Loading...
HomeMy WebLinkAboutREPAIR LOCATIONS BOOKLET PAIR LOCATIONS 3 BOOKLET RE FOR F 2018 .S, SIDEWALK AIR SSE55 RA A (1611',:igs4111111r."": 2:::::11 kfati rIoo CONTRACTN . 931 Illo m a) t< U d N man CITL • >a aao <a _ > a wi 111111111111111111111111 o ) ii N= .. � IIIIIIII ca LLI CI 'co i _ , iii00,...sistmomma . co a N o o c c a > > N o o -. N a N 'Pi, a) a� a) a> > a,Q Q Q m co U N a) m o > > Q Q u c -3 .. � N ,- o a� y N N Q `L ,p m C -C N o i ..s -� o c o 0 0 % 0 - NNN , , ` o t -c uN.- ) o J Qm rn N cc mcc o r '" c �N o o Yy NNNNo 5 8W `W < < < o o QQ`nZ � � p a, o W m 41 d o m -- N NN N ai m ay�� .� y NNNN � ,_ .c .c u o < < co Y . •we � ` d NNd. .0 ,n � 0NNNNN a ms. yNNcoNco �L r �rnrn°> c'' * �Wu1 ` u1 01- ono 0� � Lotolc) ,� � -c y c0 � LW t' cr> p6p W n Mcflti cc)) � d Q.- d' `n in k t � W LtJ ai 8� W c) t• uj W W rn d ,n p ON p r N M N M M � at) t)1 W W W W I" Y Y uj Uj W 111 N N d' d N N N p ` O N �, -(`? MN�cpc:DN 9NNN �p � NMM to pp � Nlo�o��p ��No Q. N M CD N to O NMd � N pp � lO 0 o�9p0 c� i 2>����` oop 6i61ic' � p '" Opp p N Wr M Sr. 1` NNN- ram pppC? CcVV? � N OpM pp p O d o • 1` M. NNLh O p CM c? C? N N c' co c) Np • p0000p ``` d, d) t7NNNNN co cs'-1 V-6) prnpm � To `O�99{OOO d M � M�l�< < d,� � NNN n1 Mcoco ``�. ��; c CO��coo aop� co Do -o_ Q: Np MpW MM M ` t NNNN MM pp CCD O CO LL111W (ON� M � d, 1) .� NN NNN.,I.� MM `� ,r �� prnp� , cop. r m d' N co co r `� ; rn c M co 00 NOUG� NNNN cchch,2<<< O;� ��� � MMIII Oil CL: U Z� O� U r N lila 1)137.):_ z AssisigisitillO _ -.' 11111111111111111111 111,11,10 Re ti- '; liiiiibuittrifirc- iiiiaIia1 ' ..... 0 4 ca QQluuuutauuu ' > Itl$lil' _0 0 Oa ,) issisillin Ca QJ a) - = a 111111111111 N W U N "It 0 1:16w si _ S a II 111110151 a) N � r a) 0 0 > > c c a) c)0 0 o c. c c o oWQ > Q.0001) Val e a) . -a m N o ai o > > > o 0 o N U N a a v o cnN m Eo s _ -- NN `" 00 000 -c o0 0000U U o N C� o m -C N a) m p 0 ` N N (n N co a-Op"00 a) a) a) o 0 0 0 -� "n 0 7 of, - N N o 0 0 c c o 0 0 0 '0 m ca m M a• 16 0 0 0 0 0 o U U 0 o) Ce 000 > go c = = 0ac) o > > > oo -0a � m(zcaV 000c9aR 00800UVUUUtiapOo 0 0 cG0 0a) a) > > > > QQQ oom � 000000 0p0UUUUUO - Nc•—• rMa o c 0 a) 0 > > > > Q Q a a U o a o a 0 0 0 U U U U r o ` N N a ❑❑ N QQ ��QQQ N N N a) a) 0 0 sQU V U �N� O CONO NNNNNNNr r N B Q v 1 a• `- a`) m 'S S ril mmCD 1, OONNNO NNO ` r ,rr ) 1- 5"3m - -- cpu)m o�m cc00(') `"OM � � � � � ~ Mr � cpe `` op0004 �0; N co r �.� C V N N N I- N ` p N 0 O p p 0 0 0� 4- (0 p 0 c N N .c6 — a. ` ` - � O `M O p O p p O � �o p` cn N (D-N �p N N ��� N N N N ti O O r 0 O O N N N O CO M r r ,0 1C' N CV N M chi 00 pO00O' 0000 cM t00M rchr p00 MNc•IN C. ' ch 0- 1 N0 ppO 900p00i OD (000M MNNM� � rr � � 00 �0 M � � ? ' ' C�< < ` pp47 N 009,, 0i 00') CTO � (00 MCOO ��< <" [n �000 co 0 MMOO t�cv co co � OO� � CAM � � COO N �. J e6 O ,-tip r r ! p O O 0 M M 0 O N N N r N p 6) -. W M W 0 To co CD 0 U m rt Cj pO C0`� C*;O ci c? c NNN Nr rr (fl 6) °)co M 0, O O0 Oc0 O O � OrN 0) a = MMC? NNN ! ! `.r OOCP � Oicopj °° c° NMd Mc cn N co co rN N — az coM co000000 o co 0 00 NNN `o``d! d lrr ` T C0 N 00 `-- `d r r ,-- O ` '� r W rN00�0000 .rrr ct m co O~'1 O �. r - z-' O3 z U r Co I 1iliiIliliiliiiiIiliiiiill r U 4 t cacao > a 111111111111111111111 I aao 111'lIillliIlIi'liiiIlI'lIIlI isi �a�U� 0 aQa. iiii salli so stail sill 1 ilitilitillilliti it. _ U �4 U 'l'l"l'l'i'Il"l"II"iiI"lilliillil Vfoof ccNa co m o > , , > n c N o `� c �'- m Z Z c Q, c F, c c S t N a) N cn N o Z a) � cca) 0L °j0 > > > > c � . %\\ U N acno ° 3 3(73 NN• NN co E - a� � orn rn N p rn oco oca oc`ocoNM �' MM p o N ill cr) U U U U U U p 0 N ! N M M M co N c M N Cl) r �, to p Fs) p ! M p of M M p p 0 N tn — p ua o p N p O _ O O O,is r N O ,. Q LoM -, p6) N ,_ 0 000OO p, O� c,M0 N �O NNN COV, iCUN � � CO Q'.� 0 � Np9l - NpNOOpON06� d' (CO pV� � Cn � NNN : tf') � � NNNNNN o- �, NOopO pi O co� � COO NNOO MM MOMC`; M p' pO � NNNNN McnMlCn � � ,� �� 6� ca p' OO NNNN NNMM pOOca MM.MN MM �- � `"- O pp G7MMM 7i J uld- 0ppN NNNNNN � pOONo MMMM NNMCn ` -. � O � � W W paDM a) CoWO NNN , � LJ N NMMC? NNNN r p6� 61 • • CO ca � � � NNNNNNN MMMMM <- c N � � apoO � MpMMcoM • N — O- Z M M M cM'M M { --6� cl)0 O 0) M M M M M M p M O N p pd- O W M M M M co p N M p O p p p 0 N N N N N N N N N N N N N N N N N N N N CV N N N Y — e6 0lc"9 Yop T� cNi coco ! ` ! M op,- pppp � < < NN 2 = P. Z IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 0 jI .c - • 11111111111111111111111111111111111 - DI o IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII g¢ > Q IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII _ ni IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII _ Y IIIIIIIIiiiIIiIIIIIIIiIiIIiIiIIIIIIIiIIIIIIIIi JU N W 11111111111111111111111111111111 i _ a ii iiiiiiiiiiiiiillgllllllliillllllllllllllll 3 - riiiiiininiani N IIIiIIIIIIiIIIIIIIIIIIiIIII ) - li!M a� � � � � � inin (� NN , U Y 1 U) L' t "%1 Nn U) G C N N N 67 (n N NcCC y N U. ''t,. Y p � � a �i c . ccLo m m m— ' Y (6 tY' ' Il. , ll. . LL OO s LL O p oN-, _ o ' M w0o pOO • LLLLLL � • QLL LLLL LL IL OON CC C • M C C O (O (9 N d O p p 0 N MNO CMO O N � O MI N { 00Np U) C 0 0 CL) O � 000 NO O O O O ON M N N M O p000p p 0 0 0 0 0 0 Ops- M N O NNNNNNNOOO d � � � � O (D o0 U) NU) MU)N U) NU• mNNNNNNrx �o• it'sU00 m a00 O W W °� c0 co A Z."� M M U) N M M M M w rn 0 0 0 0 0 0 0 Om opo 0 pw o00 opo a0o Om 0O W U rnrnrnrnrnrn moo co co comco � � � � � oomcoo� coao M r N N N to M N U W OMO O") N o M O M MMM M O M M M M M N M M M M N M M M Z n N N N N N N N N N N N N N N N N N N N N N N U h T i J Z Q O N till'N 11111111111111111111111 _ 11111111111111111111 Uo Q 11111111111111 11111111111111111111111111 massolossiona N U� U� 111111111111111111 I '-a 111111111111111 ft� filialliall011101.1.1.1r ummum"" `� c N U U U U V C C C C N . . NCN N ruu1 " N , U N > o ,N mmaiU) a m cN c N N m0NN C C 0 O r O C . N , ' N 00 O CC- LLLNO NOOh 'd' OMO N N O M0cNOE h' ONO N • d N� N N N �� p00O0 � O r O N �` d � OOOd' O OO OiO0000OO NN in1 MM � M NNNNO � 'r' rot N N N N N OM O N N MN NCV N� O, lM ` rrrr11WAitA N MMMMl �,.� N ��W mNNNp0 MNM �O) � � � � MOO.M W W M N Q 7 N N MN N N N ��0- Z 00 � � MMMO �" O W co N ce m N, coC io M M M M M M M M M M Z 2 M M M M O 1111111111111111111111111111111111111111111 111111111111111111111111111111111111111111111 ' - W Z J W - ❑ '0111111111111111111111111111111111111111111 will1111111111111111111111111111111110 q1111111111111111111111111111111111111111 11111111111111111111111111111111111111111111 J ❑ o U (n— •— Uiiiiiiiiiilllllllllllilllllllllillillllllll U W Q U � N a a, m m Ce (n N �J d � � � @ (tl (6 • J J J . N N N O ❑ O N U� ' . N N N N .f�- w J N N N N J J . N V — ❑¢ 'D '� '� N . N • @ c6 (6 " N N Ul N ' N O J J J N m c6 c�6 c6 N c6 N cE N • ,�@, m "" F N j Id c6 N N J N J • we d O c0 J rn U (6 c6 W '6 'aa • Y C • YYY (0 JJQJJQJ J JS1 � .fl t.C) rMrn C C C f6 O rn 0 0 0 0 (U rn N ( (O N M O N O • JMN (U (O ON N NOOOOON � '�' � N ( � • NNN fn M O • O O O O O • — rd' M O N Ornrn • rnr r C N E N M N (U O M M O (U O N 0 0 0 O N O O O Q ,d, �' m p) (.j c'7 O t : g M M O O MM M �OC9 ; , ref r- M _ N NNN N N N N NNN N T N ON O M M M M M M I� r M M N N N N M• T N N r �' r r r r r• O OO N N N N N N N N N N N N N N N N N N N N N N N N N N M M M � � � LL7 t() � t0 � �• M MM N N N N LL Z N NNN M ch c� ('� M M M c� M c ch ch ( ch M M M M c� C'') M r7 M M ch M c� (`� (`� m C� M N N N r" rn rn rn rn rn O O O rn O O rn rn rn rn rn rn rn rn O O rn O O O rn rn rn rn rn rn rn rn rn rn rn rn 3 rn rn 0) Orn rn rn rnrn N mm0000cocoo� cococowo� oomwoocococomo� o� wo� coco � c0000� oomo� wmco � oocomo� como� m a J � co NMd ticorn M V (flN O W corn v (ocorno N (O Mvmti MMMcpcU0) rn rnrnrnrn (U (U ° 0000r m O NNONd in (oco nco (o (o (ocotin � r � ti Z d d V d d O T iiiiiiiiIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIcn _ • i'111111111111111111111111111111111111111111 DIIEIIIIIIIIIIEIIIIIIIIIIIIIIIIIE — '¢o > a IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIM — HMEIIIEIIIIIIIIIIIIIIIIIIIIIIE W W iU 0N2 a ii Ct U — ca IOMEIIIIIIIIIIIIIIIIIIIIIIMI a� IP ii1 a U iiiiiiiIiiIIiiIit IIIaIIiiiiI1 — N a N N NJN(JN4 N NUNd Nt1N4S 1 N@uN 7 NcCN0O N(NCNO . n 6ti[Ni) 1 u)Illt:2:w2:::::: : ::o : :i: 1 w. zi ? JcN JcN accOM c — ) m _ ¢ QG QaQ a Qa o _ O J YO YO NJ O N T J COJ p NNcaD JY J J J JC Jd `CO`cNA I M N O Un COI � N p p O O M UN') Uv rMooN ti 6) 00 `- O 00NNNNN • OO O • OOOOOOMVOO MON O O (A O 0 0 0 0 0 O U) U) • U) Op Mp 0 000 00O pOOO000000000000 � NrrNNd. N ,• NNN • NNE L 0 0 0 r UN UT �, a. C UV N M NNN U6 _ _ � to Un � � � ` N r � Y I� I� I� N � M' N N N NM N N M N C`? V M �) C7NNN_000000OOO �--M M M M M M M M M NNNNNN •• M Lb •• W— 3 OC� UTUP UTUD UWOO6) 6) � (A 00 O M M N N M CO CU O N M V' U9 N- fA N M d' Un UO Up W W M Q m W O N N m N N N N N M M M M N - U) UL[) U) UU) U-U) Ulf) ULU) UU) UU) C UU) UU) C UU) CCU) UCD UU) CD UMU) LU UMf) UOU) O K m co U) N r r Ub M M M M M M M M M UU) M Un Un Un tU) z `L Un UU) UU) CD UU) UU) Ln CU) Uf) UU) In UU) UU) CD t() Utz o ; I F- J za — . N 'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII — DIIIIIIIIIIIIIIIIIIIIOIIIIIIIIIIIIIIIIIIIII — Sao > a IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIE i MEIIIIIIIIIIIIIIIIOIIIIIIIIIIIIIIIIIIIII i1i c6 __— — I _ �Ha W o J � uNi U t!) c4 iiiiiii111111111NEEME — wQwn� ' O. . o ma) . . ., `� a� ma� mm � ro6�O Cn NN L) U) d o 0 . 