37A0 S.F. 5"- S.F. 6 "- _S.F. Class'A'- S.F. ._ ADDITIONAL REPAIRS 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: ' l,a FORMED POURED COMPLETED — CITY OF WATERLO• SIDEWALK REPAIR SURVEY -RM PROPERTY ADDRESS ' i \ 1 L M :c. Ave _ ci:1 1 3 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect '_�- ❑ Yes El No See reverse side for Defect Codes A-F -- I See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes [] No 11/4 S WATER VAL ADJUSTMENT REQUIRED 4.0—* ❑ Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED — — — — ❑ Yes D No LOCATION OF SIDEWALK a Front Yard El Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet E7 Other DEPTH OF SIDEWALK _E]4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- t S.F. 5"- S.F. 6"- S.F. Class S.F. ADDITIONAL REPAIRS 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 : p' Date: «lZ l 9 FORMED POURED COMPLETED UN OF WA-E LOS SIDEWALK REP,A IR SURVEY FORM PROPERTY ADDRESS 1-Ii t p.s c r Ave . - — ✓ S�`�l -23 - 3i ." CCo`-1 C{-%a PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect �- — ❑ Yes L No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes la No -- WATER VALVE ADJUSTMENT REQUIRED 4-0 ❑ Yes 0 No PARKS REVIEW REQUIREDNT ❑ Yes SiNo _ ;L L' 1141 41 r. �1etile5oA Ave • LOCATION OF SIDEWALK NI Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LI 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- (55, S.F. 5"- __S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes -[ ,No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: o /3/I s FORMED _ POURED COMPLETED CITY OF WATERL.• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / ` e9 T 1io0/5oti1 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F ❑ Yes CTNo — I See below for Defect Code G I TRIM VEGETATION REQUIRED ❑ Yes ,f2No WATL A ����� ADJUSTMENTER VAVE REQUIRED 4° ❑ Yes LMNo PARKS DEPARTMENT REVIEW REQUIRED -- C ❑ Yes Er No 1 /1 7t ‘dyk) LOCATION OF SIDEWALK LY ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK 0'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 "- -I.1 S.F. 5u- S.F. 6 „- S.F. Class'At- S.F. -- ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes It No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ,k5 e Date: /0 3—) FORMED POURED COMPLETED CITY OF ATER OO SIDEWALK REPAIR SURVEY CORM PROPERTY ADDRESS 1' l l�r� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED O'Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUIRED d ❑Yes ❑ No -- 1 J( WATER VALVE ♦ �'r►,� I ADJUSTMENT REQ'D \ ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 1 � `Aft) — — ❑Yes ❑ No LOCATION OF SIDEWALK ®"Front Yard .© Side Yard ❑ Other -- WIDTH OF SIDEWALK E(4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 121 4 inches L❑55 uach"es ` 0'6 inches AREA TO BE REPAIRED 4"- ��e.LS F, 5"- S.F. 6"- - S.F. Class'A'- S.F. ADDITIONAL REPAIRS — 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. _ J FIRST INSPECTION AND FORM MADE BY : r' Date: / ` 1? FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2oo &X v 52I1 - d7Z-5 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F See below for Defect Code G - ® Yes ❑ No TRIM VEGETATION ‘1_ REQUIRED ❑Yes ❑ No -- ••� v WATER VALVE ADJUSTMENT REQ'D ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED c-e-tfrleti ❑Yes ❑ No 0,4 LOCATION OF SIDEWALK El-Front Yard ©`Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -L 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0`4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- '. S.F. 5"- S.F. 6 "- S.F. Class A S.F. ADDITIONAL REPAIRS 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: / ' ;/` FORMED POURED COMPLETED CITY OF ,o7ATERL'•O SIDEWALK REPAF SURVEY P.M PROPERTY ADDRESS t,� �uA--n0E4; ✓ C d -71 -311 — 06 ( 5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect REQUIRED See reverse side for Defect Codes A-F I ❑Yes I No See below for Defect Code G TRIM VEGETATION 1-I REQUIRED ❑Yes ❑`No -- T WATER VALVE ADJUSTMENT REQ'D — �Q � 1 ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No LOCATION OF SIDEWALK Front Yard 0`Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other —. DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class IA'- S.F. ADDITIONAL REPAIRS 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. f FIRST INSPECTION AND FORM MADE BY : 3 -1 Date: I " FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SU :VEY RIVI PROPERTY ADDRESS v 3 6. ViA ,1 -z - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A, (--.. REQUIRED See reverse side for Defect Codes A-F ❑ Yes ❑ No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes ❑ No 11/4 t WATER VALV �•.. ...