4., N a) d UJ Cn N N N .' Sn (n to (n (n N CW0.' > c a Qc c m a) o m 8. NI. . OoO &55 ZU) 1 °)Ll o > O N N o0 0 o00 oo o'Y S cG , 0 9 O N O rO M C d N O O O O O N N M M M M CO N 0) 0 0 0 6) O 0 N � ppN00000 _ N NOM N CO CO (0 I� N r O N O 4) I O O p 0 0 N M M p O O O M N O N O N M M N O O N O p O 0 N 0 0 0O N — p M 0 0 to O M to M N 0-Np O O N N 0 0 0 0 0 0 0 r O 0 N N 0 M Q N O O O O N N N N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O 0 0 aD 6) O) 6) N O) N N ` M T „ O O O O O O O O O O V' CO (O h W M ` cM- ` M ` r r t!') c0 00 6) 6) N O O N N O O O O ` cN-- M t!) to to 0_ —) M N ` O cfr 0000d' W W O N M M N N N N N i m r N N N N to to 0 0 0 0 0 0 0 M M MMM N N N N M 0 M CO CO OOOOOOOOOOO � � � MM a- , O O'� W W 00 c0 co c0 aO o� 3 r 0 0) d1 0 d7 6) of M r O O O 0) O O O (0 (0 W W CO M M c0 O OJ o O O 07 O a1 07 O d1 d) O M 07 00 W � M W 00 W CO c0 W O W M a0 (� c0 M d' � (0 I` CO O O ¢ � V d' rY co CO CO 00 01 -J N � NM � (9OOrNMI� ONM 'd_ � N NNMMMMMMMMd' d" coMMM N O 0 W CO W O M V 0 d) O CO CO O O O O) O M M D M M O M Z O N N N N N M (0 (0I (0 (M) 0) in to i)) CO C' (0 (-0 (0 NN0 [NN (N0 CNo M O c0 c0 M O r O O) a) I 11111111111111111111111111111111111111111111 DIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII e11111111111111111111111111111111111111 rlIllatIIIIIIIIIIIIIIIIIIIIIII 11111111111111111111111111111111111111111111 NC 2i UQa U � �ill1111111111111111111111111111111111'� ws - 1 N - 111111111111111111111111111111111111 - • Ewa waU = • w ❑ : � tN `r N O N � � � Ii \ I N N (n(n a) N (n N N N N N ' N N N N O cn N cn U _ co m m m c�°ainicninin < cn (ncntn s � �a) a) a) a a a a y • Y yYo � m m m m a) a) a) a) `, cG ' • Q S�Q m m m j N Y Y Y Y • 0 0 0 0 0. s � g —a ' � � � a ; mz � aaan as � n � rn 7O 0 �� � Q ' L.)( ZZZZOtOONd CO (MOp � ! O O NMM� � cG' Opp . NO M� O l � d '� d' ,rN NNMMN_ • Od' �' • N VM' CO CO CO 'r N Nr E r �- h CO O d' N N h hQN M h N O O Oi ' h M M MNN N NNp 0 0 p 0 0) 0)0) 0)N itca O M 0) r O r 0 r r r r r OO' p0 0 0 N NNNNJ � � � uj � of � �� �� � � N N N M O O O OOO OO � MchMM M MM G MUm � � � t.() to t!') tnN �� NNNNNNNNO NNNNNN ��� OOO � � �� � � W c0aDm_ QM M c� c� M c") M M M M M M O ON o0 0�o� °� c0 °� of o7 �O M °� MQ- Z 0) 0)0) O 0) 0) Om 0) 0 M Q N o0 W• M a0 M O M h 0 p M t0 O N d' N N N N M M M co ti -r h h N h ON — 0 m (O (O CO CNO CEO (O (�9 [hO CrMO CMO COO COO COO N h h h h h h h h h h h h h h ti Z � � CO 0 0 O � cn I N LL1 Z J W 0 111111111111111111111111111111111111111 - qillaIIIIIIIIIIIIIIIIIIII - mllaIIIIIIIIII - illIllIllaIIIIIIU - 1 U 111111111111111111111111111 aQ. 3 — NQ J s � � f° — MINIIIIIIIIIIIIIIIII iiiiiiiiiiiiiiiiiIiIiiiII!iliIIiIit — • _ r _ O � � M N N � � N O _ N — (n (n U ' (� N N N N N N 4) 4) (n ' i) (n (n (n N p (n (n U1 ' N N lJ.l � p p N O p O p N `) E N N N N � � C �, � � � EE � . E 000@p000 inin cn rn o 111 ' r m a) � � � o E E E E E ° E E E E U — NC) 0 U O o U) w � N � � cncn � � � � cnUUUU � � � � Y E cA m v N cn cn n cn c > j stt � � t � Y . � � iAcocoNW a rrnoo � � o N o 0 � 0 • N0 00) - N0 � N Nor ` 0N00 N N00N0 NO (00000 0 00) 0 • O) r— NNN NM M � I i m ON N N N0 0 N 11 N NN 0 0 M 111 W ON0 O N11 O Q In N M 'd' � CO I� OO W Z ll.l co r 0 N CO C00 N N NNN N N W h r N 0 O O 60i 0) M 0M W W W W c0 W N N N0 W W W W d' to _ cO 0 cO o0 CO aD CO cO C0 6) Of� ti h 1� N wm NmcoNNNNNNNNNNr Nr Z � ti � tititi O 7 11111111111111111111111 11111111 W Z Q Q) — F-O — 111111111111111111111111111111 W — W Z d � W ~ O > Q W W H J = � aQ J W Y 10111111111111111111110 U W 1111111111111111111111111111 M �_ fn Q N cn Q 0 O _ U N ' ai p- Y u7 — WR Q U Ea w w o 111 a) _ wow J U v U � S rn _ co WQ U • rn — -6 Uto sO 0O ❑O ❑o(O ❑No 9❑ow ❑N Op 9pp 00 0o ns0(0 O I )U � cf) E WiUoU ❑NQQ 6� WwILILLLLLWyYr4rnU 0 a a a 01 t°0a0 NCoO � po0t00` � � � � 0) 0) Vow a) E N N T N O O O O O N O O N O w 0 0 h O r (O CO d' M to to M r' O O p Q O N O O o 0 0 0 0 0 0 0 L O O 0 0 0 0 0 O O O � � O � Oi pi 6th� t O' O p 0 0 0 0 0 0 0 0 N ti N N 4 w N Nc6 w 0 0 N 0 0 0 N c, M O O D �C7 O N M N N W W N pM N O N N 0 M N N M T r T r r r r r N N p p LoO O O O N o M M c7 M w w w w w w w w w w w w w w w w w w w w w w QO N w w c0 w w c0 c0 w ;6 in -J ec— N cM d' 0 w N w d7 O N Q N M d' tL')[0 w d7 0 • m N M 0 0 t0 N 00 O O r E— 0 co Ln 0n 0n `n `n of co co co co w co m w w w ti N ti r N w w Z w ww ww w w w w w 00 ww ww wco corn ww ww ww ww cow ww O P, CITY OF W K ERL•O - S DEWA K REPAIR SURVEY FORM PROPER TY Y ADDRESS 30/ LSD 577- � 3 02/3 -04 e - I a CONTROLNO. PARCEL CODE - \ • _- -..-7, Type of Defect 9CLEAN SIDEWALK See reverse side for Defect Codes A-F 0,4 ❑ Yes Li7 No See below for Defect Code G I 1 TRIM VEGETATION \ R ❑Yes Kil No 0 if �{, WATER VALVE — �" '�f-" ADJUSTMENT REM//��, I El Yes ®,No 1 PARKS DEPARTMENT REVIEW REQUIRED u- ❑Yes 1W No _ 42 E,______ _____ — LOCATION OF SIDEWALK pq Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet LI 5.3 Feet ti Other f�;� ❑ 6 inches ���5 DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ���; �� fia AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.f t. 6 in. CODE F - PATCHES W Yes ❑ No No.of Squares with Patches 0--- - CODE G - — NOTE:Areas marked with an"F"may a repaired by patching.All other areas shall be repaired by reconstruction of fulls p 3-Zq ! FIRST INSPECTION AND FORM MADE BY �Z-1 �b5 Date: _ PERMIT ISSUED FORMED POURED COMPLETED __ SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 44Z- 4--p4 . 474 /. - e,1 -zel e v of 7 4- PARCEL CODE CONTROL NO. — Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes ® No 11-1* TRIM VEGETATION Nt, ❑Yes I� No ......,0,. co j, a WATER VALVE v ADJUSTMENT REQ'D — I Z ❑Yes Q No PARKS DEPARTMENT °`� — _ REVIEW REQUIRED Yes El No MI I •/ ///1 0 #lkefa�,n' 5 g' ____ , 4 . -5-/- LOCATION OF SIDEWALK P2 Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet ❑5.3 Feet F4 Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches ❑ 6 inches its %q" AREA TO BE REPAIRED 10 9, Z sq.ft. 4 in. _ --_sq.ft. 5 in. sq.ft, 6 in. 5-7 i 3_ -- , CODE F - PATCHES ❑Ye ��j s El No No. of Squares with Patches — CODE G - NOTE:Areas marked with an "F"maybe repaired — r z._ full_id by patching.All other areas shall be repaired by rCLu„buuCi,u,i of,un sidewalk panels. FIRST INSPECTION AND FORM MADE BY : — Date: PERMIT ISSUED FORMED POURED COMPLETED or Z CITY OF WATERL“ 7 SIDEWALK REPAIR SURVEY FORM PROPER( ADDRESS - 8 1 - 29- 3(.0- O9 a PARCEL CODE CONTROL NO. CLEAN SIDEWALK ❑Yes ii No Type of Defect — See reverse side for Defect Codes A-F TRIM VEGETATION I See below for Defect Code G— ❑Yes fix' No I WATER VALVE — \ 10 it ADJUSTMENT REQUIRED ❑Yes fl No .4...0,—+ I i 4,— PARKS DEPARTMENT I REVIEW REQUIRED x'gYes ❑No — — \4a,700'6.'la ee / o e t i.Z "6.r LOCATION OF SIDEWALK L4 Front Yard Side Yard A Other ---- — OF SIDEWALK 0 4 Feet 0 5 Feet 0 5.3 Feet 10 Other .--- WIDTH �_6 inches 1 4 inches 0 5 inches r DEPTH OF SIDEWALK / — sq.ft. 6 in. AREA TO BE REPAIRED sq.ft. 4 in. —54 ft. 5 in. ---- CODE F - PATCHES ❑Yes g No No.of Squares with Patches ---- — CODE G _ re aired by patching.All other areas shall be repaired by y be NOTE :recos nstwct on of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3_ — PERMIT ISSUED COMPLETEDFORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS z ( 3 • Z—Z—3 E tit _ E 13 —.-; PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑ Yes ® No I See below for Defect Code G I I TRIM VEGETATION ' I ❑ Yes C] No WAT — F ~ ADJUSTMENT T REQUIRED /j \ 0 Yes ® No I ♦ I _ I PARKS DEPARTMENT REVIEW REQUIRED `'3 6.v 5. ; ❑ Yes ID No /�`I sa ` i— — — `�_ tom, l `� yyi•Js�azs,w / i 14.1 -II 1j/:/1 ��/e •�-- ,nr---- ---7-7-/t/ - ,'.. ii if -:,;-,17513--- �` LOCATION OF SIDEWALK ea .si7;j , 14,."7 Ci,g 4• t:I r 1 kir-. 5 i De �� - 0�:7'_ Front Yard 0 Side Yard 0 Other WIDTH OF SIDEWALK --- ❑4 Feet ❑ 5 Feet ❑5.3 Feet M'Other _ DEPTH OF SIDEWALK ll 4 inches 0 5 inches AREA TO BE REPAIRED 2 8c�•,�' 0 6 inches ----sq,ft. 4 in. sq. ft. 5 in. — CODE F - PATCHES ---sq. ft. 6 in. ( Yes 0 No No. of Squares with Patches ✓ — CODE G - - NOTE:Areas marked with an reconstructionreas marked "F"may be repaired by patching. of full sidewalk panels. FIRST INSPECTION AND FORM MADE � All other areas shall be repaired by — BY : - gay Date: 3 -23-(-7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOS — SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS r� 2)3 CONTROL NO. - PARCEL CODE CLEAN SIDEWALK Type of Defect ,, ❑Yes ®No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes Cal.No — _ 10 1( J i WATER VALVE ADJUSTMENT REQUIRED 4.—Q--► ,3;` ,J' `' ❑Yes g No I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes 2 No0 — \ • %, I - - LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0v5.3 Feet ❑ Other — DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches LI 6 inches s ft. 5 in. ���C sq•ft. 6 in. — AREA TO BE REPAIRED sq.ft. 4 in. q- CODE F - PATCHES ❑ Yes L No No. of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — Date: ��V-'�' � — FIRST INSPECTION AND FORM MADE BY : f"� rl'f)) qi — PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS Za9 5/�''`' ‘ ,- , (� — f PARCEL CODE ` CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes 4 No I See below for Defect Code G I TRIM VEGETATION I ❑ Yes X No 1 , WATER VALVE — —4- ADJUSTMENT REQUIRED i40 �� El Yes $No — I PARKS DEPARTMENT rgoA REVIEW REQUIRED ____ia ! _ � _ ❑ Yes No °K GeV, _ sT LOCATION OF SIDEWALK ;0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK d 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other — DEPTH OF SIDEWALK /I;4 inches O 5 inches ❑ 6 inches AREA TO BE REPAIRED �` --_sq.ft. 4 in. sq. ft. 5 in. _ sq. ft. 6 in. CODE F - PATCHES ❑ Yes S No No. of Squares with Patches CODE G - AWI.kocia 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 : — Date: PERMIT ISSUED , FORMED POURED COMPLETED CIX OF WATERLOO SIDEWALK REPAY!" SURVEY FORM PROPERTY ADDRESS 3 e. q7 - i5 -i - 130 - 01 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' ''No • See reverse side for Defect Codes A-F See below for Defect Code G ! TRIM VEGETATION ❑Yes , 51,No - WATER VALVE �'t/ ADJUSTMENT REQUIRED �... ..•► ❑Yes E 't o \ ! ! PARKS DEPARTMENT REVIEW REQUIRED ❑Yes E`No LOCATION OF SIDEWALK ®Front Yard ❑ Side Yard / ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet I�"5.3 Feet ❑ Other DEPTH OF SIDEWALK I2r4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes E 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: 3'9 47 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 411_ l� , 1n — tZ. — 02_0 V 1,6 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G I — TRIM VEGETATION ❑ Yes ® No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes ® No I I PARKS DEPARTMENT — REVIEW REQUIRED 4 ❑Yes ® No LOCATION OF SIDEWALK l Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 01)5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED , 5-°s sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No. of Squares with Patches CODE G NOTE:Areas marked with an "F"may be repaired by patching All other areas she!!be repaired by reconstruction of full sidewalk panels. r repaired vca p FIRST INSPECTION AND FORM MADE BY : � 2) '5 Date: ._S-- PERMIT ISSUED FORMED POURED — COMPLETED 1 of)_ -- — CITY OF WATERLO S SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a S f, -2, - / - a - 3 -c, z_--/ i PARCEL CODE CONTROL NO. 7 Type of Defect d CLEAN SIDEWALK See reverse side for Defect Codes A-F , 4 — ❑Yes ® No — See below for Defect Code G 7—'s —" x \� 'jI 'S (: TRIM VEGETATION ❑Yes No 4.112)..0. A-Azg- WATER VALVE \ F� ADJUSTMENT REQD Ir j • I �' ❑Yes 1p No „ PARKS DEPARTMENT Les) CYA REVIEW REQUIRED 4_Ir ) — - — _ Yes ❑ No — _ J t 1 LOCATION OF SIDEWALK la Front Yard 0 Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 1i1 5.3 Feet ii Other .° — DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches 1 '6 inches AREA TO BE REPAIRED it649 sq.ft. 4 in. sq_ft. 5 in. 4 sq.ft- 6 in. CODE F - PATCHES ❑Yes 0 No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY 170'5 Date: 3-5- 1 PERMIT ISSUED — FORMED POURED COMPLETED py ggCI;peg/A OF WATERLOO ERLOO IDEWALK •EPAIR SURVEY FORM PROPERTY ADDRESS 4--!S a , ,, ,/ El?bt -2 --- 4— V PARCEL CODE CONTROL NO. — sr Type of Defect See reverse side for Defect Codes A-F GLEAN SIDEWALK — See below for Defect Code G JEl Yes ❑ No — I RIM VEGE I ATION t L `I ❑Yes P® No \ a s WATER VALVE j ' l .4 ADJUSTMENT REQ'D ❑Yes p No — 1 RPARKSEW DEPARREQUIRETMENTDEVI a — ----j — — ❑Yes ,D No a k 1 \ [ ) LOCATION OF SIDEWALK fp Front Yard 0,Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet E] 5.3 Feet 0 Other DEPTH OF SIDEWALK 10 4 inches ❑ 5 inches Erg inches AREA TO BE REPAIRED Aid)4j sq.ft. 4 in. ' sq.ft. 5 in. �.��° sq.ft. 6 in. — CODE F - PATCHES ❑Yes l No No.of Squares with Patches CODE G - NOTE :Areas marked with an "Fe 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 BC) Date: 'e5-l-I — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -. PROPERTY ADDRESS e::) el< "d`'i PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes in No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 0 No WATER VALVE 1 ! ADJUSTMENT REQUIRED t— --► ❑Yes ® No PARKS DEPARTMENT REVIEW REQUIRED ID Yes 14No LOCATION OF SIDEWALK P Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet CS Other ° a DEPTH OF SIDEWALK ,[ 1.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 3. /sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ,® No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F" 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-11 '— PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a c-1 � 5 ‘5 - - t - �� - ✓ / — PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G J CI Yes No TRIM VEGE I ATION — �t ❑Yes El7 No WATE I VALVE NA& ADJUSTMENT REQ`D ❑Yes g No 4 PARKS DEPARTMENT REVIEW REQUIRED 1/ 1 — — — — ❑Yes C 'No 75, J LOCATION OF SIDEWALK El Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK Cf 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 92.2 fsq.ft. 4 in. sq.It 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No.of Squares with Patches CODE G - NOTE E _Areas marked z frith µn ''F°may be by patching.Allother shall j repaired }�auaiiy.rvi areas alicil!be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ''5 m c Date: . B PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 . S e —C' / 3 -. - C,N5 — '- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes Q No WATER VALVE t _ ADJUSTMENT REQUIRED 4,0—* ❑Yes I No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes R No A LOCATION OF SIDEWALK . e Front Yard ❑ Side Yard ❑ Other - WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet it 5.3 Feet ❑ Other DEPTH OF SIDEWALK C 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 30 '` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 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 : %P Date: 3® 8- 11 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTYADDRESS 2e6, r r" 5 Ree 8V3 -2S -137 - 0/9 ✓ Z PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK — See below for Defect Code G 1 ❑Yes ® No TRIM VEGETATION — ❑Yes IXI No 41-13)—#. if WATER VALVE ♦ & ADJUSTMENT REQD t ❑Yes '® No — PARKS DEPARTMENT 1- k_ _ j� I C•3 s.t i ® s REVIEW REQUIRED — 1 / ,A .-7/1 14 I ' ❑Yes No j Le. e -te — LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet ®5.3 Feet 0 Other DEPTH OF SIDEWALK D 4 inches ❑ 5 inches — ❑ 6 inches AREA TO BE REPAIRED 'Hi.i.3 /sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked withan"F'may be repaired — reconstruction of full sidewalk panels. by Patching.Ali other areas shall be repaired by FIRST INSPECTION AND FORM MADE BY : ��S D`i 3-m,-4') Date: — PERMIT ISSUED — FORMED POURED COMPLETED CI—Y OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS_.. . . /71) , g` - Zc - 10 - oo Z=. - PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect s 0 Yes ' 1No • See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes [ No * WATER VALVE r" 1 J1 ADJUSTMENT REQUIRED �-- -► ❑Yes Digo if01 PARKS DEPARTMENT REVIEW REQUIRED _ ❑Yes o — — — — is LOCATION OF SIDEWALK Et rontYard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet IB'5.3 Feet 0 Other DEPTH OF SIDEWALK Er4 inches 0 5 inches ❑ 6 inches 5-4 AREA TO BE REPAIRED sq.ft. 4 in. sq.IL 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes ®io No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : g 5 Date: 3- PERMIT ISSUED FORMED POURED COMPLE I ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS G(ve -4o Sr -" PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK _ See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G TRIM VEGETATION — 1 ❑Yes DINo 1` 1 JI WATER VALVE ©� ADJUSTMENT REQUIRED ❑ Yes tNo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes MNo TX IVA 57 LOCATION OF SIDEWALK K1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IN,5.3 Feet ❑ Other — DEPTH OF SIDEWALK r�4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 53 9sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: S. 17 5k1 7-z.4-17 PERMIT ISSUED FORMED POURED COMPLETED_ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM —' PROPERTY ADDRESS low m a `` - y ✓ r^ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes © No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes Q No WATER VALVE ADJUSTMENT REQUIRED —Q--► ❑Yes ® No — I ,04 I I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ® No • VA LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other — . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet i'Other ` DEPTH OF SIDEWALK J}4 inches ❑ 5 inches Al 6 inches AREA TO BE REPAIRED A-3.-1 sq.ft. 4 in. sq.ft. 5 in. 7o•i3 sq.ft. 6 in. CODE F - PATCHES ❑Yes El No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R-5 °517.4 Date: 3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS J, . crnr PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect e ❑ Yes ❑ No See reverse side for Defect Codes A-F _ See below for Defect Code G I TRIM VEGETATION ❑ Yes CINo WATER VALVE ADJUSTMENT REQUIRED �--®—► — I �� ❑ Yes ❑ No I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes ❑No '0 - - LOCATION OF SIDEWALK ❑Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 5 4 inches ❑5 inches ❑ 6 inches AREA TO BE REPAIRED g ° b sq.ft. 4 in. �' `sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas she!!be rev fired by — I ew►,5L!uction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK •,EPAIR SURVEY FORM PROPERTY ADDRESS of e`)i 3 - - 13 7 - cx F'r PARCEL CODE CONTROL NO. CLEAN SIDEWALK r Type of Defect ❑Yes fl No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I 1 ❑Yes I],No 1 WATER VALVE ADJUSTMENT REQUIRED t--Q--► ❑Yes 0 No \ PARKS DEPARTMENT REVIEW REQUIRED l�r } ❑Yes 0 No eTr LOCATION OF SIDEWALK t.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IN,5.3 Feet ❑ Other DEPTH OF SIDEWALK I 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED j. -, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ®""No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other:areas shall be repaired by reconstruction of full sidewalk panels. — • FIRST INSPECTION AND FORM MADE BY : f Date: A- ""/l IQ 7-zs i7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 310 / 91/ -Z1 - 13i - S PARCEL CODE CONTROL NO. CLEAN SIDE,LK Type of Defect — ❑ Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G — TRIM VEGETATION ❑ Yes [1"No -` At if WATER VALVE ADJUSTMENT REQUIRED ❑ Yes eNo PARKS DEPARTMENT _. REVIEW REQUIRED ❑ Yes CTKIo 1/4 LOCATION OF SIDEWALK ©'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 04.3 Feet ❑ Other DEPTH OF SIDEWALK �4 inches Ainches ❑ 6 inches — AREA TO BE REPAIRED 9.5; 7sq.ft. 4 in. /d`, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes �o No.of Squares with Patches CODE G - NOTE 'Areas marked with iv,,,n"Fe iS'4ay be repaired by patching 'Ali other area shall `�' r•- Y" �•`..i• other areas shall be repaired by '- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY ; I ( Date: 3 4-l PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zo E. fg13 -13% - 0 `>. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes ErNo WATER VALVE — 10 II ADJUSTMENT REQUIRED -- --► ❑Yes 12Alo I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes C7'No 1°'-1',,/k r/f Rrt LOCATION OF SIDEWALK 2-Front Yard ❑ Side Yards ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet E1 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED (= ,1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 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 CLT Date: PERMIT ISSUED FORMED POURED COMPLETED Rev/se-- CITY OF WA ERLO® SIDEWALK EPAIR SUS N E L F•RM PROPERTY ADDRESS 1409 sd O-Yvt- 3'I/'3 -j - /32 - 007 Lie PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes o See reverse side for Defect Codes A-F _ See below for Defect Code G TRIM VEGETATION ❑Yes ,"No t WATER VALVE ADJUSTMENT REQUIRED Aces ❑ No A j\ r I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Frt No redii LOCATION OF SIDEWALK Front Yard ❑ Side Yard Cl Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet R5.3 Feet ❑ Other DEPTH OF SIDEWALK g4 inches N'5 inches ❑ 6 inches — AREA TO BE REPAIRED Z1•5sq.ft. 4 in. VP-5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES WYes ❑ No No. of Squares with Patches NOTE:Areas marked with an"e-="may be repaired by patchina,All other areas shall he repaired by reconstruction of full sidewalk panels. r- FIRST INSPECTION AND FORM MADE BY : f � `� `� Date: 3'2O.11 6-1-i- - PERMIT ISSUED FORMED POURED • COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 4- l a , )t5 - of PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes © No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED �' "♦ ❑Yes Q No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ® No LOCATION OF SIDEWALK liN3 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet `i 5.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 22 ° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ,H No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 11-5 Date: 3-�°—t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c)? PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ®`-No See reverse side for Defect Codes A-F See below for Defect Code G ► TRIM VEGETATION ► J ❑Yes Cf No WATER VALVE �At if ADJUSTMENT REQUIRED ~W� ayes ❑ No PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes IR No op c"-t 1 fl 1w= : LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet f L 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. 3°H` sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Q,No No.of Squares with Patches CODE D - °%i t S3 C ,r-.r. \J. 1 NOTE :Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by reconstruction full sid. aIk panels. �St;u��wi�of full�iucriain pai iCis. FIRST INSPECTION AND FORM MADE BY : 1 15-5 Date: 3 ZZ-}'/ f I ,�. \.i ;�....r 7- 7 — PERMIT ISSUED 5 FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i ( PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes p 0No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 l ❑Yes I l No WATER VALVE ADJUSTMENT REQUIRED ❑Yes El No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Ill No $`�(4 I -r LOCATION OF SIDEWALK ),Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I=1 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED `} 5,0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 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 : l� Date: t2) 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 2e a ` 5 - - 44- PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G Yes ❑ No — TRIM VEGETATION ��� ❑ Yes ® No "— N WATER VALVE ADJUSTMENT REQ'D �.. I 1- ❑Yes No PARKS DEPARTMENT _ REVIEW REQUIRED cua '4 AYes ❑ No LOCATION OF SIDEWALK L!FFront Yard I Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I .5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches f 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 ° sq.ft. 4 in. Z sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ® No No.of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by_ — reconstruction of full sidewalk panels FIRST INSPECTION AND FORM MADE BY : Date: `11 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 'ZOO Et . / � � _ -z-c - cL. / 26 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes M No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes [ No 2 \ t WATER VALVE ADJUSTMENT REQUIRED t— --► ❑Yes r No NI, PARKS DEPARTMENT REVIEW REQUIRED ❑Yes M No t1 ,� LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet F'5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 914 si 1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes M No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 5 Date: 3- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWAL< REPAIR SU VEY FORM PROPERTY ADDRESS '13 5' g3 R it ) f PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect irI ❑Yes O`No See reverse side for Defect Codes A F _ See below for Defect Code G TRIM VEGETATION ❑Yes []No 1�t WATER VALVE --► ADJUSTMENT REQUIRED _ f ❑Yes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes ❑}No L t R ram. LOCATION OF SIDEWALK .I]Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet p'S3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 39.3/q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches- CODE G NOTE_Areas marked with an"F"may be repaired by Patching,Ali other areas shall be ren d by reconstruction of full sidewalk panels. ralr� �y FIRST INSPECTION AND FORM MADE BY : IY Date: '" 1 " PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 16. i C g'i r _ z PARCEL CODE CONTROL NO. Type of Defect d. See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G I ❑Yes 0 No TRIM VEGETATION ° ❑Yes li3No N�, i� •'a a `5" WATER VALVE ADJUSTMENT REQ'D ❑Yes ❑'No PARKS DEPARTMENT ° REVIEW REQUIRED ❑ Yes 0No LOCATION OF SIDEWALK 2-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .0 5.3 Feet ❑ Other DEPTH OF SIDEWALK LI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED V'ig sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: J'' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 343 6, to `' iit3 - 4 - g18 - o7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 6 ❑ Yes RrNo See reverse side for Defect Codes A-F _ See below for Defect Code G I TRIM VEGETATION ❑ Yes 0'No WATER VALVE ADJUSTMENT REQUIRED — ❑Yes �o I � 1 PARKS DEPARTMENT — REVIEW REQUIRED E l es ❑ No Iir LOCATION OF SIDEWALK L2'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C'1'5,3 Feet ❑ Other DEPTH OF SIDEWALK ❑finches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 61)4 / sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes E No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstnintinn of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : gS Date: 34'17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS \� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes © No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ' I I ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED ❑Yes [V No aj\ I PARKS DEPARTMENT I REVIEW REQUIRED _ 6 ❑ Yes RI No 1(4 7 P- 0 Leo LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet p 5.3 Feet El Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches fill 6 inches, AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 5`1C I sq.ft. 6 in. CODE F - PATCHES ❑ Yes LI No No. of Squares with Patches CODE G - NOTE : Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Imo% lit.)47 Date: 3-2-4- s 1 -7 PERMIT ISSUED FORMED POURED COMPLETED c?r- __- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f - t a , L\ t ; B - 51- — PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes KI No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes In No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 2, No — /I I PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes 113 No A LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ® 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3(2-U sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IM No No.of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of fuii sidewalk paneis_FIRST INSPECTION AND FORM MADE BY : 1. i Date: " 7 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z-o 7 1, of PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ❑ No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes 0 No WATER VALVE ADJUSTMENT REQUIRED �_. ..♦ ❑Yes 0 No I/04 I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ElNo o V1 A A'A, LOCATION OF SIDEWALK 12] Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ( 5.3 Feet ❑ Other DEPTH OF SIDEWALK lI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED !1 I. "sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — �� 7 � _ FIRST INSPECTION AND FORM MADE BY ��'�� Date: � PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c'o aeg lirl 5 77. gcw -7,5 - l1 - / PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes See below for Defect Code G I — TRIM VEGETATION ❑ Yes LI No \ 1 r WATER VALVE ADJUSTMENT REQUIRED \ CI Yes El No — PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes L7 No 4,1 141 i — LOCATION OF SIDEWALK LFront Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches lirCinches _ AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 3z. s .ft. 6 in. ��OO q CODE F - PATCHES El Yes C1 No No. of Squares with Patches CODE G - NOTE :Areas marked with an 'rF"may be repaired by p_tching.Al!other areas shall be repaired by reconstruction of full sidewalk panels. repaired by FIRST INSPECTION AND FORM MADE BY : �� Date: -7r -1-7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Ul . . / "?