� AD�USTMEt TE REQUIRED �(� I ❑ Yes ❑No -- I PARKS DEPARTMENT REVIEW REQUIRED I t ❑ Yes ❑.,No I � c 21,3/ 5,.) LOCATION OF SIDEWALK 0"Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0"5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches E 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 313.2 ✓S.F. 5"- 2 .X /S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS _ 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: _ . FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPA ': SURVEY F S RM PROPERTY ADDRESS ✓ '3 ,,+°l rUi ` - 3r2- - co PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect --- ❑ Yes ❑."No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G REQUIRED ❑ Yes 0 No WATER VALVE 4 ADJUSTMENT REQUIRED -- F �1 ❑ Yes ❑'No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No x LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet o 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- e. ✓S.F. 5"- S.F, 6"- S.F. Class IN- S.F. ADDITIONAL REPAIRS CODE F PATCHES ❑ Yes E No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ;1 :1 Date: /0"4 -4? 1 FORMED POURED COMPLETED �,,, CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS R is 14147- -- 9/3 - Z4- .3c - 001 AZ99 PARCEL CODE CONTROL NO. Ifi CLEAN SIDEWALK Type of Defect 4, G i ! - I REQUIRED See reverse side for Defect Codes A-F I ❑Yes q No See below for Defect Code G <-I 1,' TRIM VEGETATION 1= REQUIRED 1 ❑Yes 17 No \ , ♦.dir WATER VALVE ADJUSTMENT REQ'D .1I^ , . ❑ Yes XNo PARKS DEPARTMENT `, i REVIEW REQUIRED -- --- __. — qt_li;' — _411 � ' El Yes ( No _ ,: e._. :st"A'' 4vr,=e, J LOCATION OF SIDEWALK Ns Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet III Other e` L DEPTH OF SIDEWALK IS,4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 4"- 47 0 S.F. 5"- S.F. 6 S.F. Class'A'- SW, S.F. ADDITIONAL REPAIRS 7 7 l' g-y u.7-77r-iz = Z4 CODE F - PATCHES ❑ Yes ix;No No. of Squares with Patches — CODE G - D4• NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 45 1L Date: ID 4- J) — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAI'.' SURVEY F t•R PROPERTY ADDRESS ✓ 1113 — — 31Z- Ls. . PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect _ '' ❑ Yes L No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑Yes ❑ No WATER VALVE jI ADJUSTMENT REQUIRED — '. — El Yes 0 No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes El No .i LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑`5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 4"-2 ✓S.F. 5"- S.F. 6 "- S.F. Class'AY- _ S.F. ADDITIONAL REPAIRS CODE F - PATCHES El Yes ❑'No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ILT Date: <c... r f FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / 1 . PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F ❑ Yes See below for Defect Code G I C� No TRIM VEGETATION REQUIRED ❑Yes `❑ No v WATER VALVE ADJUSTMENT REQ'D ❑Yes °S'No L PARKS DEPARTMENT REVIEW REQUIRED .i ❑Yes l �,No Kei 1/4 \ ) .,;_ LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L:5,3 Feet ❑ Other DEPTH OF SIDEWALK l] 4 inches ❑ 5 inches ❑ 6inches — AREA TO BE REPAIRED 4 _ ° S.F. 5"- S.F. 6"- S.F. Class IN- S.F. ADDITIONAL REPAIRS 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: ftM J o . . FORMED POURED COMPLETED CITY OF WAJERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . / rs' y / PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect A- ❑ Yes ffNo See reverse side for Defect Codes A-F TRIM VEGETATION ( See below for Defect Code G I REQUIRED ( ( ❑Yes dNo WATER VALVE ADJUSTMENT REQUIRED —► 7 ❑ Yes E' o �,OC ( — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes EFNo f A _ — — — /41 LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet L14 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑inches Er5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 015,0 S.F. 5"- ,� y S.F. 6"- S.F. Class A! S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes Er No No.of Squares with Patches • CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : s �-�y� Date: AD- 24 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY'ADDRESS / c 05 PARCEL CODE CONTROL NO. Type of Defect A- CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F I ❑ Yes �o See below for Defect Code G TRIM VEGETATION \\� REQUIRED ❑Yes ❑-No tJI =- N --► WATER VALVE , 5 I r ADJUSTMENT REQ'D ❑ Yes D'No PARKS DEPARTMENT REVIEW REQUIRED �es No 5,W 0 LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet .f5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- riS, S.F. 5"- — S ' S.F. 6"- S.F. Class S,F, ADDITIONAL REPAIRS CODE F - PATCHES ❑Yes 1No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : P-5 /`S (E Date: FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY F MI PROPERTY ADDRESS _ ) -1 ! =B 596 -i4 - to ff -01.7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes [(No — See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes I No — WATER VALVE 1 / ADJUSTMENT REQUIRED 4— _.