‘115 -z -riV - 0i (d v 43 - PARCEL CODE CONTROL NO. Type of Defect A 4 CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes 2-NoSee below for Defect Code G I �I TRIM VEGETATION 1 z. ❑Yes 0,No — 10 e, �; ` �0—.0. WATER VALVE Ie l\ I ADJUSTMENT REQ'D _ ❑Yes Er No I PARKS DEPARTMENT — REVIEW REQUIRED �,� L Yes ❑ No — 66 10_____ / J/ /11 LOCATION OF SIDEWALK ❑ Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El5 Feet `5.3 Feet ❑ Other — DEPTH OF SIDEWALK gz4 inches relinches ❑ 6 inches AREA TO BE REPAIRED b a C sq.ft. 4 in. Ze%5- sq.ft. 5 in. sq.ft. 6 in./ CODE F - PATCHES p'Yes ❑ No No. of Squares with Patches I `� CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : Cc- Date: 34-17 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS {; ';_ (C. 111_,, — PARCEL CODE ,•`� (O / .,-,7. CONTROL NO. Type of ` `' ,. —Defect , (.- e�y k See reverse side for Defect Codes A-F ` - CLEAN SIDEWALK — See below for Defect Code G ❑ Yes ® No s �1 _ TRIM VEGETATION — � 11 ` ❑ Yes 0 No �'JI ; `' WATER VALVE yam; .� ADJUSTMENT REQ'D ❑ Yes A No R PARKS DEPARTMENT f ¢t REVIEW REQUIRED — ,DYes ❑ No p: %I Li ` J/ LOCATION OF SIDEWALK I .Front Yard q Side Yard ❑ Other — WIDTH OF SIDEWALK y` 4 Feet ❑ 5 Feet ❑ 5.3 Feet I Other t1, 1 DEPTH OF SIDEWALK El ❑ 6 inches 4 inches ❑ 5 inches —_ AREA TO BE REPAIRED w C%:' c= sq.ft. 4 in. lb_ )sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - X 3,, --f NOTE :Areas marked with an 'F" may be repaired by patching.Ail otherareas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : =' 1 � ,_. Date: 3 •�a?' -i i PERMIT ISSUED FORMED POURED COMPLETED CITY OF ATERL!)• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect i1 Yes ❑ to See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I 1 El Yes `E No WATER VALVE ADJUSTMENT REQUIRED ~ — ❑Yes Q No teyok PARKS DEPARTMENT REVIEW REQUIRED ❑Yes oLNo g1 57 LOCATION OF SIDEWALK jFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK F';4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 i sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑Yes %No No. of Squares with Patches -- CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : a Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 475 Ai -,,P / 5'1 Z -36 - 15 - / , -7," - PARCEL CODE CONTROL NO. Type of Defect A ; " See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes ❑-No _ I '-'-') TRIM/VEGETATION f]`Yes ❑ No ' _ -;` WATER VALVE 4 I y., " ® * ADJUSTMENT REQD — �� `Yes ❑ No I Lil i1 -- ) i ❑PARKS DEPARTMENT (4 , ( � REVIEW REQUIRED ;, _q= —. ;, ❑Yes O'lelo VA F:,1 1,-;r 1 h:1 Vilf' 5,3 ' , :.) ,f VI;1v --- S.7: PrL LOCATION OF SIDEWALK ❑ Front Yard p Side Yard ❑ Other WIDTH OF SIDEWALK LI 4 Feet ❑ 5 Feet p 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 0°4 inches 0"5 inches ❑ 6 inches / _ AREA TO BE REPAIRED I s e.1 sq.ft. 4 in. ` . i sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑•"NoFr No.of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by rcvi V 1st!uctioi 1 of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : \v V``S f�l Date: , 7 r PERMIT ISSUED FORMED POURED COMPLETED --- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑-Yes ❑ No See reverse side for Defect,Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED — �� I ❑Yes CI No l PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No q i tj4-LI? I LOCATION OF SIDEWALK IN-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z - sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : i3ij Date: 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `/` 9 /2 V 36 - - A,� <- / Ems , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect / ❑Yes DiNo See reverse side for Defect Codes A-F _ See below for Defect Code G TRIM VEGETATION ❑Yes Li No WATER VALVE ADJUSTMENT REQUIRED ~0-10- ❑Yes 0 No /1,04 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes E No 63 - f j F 'Af LOCATION OF SIDEWALK 111 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 0'4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK 04 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : PT IA/ Date: 3-2"i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM I PROPERTY ADDRESS /2_ - i;t) - - 75 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect rji El Yes E] No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION El Yes LiNo \ WATER VALVE ADJUSTMENT REQUIRED ID Yes 1 No PARKS DEPARTMENT REVIEW REQUIRED El Yes 4I1No • 3 3 1 t+LIL LOCATION OF SIDEWALK EL Front Yard Li Side Yard CI Other WIDTH OF SIDEWALK El 4 Feet El 5 Feet El 5.3 Feet El Other DEPTH OF SIDEWALK K,4 inches El 5 inches El 6 inches AREA TO BE REPAIRED 80 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes CrNo No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : LC. rj r-S Date: / PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,°� � - rr' - :3(.3 - / C - '° i , PARCEL CODE CONTROL NO. R CLEAN SIDEWALK Type of Defect 1 ❑ Yes Cl No See reverse side for Defect Codes A-F _ See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 0No WATER VALVE ADJUSTMENT REQUIRED 1-0—* ❑ Yes E No — Ie PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 0 No N f LOCATION OF SIDEWALK Lii Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Li 5:3 Feet ❑ Other DEPTH OF SIDEWALK E`4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 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 — rec nstr:..°ction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : --U 1.1~' Date: 5" 2.1.. €7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5"l 4/4c. S9)1 -30 - /`( - O ;- 7g t; 7 J` l PARCEL CODE CONTROL NO. CLEAN Type of Defect Er Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED fQ� ❑Yes ❑ No Nk PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No A 5Z :, LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other — DEPTH OF SIDEWALK L(4 inches ❑ 5 inches ❑ 6 inches v/I AREA TO BE REPAIRED 3W,0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : LC Date: -5- PERMITISSUED FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 64'S ,0c_-� c= PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes q No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION — 1 ❑Yes q No �.w WATER VALVE ADJUSTMENT REQUIRED l ��\ ❑ Yes C.�,No — 1 PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes q No fr ,f LOCATION OF SIDEWALK p.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet CI 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 0.5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. (f /),l sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No.of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels_ — FIRST INSPECTION AND FORM MADE BY : -` Date: 5 7 I " i 1 -2.1 _i7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS r26`2, _,Ei PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect £'`• '�` ` ❑Yes ❑-`No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes ONo WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes L No _z 7 LOCATION OF SIDEWALK El-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 l� j AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑`No No. of Squares with Patches _ CODE G - ti <L'r.(:f xx= - 6 F L., .f NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /43 -0/ Date: _ -'-Z/ 1 7' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `: '�- / L. - 1 - ,. O f A frr PARCEL CODE CONTROL NO. Type of Defect I ,t- ter: CLEAN SIDEWALK See reverse side for Defect Codes A-F a — See below for Defect Code G { I ❑ Yes 0,No TRIM VEGETATION ❑ Yes []'No 74 N WATER VALVE -� ADJUSTMENT REQ'D I �- ❑Yes E No PARKS DEPARTMENT r`= REVIEW REQUIRED ❑Yes 0"No — 2. z9 ' f'? ;�.::��.f..,,1 oLJgd LOCATION OF SIDEWALK IA Front Yard ❑"`Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches / C7 5 inches ❑ 6 inches -- rt ,® AREA TO BE REPAIRED 5 sq.ft. 4 in. q.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑`Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY � 1 Date: 1. 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 6c) ,bZd 6117 - 36- IZ7 - 0/8 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes KNo See reverse side for Defect Codes A-F See below for Defect Code G ITRIM VEGETATION I ❑Yes ta‘No WATER VALVE ADJUSTMENT REQUIRED J ` ❑Yes AND a J PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ',No 4,6 VA Ar17�" . LOCATION OF SIDEWALK El Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet El 5 Feet ❑5,3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches El 5 inches 0 6 inches AREA TO BE REPAIRED sq.ft. 4 in. �2°- sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El 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 : D g Date: ?lzol 87 PERMIT ISSUED FORMED POURED COMPLL I ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 ! z- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes E`No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑Yes 0`No WATER VALVE ADJUSTMENT REQUIRED — I \ ❑Yes ❑ No I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes I]No LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 2 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0`4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED ( sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes El No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may repaired patching.All other area_ hall — � be r-.—.,..., by n vie eca areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S ' Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOI SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /3(p 9t7 - 30-/5,3 3 PARCEL CODE CONTROL NO. Type of Defect A. e P • CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G I 7 Yes M No TRIM VEGETATION t� � Yes ® No aik WATER VALVE �(� I ADJUSTMENT REQ'D ❑ Yes [ ] No PARKS DEPARTMENT REVIEW REQUIRED Yes ®,No '3LLT LOCATION OF SIDEWALK Front Yard IM Side Yard ❑ Other WIDTH OF SIDEWALK IR 4 Feet ❑ 5 Feet ®5.3 Feet ❑ Other DEPTH OF SIDEWALK �4 inches © 5 inches ❑ 6 inches AREA TO BE REPAIRED 7. &• sq.ft. 4 in. 17,4, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES pt Yes ❑ No No. of Squares with Patches 1 CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3' (-/ i) 60 4- -17 PERMIT ISSUED FORMED POURED COMPLETED RE.vlsen CITY OF `y;,'ATE'LOO SIDEWALK ir*EP ,Y'_ SURVEY FORM PROPERTY ADDRESS //L/ 13u e-r. -30 -/s7 - oca 95 PARCEL CODE CONTROL NO. - Type of Defect d ; C-- See reverse side for Defect Codes A-F CLEAN SIDEWALK — See below for Defect Code G ❑ Yes No TRIM VEGETATION ❑Yes elgs No ~ N ` WATER VALVE Ic&I ADJUSTMENT REQ°D ❑Yes XNo — p' PARKS DEPARTMENT e — — — — REVIEW REQUI"ED — 1'1 ❑Yes to No J4.1' — t3io LOCATION OF SIDEWALK d-Front Yard A Side Yard ❑ Other — WIDTH OF SIDEWALK S4 Feet ❑ 5 Feet J5.3 Feet ❑ Other DEPTH OF SIDEWALK X4 inches ) l'5 inches ❑ 6 inches AREA TO BE REPAIRED 32 •° sq.ft. 4 in. 21,'° sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes , 'No No.of Squares with Patches CODE G - — NOTE Areas marked with an'°F°°may be repaired by patching.Ail other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: -"2_/7 — ,� m/9-)7 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I f 7 b f= PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes Q-o WATER VALVE ADJUSTMENT REQUIRED ❑Yes L o PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Asio 5EI. LOCATION OF SIDEWALK L 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®'S 3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED -�®- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 1rNo No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : YU. oce Date: 1 -Z717 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /21 ri C:r t riL 1 t -36 - 1.5 4- - ))I'? 9 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A Yes No See reverse side for Defect Codes A-F "- See below for Defect Code G TRIM VEGETATION ❑Yes o — WATER VALVE 1 ADJUSTMENT REQUIRED ♦'Q"'* CIYes Q/No PARKS DEPARTMENT — REVIEW REQUIRED -1?1-Ys ❑ No 7rl 7i - e41?`y�, LOCATION OF SIDEWALK ®Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E]'5.3 Feet ❑ Other DEPTH OF SIDEWALK .a 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED # q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes lio No.of Squares with Patches CODE G - — NOTE Areas marked "F" be repaired by_at-hiii h NOTE v :Areas marked 1C89 new with an � may try repaired Cl] UdLC:ildSlil.f'.11 ether areas shall�f?rena►rPn h�/ reconstruction of full sidewalk panels. ,,��`` FIRST INSPECTION AND FORM MADE BY : v! 45 Date: T ZZ-17 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM J _ PROPERTY ADDRESS 'f'``2 V,t ` PARCEL CODE CONTROL NO. CLEAN SIDEWALK. Type of Defect d' ❑ Yes ❑allo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes L-No * WATER VALVE 1 ADJUSTMENT REQUIRED ❑ Yes 0 No I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑'No • J t,t i LE Y_ s a� LOCATION OF SIDEWALK E1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Ll 5.3 Feet ❑ Other DEPTH OF SIDEWALK 12,4 inches , ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED n 5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : . Date: _ -2/-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS = c 6!z Ce(' ft ?,z.. - N - - +cj 3 1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes 0"No See reverse side for Defect Codes A F — See below for Defect Code G I TRIM VEGETATION 1 ❑ Yes E No *lf WATER VALVE 1 ADJUSTMENT REQUIRED 41-4:11-10. ❑ Yes ❑'No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes 0No o: , 6,1) LOCATION OF SIDEWALK ❑-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0.5.3 Feet ❑ Other DEPTH OF SIDEWALK ©4 finches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED v° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES .❑Yes (].No No.of Squares with Patches G®DE = (xi m ° °}Pc;or 1;SA 0,k l ' Cam` rr. reps 9 Ct . a ��. a 9 NOTE :Areas marked with an'°¶"may be repaired by patching.All other h lld � All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : r K J Date: e- 21.17 PERMIT ISSUED FORMED POURED COMPLETED, CITY OF WATERLOO 5f SIDEWALK REPAIR. SURVEY FORM PROPERTY ADDRESS I fi - J 0- 154 - `'/j�I (( -`'} PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ❑``No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes 0/No WATER VALVE ADJUSTMENT REQUIRED ~Q� (]Yes ❑ No hr i s,5„.• PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 0 No LOCATION OF SIDEWALK I11-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet o`5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ® 5inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 3/. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0--No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : pat; ,43- Date: % Z t_r` 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS %Za r r:'' I; -_ O - / 7 - Ui5` f04 PARCEL CODE CONTROL NO. z CLEAN SIDEWALK Type of Defect =' ❑ Yes D No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑Yes El WATER VALVE l ADJUSTMENT REQUIRED *4Q ❑ Yes ❑No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes ❑'No 4 'ff LOCATION OF SIDEWALK El-front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1]-5.3 Feet ❑ Other DEPTH OF SIDEWALK ;.H 4 inches e ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED Z( Z- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 1=1 No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.Ali other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : L-( - ��' Date: 'a 1'7 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM i PROPERTY ADDRESS =24 b ei; t6-- � is _ _ ir1 _ �;tV 1 0 PARCEL CODE CONTROL NO. z Type of Defect .. ' if CLEAN SIDEWALK ` See reverse side for Defect Codes A-F See below for Defect Code G I ❑ Yes [1No — I TRIM VEGETATION ❑ Yes I]`No — \S e 40""0-41.. E - WATER VALVE — i 1\ v _ ADJUSTMENT REQ'D 4 ❑Yes ❑ No — s PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes ❑FNo �;f,. — AIE ) /` LOCATION OF SIDEWALK l Front Yard ,I]-Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet CI5 Feet 015 3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches / ®``5 inches El6 inches /1 ,/, AREA TO BE REPAIRED Z52,� sq.ft. 4 in. Zig1 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes El ANo No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : i-(-- 3 !,'V Date: ` " PERMIT ISSUED FORMED POURED COMPLETED CITY OF !MATES'L®® SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 3c%t:;` - /6O - cc F.'�; PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect YP ID Yes El No See reverse side for Defect Codes A-F — J See below for Defect Code G I TRIM VEGETATION I I ❑ Yes L No lf WATER VALVE ADJUSTMENT REQUIRED ❑Yes ID No I raj . I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No • r1; . = `� LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other „=f WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet El 5.3 Feet ❑-°Other . i DEPTH OF SIDEWALK 0-4 inches ❑ 5 inches ❑ 6 inches -" AREA TO BE REPAIRED 7, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No.of Squares with Patches CODE G - — NOTE :Areas marked with an "F"maw be by patching.All othershall be — !.-� repaired ..� areas repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : l- : " `=. Date: -° I .� PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SU VEY FORM PROPERTY ADDRESS i 3 of i 1 !t: ? fi j ' �f PARCEL CODE CONTROL NO. CLEAN,SIDEWALK Type of Defect 0-les ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ❑ No PARKS DEPARTMENT C!: REVIEW REQUIRED L '� e`A' � ❑ Yes ❑ No B ttt s LOCATION OF SIDEWALK /Front Yard ❑ Side Yard ❑ Other — -. ._ WIDTH OF SIDEWALK tt, 4Feet ❑ 5 Feet ❑ 5.3 Feet- ❑ Other ji --` DEPTH OF SIDEWALK 04 inches 0f5 inches ❑ 6 inches -- � AREA TO BE REPAIRED Z77a Z sq.ft. 4 in. W.° sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .° V`L Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ,Ary a r PROPERTY ADDRESS ,vi P PARCEL CODE CONTROL NO. a' CLEAN SIDEWALK Type of Defect I1 ❑Yes O No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑ Yes l]No 1 WATER VALVE ADJUSTMENT REQUIRED —f --► ❑Yes L 1-?o — NA PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes ❑tNo 9 LOCATION OF SIDEWALK ❑{Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L 5.3 Feet Other DEPTH OF SIDEWALK 04 inches ❑ 5 inches ❑ 6 inches — 1v AREA TO BE REPAIRED '' Q' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes []`No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall_be repaired by — ;ruction sidewalk rviunsu ucu�u of full panels. FIRST INSPECTION AND FORM MADE BY : 1` ALL' ) Date: ="4`-f`` PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS S - G0140,400 vs -3 0 - $ - c o = ! PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes Er No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION 1 I ❑ Yes CINo WATER VALVE ADJUSTMENT REQUIRED 44-41) ❑Yes 0-No I I PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes C'No fehtswil LOWS,; LOCATION OF SIDEWALK E L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED J4 ,_" sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1311) Date: .5- d/ PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 7` /D r: ' Z,.- - - 70 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes ®`No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I l ❑ Yes ❑`No WATER VALVE ADJUSTMENT REQUIRED — ~�l� El Yes Zi-No I o j I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ElNo LOCATION OF SIDEWALK ®°Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet 01.