► IZI ❑ Yes 6No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes l o -A- - - lq LOCATION OF SIDEWALK . Front Yard ❑ Side Yard ❑ Other ' WIDTH OF SIDEWALK ❑ 4 Feet Ei 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 0'4,5 'S.F. 5"- S.F. 6"- S.F. Class'Ai- S.F. _ ADDITIONAL REPAIRS 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 : 25 Y-3 Date: (° FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / PARCEL CODE CONTROL NO. Type of Defect l CLEAN SIDEWALK REQUIRED See reverse side for Defect Codes A-F See below for Defect Code G I ❑ Yes LIe TRIM VEGETATION REQUIRED \i ❑Yes DI o WATER VALVE ADJUSTMENT REQ'D ❑Yes `B`No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes j2i No 3,0 LOCATION OF SIDEWALK 1Front Yard El-Side Yard CJ Other WIDTH OF SIDEWALK ❑4 Feet Feet El 5.3 Feet C'Other ,/I DEPTH OF SIDEWALK V(4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED 4"- S.F.4, 5"- S.F. 6 - S.F. Class'A'- S,F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes lNo No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : - /,� / Date: Z3--79 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 603 i1 b PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect A D Yes No See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes $1,No t WATER VALVE — ADJUSTMENT REQUIRED t— — Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes E No 6-.6 LOCATION OF SIDEWALK la Front Yard ❑ Side Yard D Other WIDTH OF SIDEWALK ❑ 4 Feet p.5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK fl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- _S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : , .5 Date: / - m FORMED POURED COMPLETED CITY OF WATER._O0 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / t364- U C41 - 1a -col 4 54 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A, o ; REQUIRED See reverse side for Defect Codes A-F I ❑Yes ®'No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes KNo �� WATER VALVE `� . I ADJUSTMENT REQ'D a ❑Yes ®'No PARKS DEPARTMENT _ REVIEW REQUIRED E1Yes El No LOCATION OF OF SIDEWALK front Yard 217Side Yard ❑ Other WIDTH OF SIDEWALK El 4 Feet L'S Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 2/4 inches 7115.inches ❑ 6 inches AREA TO BE REPAIRED 4"- S.F. 5"- 5.5 /S.F. 6 "- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES El Yes 6o No. of Squares with Patches CODE G - NOTE :Areas marked with an"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: /D , FORMED POURED COMPLETED Cfl( OF ' r ATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' 361 ;,oJ i 3413 -2,f- log !�` ;a PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes eNo See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED 1 I ❑ Yes a'No — WATER VALVE � ADJUSTMENT REQUIRED -- I � � ❑ Yes ?I No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No A A — — - — 50 tiA LOCATION OF SIDEWALK Cr-Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet Cfi5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK K 44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 9CP° S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ZlIClo No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : it S Date: /10-24-1l FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REP, ,IR SURVEY FORM PROPERTY ADDRESS . r" 3 t 5' t/d PARCEL CODE CONTROL NO. CLEAN SIDEWALK 1 ype of Defect REQUIRED See reverse side for Defect Codes A-F ❑ Yes 0-No See below for Defect Code G TRIM VEGETATION REQUIRED ❑ Yes ❑'No "`4 WATER VALVE 31s ADJUSTMENT REQUIRED I� ❑ Yes R No I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet [ Feet ❑ 5.3 Feet LI Other DEPTH OF SIDEWALK C(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ° S.F. 5"- S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes ETho No. of Squares with Patches CODE G NOTE =Areas truction marked withoffull ansidewalk"F"may be repairedpanels. by patching.All other areas shall be repaired by recons FIRST INSPECTION AND FORM MADE BY : Date: _ 10-Z4119 FORMED POURED COMPLETED CITY •F ATERiO® S DEW LK REPAIR SURVEY FORM PROPERTY ADDRESS 3/e PARCEL CODE CONTROL NO, CLEAN SIDEWALK REQUIRED Type of Defect A X ❑ YesSee reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yes 2-No — WATER VALVE 4 ADJUSTMENT REQUIRED — P� ❑ Yes .