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes NoNo.of Squares with Patches CODE G - — NOTE :Areas marked with an"P ma:,be tch•nn Ail i — ...' repaired by @:aade;lti➢8td.C988 other areas shall P4�r�vsairesrl by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 6P LC- 14 Date: - d �i7 � _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' c4,04.40,Z140 ve` 1% PARCEL CODE CONTROL NO. Type of Defect ' CLEAN SIDEWALKr See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes ®No 2 WATER VALVE ADJUSTMENT REQ'D ❑Yes 0 No 7e PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No N rat, Cog ce' LOCATION OF SIDEWALK Zfront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Erg-Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK IE 4 inches/ ❑ 5 inches ❑ 6 inches 0'7 ! Ei AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ,LD No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: -)` PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS g r Lok4Do crZ -So - 1'3 - 069 E74 PARCEL CODE CONTROL NO. CLEAN SIDEWALK�AL Type of Defect ' L]❑ Yes No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION 1 ❑ Yes 0`No WATER VALVE ��At� ADJUSTMENT REQUIRED _ LiYes ,,❑ No a r I PARKS DEPARTMENT 1 REVIEW REQUIRED ❑ Yes 0'No c.o � �I.,,) to I040 Caz tvAiDfo LOCATION OF SIDEWALK V Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ©'a 3 Feet ❑ Other DEPTH OF SIDEWALK 214 inches ❑ 5 inches ❑ 6 inches tt AREA TO BE REPAIRED / sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes r '❑:"No No.of Squares with Patches CODE G - — NOTE :Areas marked with an °F®may be repaired by pat thing.Ail other areas shall he repaired by l N p.u.�...0 .,y reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : P i T Date: 7- 7 PERMIT ISSUED FORMED POURED COMPLETED ®CITY OF W.\, TERL4 SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS /1 7 c %/_2-,,% LL 0.'7)e -SO -.1670 -`7// 1 -' PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I ❑Yes + No TRIM VEGETATION ❑Yes 0No t1 + N —4. WATER VALVE /1' ADJUSTMENT REQ'D "— ❑Yes d No PARKS DEPARTMENT REVIEW REQUIRED =` — ❑Yes ' No 1r �fl i LOCATION OF SIDEWALK ,; Front Yard . ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet Lf 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches Q 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. / F sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ®Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : )tJ k Date: 5--2 ' -1 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a °) _ fi.=:; PARCEL CODE CONTROL NO. ,�f ACLEAN SIDEWALK — Type of Defect ;`u% ❑Yes ©`'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes LI No WATER VALVE ADJUSTMENT REQUIRED ❑Yes El No ..... \ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes L"No I A •r LOCATION OF SIDEWALK E Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK Ili Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches F 5 inches ❑ 6 inches — 4 AREA TO BE REPAIRED + ®3 sq.ft. 4 in. 2:8A sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes p'No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : _"Y" ` Date: ? PERMIT ISSUED FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS )09 ((I/008o 8912 - 30- )37. - co /19 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes gNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes I No 1 WATER VALVE ADJUSTMENT REQUIRED �Q� ❑ Yes gt No I I I PARKS DEPARTMENT REVIEW REQUIRED a��\\ ^^�� ❑ Yes ' No VIA i74 0 = 0 LOCATION OF SIDEWALK ®`Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 145.3 Feet ❑ Other DEPTH OF SIDEWALK 0.4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 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 : o b DDate: 3/721 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /2/he 44,44 3.71. B 1 -3a -/.3© -o2Z /30 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4` e- ❑Yes j o See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION 1 ❑Yes No WATER VALVE ADJUSTMENT REQUIRED...e4-112 _ ` -400. ❑Yes [J�No I PARKS DEPARTMENT REVIEW REQUIRED %Yes ❑ No 51 .J! to,9! — K ' � - - - - CD C;) d4r4deS - LOCATION OF SIDEWALK Xftront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet5.3 Feet ❑ Other DEPTH OF SIDEWALK e4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Y o7• sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [ -No No. of Squares with Patches CODE G - � �� - cepLte ! !ate. -it skr- — — NOTE :Areas marked with an 1Fn may be by patching. All fepRired by repaired...� r-u! uiucd Gil'CciS shall be__r � reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : W1 '' Date: '11-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f PARCEL CODE CONTROL NO. Type of Defect =f See reverse side for Defect Codes A-F CLEAN SIDEWALK — See below for Defect Code G I ❑ Yes allo l TRIM VEGETATION -` Li Yes EXNo sz, fQ—* - - _ WATER VALVE I(4, ADJUSTMENT REQ`D - .,;; ❑Yes .1 No (--.) r,_ G . ``_ : PARKS DEPARTMENT \j � REVIEW REQUIRED - a �. _ ❑Yes ), No r1 — i`_ K issl /` LOCATION OF SIDEWALK p Front Yard 0,Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 11 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0,4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED ! u-4-sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches _ CODE G - ?:` ` a`r_ , L,._ a� 12. -,-,t- - It 3r'_ rl iN R .2e.itt r:7 Q a.�.P;•,=11 A f3A Lia el n i l ,- `k= -_ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : P\^ Date: A=' %''"`a 7 4 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM Iy PROPERTY ADDRESS /0 aeo-1 6- 63: 41e 4it 3o - - 13 PARCEL CODE CONTROL NO. Type of Defect ' CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes ®No See below for Defect Code G TRIM VEGETATION a ' ❑ Yes ❑`No N ; -� WATER VALVE t ADJUSTMENT REQ'D ❑Yes UrISO PARKS DEPARTMENT c) REVIEW REQUIRED _ �' — — — — ❑Yes ❑-N �s rrl LOCATION OF SIDEWALK M,Front Yard fide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet LI 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK L.4 inch ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED f61 '6` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ONo No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — rva^.rnnn��..�s.... Fr..n •�----- by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : fir s Date: 3 2"4 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO• ATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS erg l '. - !r` _C` _ O2 y - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Q No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION I ❑Yes I\No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ® No I PARKS DEPARTMENT REVIEW REQUIRED I ❑ Yes IE\No a 3 jl M1 4 LOCATION OF SIDEWALK L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IS,5.3 Feet ❑ Other DEPTH OF SIDEWALK 1E-4 inches 0,5 inches ❑ 6 inches AREA TO BE REPAIRED 53, sq.ft. 4 in. '.5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Gq No No.of Squares with Patches CODE G - NOTE :Areas marked with an"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: S Z6 a .l %� PERMIT ISSUED FORMED POURED - COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS s214- conit -c 61.011E. e .1) 36 - 003 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A 0 Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETA-9,0N I 0 Yes E N D \At if WATER VALVE ADJUSTMENT REQUIRED 0 Yes 0'No Ae PARKS DEPARTMENT REVIEW REQUIRED Yes 0 No 6or746 r (AD / LOCATION OF SIDEWALK aFront Yard 0 Side Yard 0 Other WIDTH OF SIDEWALK 0 4 Feet 0 5 Feet 2-5.3 Feet 0 Other DEPTH OF SIDEWALK 0-4 inches 0 5 inches 0 6 inches 5-1 AREA TO BE REPAIRED " sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. /CODE F - PATCHES 0 Yes Ac No.of Squares with Patches CODE G - NOTE :Areas marked with-an"F"may be repaired by patching.All other areas shall he repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 61-1- Date: ---2 o-y7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS >15 k--•-,iA debt% l/ 1z -5c;- it3,0 - o 'o /44.- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes p No WATER VALVE ADJUSTMENT REQUIRED 40.-0-111. Yes ❑ No • PARKS DEPARTMENT REVIEW REQUIRED a. ❑ Yes P No r I1 \ p vsj LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet q5.3 Feet ❑ Other DEPTH OF SIDEWALK EH 4 inches El 5 inches El 6 inches AREA TO BE REPAIRED E-/; sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes D No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: & Z£ _I P 1 . _/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 211 ' ,f.> 6:/ f , 1 L - ifr - , ;/ - ) 1 �' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect _' ❑Yes III No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 ❑Yes ES No 0, WATER VALVE ADJUSTMENT REQUIRED ~©� ❑Yes ® No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 121 No <; f C? P1 /� 6-121:)4,c LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK F3 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED h9t,>5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes L`No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .'44 i; I Date: - 7/9"17/ 3 f 7-4_i7 PERMIT ISSUED FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 47119 C t'ri = PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I 1 ❑Yes ❑ No WATER VALVE )� ADJUSTMENT REQUIRED ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED Ir . 2.(f, (4 ) ❑Yes ❑ No — e LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Er5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑'44 inches [❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. )5_ ( sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"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 i )' Date: lc-`,`l 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS $,2 Cyr/AO 6- E/ - fC_c -c/4 is PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect -i ❑Yes ❑No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes O No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes I]No - I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes © No y LOCATION OF SIDEWALK L-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ' 5.3 Feet ❑ Other DEPTH OF SIDEWALK _.Ifi`4 inches ❑ 5 inches ❑ 6 inches — a! AREA TO BE REPAIRED 2 ° Lfi sq.ft: 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yeses No No.of Squares with Patches CODE G - NOTE : Areas marked an"Fa by .