©'No /jam I PARKS DEPARTMENT REVIEW REQUIRED /1 ,-1 'es ❑ No LOCATION OF SIDEWALK -El-Front Yard ❑ Side Yard ❑ Other '— WIDTH OF SIDEWALK ❑ 4 Feet -in-5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 64 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- 50,6 'S.F. 5"- S.F. 6"- S.F. Class IN- S.F. ADDITIONAL REPAIRS 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. n FIRST INSPECTION AND FORM MADE BY : Date: ( Z 1 I 9' FORMED POURED COMPLETED CITY OF WATERLOO -- SIDEWALK REPA SURVEY FORM PROPERTY ADDRESS - 3 /4t,V FL y13 24- -40+ - PARCE_CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect , REQUIRED A See reverse side for Defect Codes A-F �� ❑Yes ckicio See below for Defect Code G TRIM VEGETATION REQUIRED .\� ❑Yes 2-No `. WATER VALVE ADJUSTMENT REQ'D a 313 I ❑Yes (0 No PARKS DEPARTMENT REVIEW REQUIRED n — — — — — — ❑Yes o lott aliVCt1 LOCATION OF SIDEWALK itiFront Yard Otide Yard ❑ Other — WIDTH OF SIDEWALK ❑ 44FFeet I Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 1? inches Lev inches ❑ 6 inches AREA TO BE REPAIRED 4"- C®, S.F. 5"- a5°® S.F. 6 "- S.F. Class IN- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes CI-KO No. of Squares with Patches _ CODE G - NOTE ;Areas marked with an"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 z4V FORMED POURED COMPLETED CITY OF WATE LO• SIDEWALK REPAIR SU \'EY FORMPROPERTY ADDRESS . ` -53 i� - - 10 - oIz— PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ❑ Yes C-No See reverse side for Defect Codes A-F TRIM VEGETATION — 1 See below for Defect Code G I REQUIRED ❑ Yes 121-No — ! WATER VALVE �-`- ADJUSTMENT REQUIRED — 4( 133 ❑ Yes ®'No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes M No /4'6 LOCATION OF SIDEWALK Er-Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 1 5 inches LI 6 inches AREA TO BE REPAIRED 4"- S.F. 5"-_33,0 'S.F. 6"- S.F. Class'A'- S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes El-No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : c Date: /1-Z4 9 FORMED POURED COMPLETED CITY OF WATERLOO ERLOO -- SIDEWALK REPAlH SURVEY FIRM PROPERTY ADDRESS ✓ 4c 4 6(0103 -2*-- Io Z - von PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A A REQUIRED See reverse side for Defect Codes A-F I ❑Yes �I No See below for Defect Code G TRIM VEGETATION REQUIRED ❑Yes 2-No z WATER VALVE \N I a ADJUSTMENT REM) ❑Yes ell() PARKS DEPARTMENT REVIEW REQUIRED QYes ❑ No 11--4 - - A-- - 411 to z- 5.2 sr° Liut LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 15 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK inches LI 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ft :3 S.F. 5"- S.F. 6 "- S.F. Class'At- S.F. ) ADDITIONAL REPAIRS e0b-1 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 : 25 I"Iy� Date: (o-244 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . 43 PARCEL CODE CONTROL NO. CLEAN SIDEWALK n REQUIRED Type of Defect At ❑ Yes ,B' io See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G I REQUIRED ❑ Yeso WATER VALVE fi I ADJUSTMENT REQUIRED — t' !� ❑ Yes ET No I 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes errNo 9.6 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 2'6 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK -61 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4"- ��• S.F. 5"- S.F. 6"- S.F. Class'At- S.F. ADDITIONAL REPAIRS — CODE F - PATCHES ❑ Yes i 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 : ` Date: N''"2 l/ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS . -3, i3 - - !OZ- oo7 44 PARCEL CODE CONTROL NO. CLEAN SIDEWALK REQUIRED Type of Defect ri Yes a'Na See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION REQUID es ❑ No 4 ( WATER VALVE / ADJUSTMENT REQUIRED E ❑ Yes _ I PARKS DEPARTMENT REVIEW REQUIRED El Yes .44i1 biers, LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard .4?rt5ther WIDTH OF SIDEWALK ❑ 4 Feet 7 b Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches inches AREA TO BE REPAIRED 4"- S.F. 5"- S.F. 6"- S.F. Class IA'- cQ7 5 S.F. ADDITIONAL REPAIRS CODE F - PATCHES ❑ Yes No. of Squares with Patches CODE G - • • NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : '� Date: -14-19 FORMED POURED COMPLETED