� with i may be repaired patching_All nTC!?S'areas shall 6e®repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .!v la- Date: 3 2h`1,7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Co}101-6- ,eoGIL -Z '/- / -Li .; / 1 y 1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C ❑Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 0 No WATER VALVE 1 ADJUSTMENT REQUIRED ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED } ❑Yes ENNo Kti LOCATION OF SIDEWALK El/Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2-5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 2-4 inches 2.5 inches ❑ 6 inches - AREA TO BE REPAIRED `7° 0 sq.ft. 4 in. 7- t, t sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes -ElN No.of Squares with Patches _ CODE G - NOTE :Areas marked with an"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 3 Zi': 7 Date: PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS- 107) PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes in No See reverse side for Defect Codes A-F .See below for Defect Code G 1 RIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED /-- l —► ❑Yes ® No if PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No • pa _ "r --L. - LOCATION OF SIDEWALK n Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet lI 5.3 Feet ❑ Other DEPTH OF SIDEWALK lB 4 inches ❑ 5 inches ❑ 6 inches '- AREA TO BE REPAIRED •0�' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Q No No. of Squares with Patches CODE G - NOTE: x__ .. Areas marked with an"F" may be repaired by All shall repaired patching.All other areas be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 '3� 3- f(3-f 1 Date: — PERMIT ISSUED • FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I C-5=73 U 14- A- L> a ✓ 5 - - 2_0 - c, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes I No See reverse side for Defect Codes A F _ See below for Defect Code G TRIM VEGETATION I ❑Yes [ No i WATER VALVE ADJUSTMENT REQUIRED C No /Ij\ i PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No A, LOCATION OF SIDEWALK In Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 7 5.3 Feet ❑ Other DEPTH OF SIDEWALK C 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ‘`°° sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : e Date: -I O e PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS 1 / F PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G J ] ❑Yes El No TRIM VEGETATION ❑Yes ®;No �— ,f —► ' 5 WATER VALVE �C • 1I ADJUSTMENT REQ`D ❑Yes 1p No — PARKS DEPARTMENT REVIEW REQUIRED - - — S, 9•2 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 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ZtC- I q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes I No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED -- FORMED POURED COMPLE I ED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS e.«. �`��E�6 a � -: v'3\3 -zc - -oc f` f PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 0.No See reverse side for Defect Codes A F _ J See below for Defect Code G I TRIM VEGETATION J 1 ❑ Yes © No — WATER VALVE ADJUSTMENT REQUIRED f—Q� ❑Yes C No J I PARKS DEPARTMENT REVIEW REQUIRED i.A3 7, ❑Yes © No — — — — _ Vrri LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ®5 Feet ❑ Other DEPTH OF SIDEWALK I 4 inches ❑ 5 inches ❑ 6 inches • AREA TO BE REPAIRED I.5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ".5 > 5 Date: 3 " PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1 I- c , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ( No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑ Yes [a No WATER VALVE ADJUSTMENT REQUIRED ❑Yes (],No a I PARKS DEPARTMENT — REVIEW REQUIRED 'Yes ❑ No LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet i 5 'eet WI 5.3 Feet ❑ Other DEPTH OF SIDEWALK [J°4 inches ❑ 5 inches ❑ 6 inches I AREA TO BE REPAIRED 2`7.© sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : E 5 f Date: 3 ' t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPER I Y ADDRESS ,/ :rah , - -. PARCEL CODE CONTROL NO. Type of Defect �v 3 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G _ J J ❑Yes &I No TRIM VEGE I ATION ❑Yes 0 No WATER VALVE ADJUSTMENT REM)Li‘ � ❑Yes 0No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No kite A1- . LOCATION OF SIDEWALK ❑ Front Yard ® Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet 0 5.3 Feet ❑ Other ._ DEPTH OF SIDEWALK 1 4 inches ;.5 inches CI 6 inches AREA TO BE REPAIRED ,0 7sq.it 4 in. a7 '"sq.ft. 5 in. sq.ft 6 in. CODE F - PATCHES ❑Yes I No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2 0I>> Date: 3 ® 10`"' I / PERMIT ISSUED - FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 (2-- 0 LA--A> sT - e,Dt -z -Zo7 - s� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect la Yes ❑ No See reverse side for Defect Codes A-F _ See below for Defect Code G TRIM VEGETATION I El Yes ® No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes IT No PARKS DEPARTMENT REVIEW REQUIRED 3.7 r ' p Yes ❑ No coue„-ri„.A.,„4:0 LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ( 5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches I 5 inches ❑ 6 inches -- AREA TO BE REPAIRED z(- -6sq.ft. 4 in. 5I h' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes C No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas sl ell be repaired by reconstruction of full sidewaik panels. FIRST INSPECTION AND FORM MADE BY : R 7) V>V7 Date: 3-4 3 17 PERMIT ISSUED FORMED POURED COMPLETED T CITY OFWATERLOO SIDEWALK REPAIR SURVEY FOR PROPERTY ADDRESS ,��6 -�� - -i - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑'Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes El No WATER VALVE ADJUSTMENT REQUIRED ~ —* ,Yes L No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ® No pi LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK a 4 inchesp 5 inches ❑ 6 inches AREA TO BE REPAIRED ' . sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 15 '? Date: 3 d -3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1106 Oik COuP-Haft69- 54. - ,° -2 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect p Yes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED 4-4—* ❑ Yes ® No 1 PARKS DEPARTMENT REVIEW REQUIRED El Yes ENo l LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other 9 DEPTH OF SIDEWALK 14 inches r 5 inches ❑ 6 inches '- AREA TO BE REPAIRED + sq.ft. 4 in. 7-I.5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes k'No No. of Squares with Patches CODE G - -- NOTE Areas an"Fn be: .. markedwith a may repaired by pc3LG15161Ct.Ali other areas slight Q:sF?r€?pair€sri Fsy reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f- Date: 3- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4-D\ coo L ; , PARCEL CODE CONTROL NO. 4_ Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes 12,No TRIM VEGETATION 1 Yes ❑ No WATER VALVE ADJUSTMENT REQ'D ❑Yes ElAi No I U PARKS DEPARTMENT4.3 REVIEW REQUIRED ❑ Yes J No LOCATION OF SIDEWALK D Front Yard ❑ Side Yard El Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet II 5.3 Feet ❑ Other DEPTH OF SIDEWALK l 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED LIL t sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Q No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : % r6°," Date: 3 44 " ( 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS & ' °- -1 _ +- at / 6 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect r ❑ Yes I No See reverse side for Defect Codes A-F { See below for Defect Code G I TRIM VEGETATION { I ❑ Yes j No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes ( No { I PARKS DEPARTMENT — REVIEW REQUIRED ra Yes ❑ No 1.6 LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - — NOTE Areas`marked with an"Fn may,be repaired patching+ Ali t h ll b . � J repaired by patching.nJ.,rate other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4t L)'' t : PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ® No 0 See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED �—Q--� ❑ Yes r No 1,04 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ®'No f A 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 ❑ 6 inches AREA TO BE REPAIRED 2 3-`t sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ! No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: — `17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS tom% 1,a coo ` er 55t3 -Z� - - s PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect fl Yes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes 0 No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes /0 No I j I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ® No X 5 LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK i] 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 t2-0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I No No.of Squares with Patches CODE G NOTE :Areas marked with an"P°may be repairedby h• Ali areas shall he repaired by — �aLli91111li,Ali other e...- 7 reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : PDT'S Date: 3®24-17 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS S j/ 2 ro "( /a 467 - j - .Go3 )7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect M ❑Yes .allo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes `4No WATER VALVE ADJUSTMENT REQUIRED ° ❑Yes PiNo PARKS DEPARTMENT — / REVIEW REQUIRED ❑Yes ❑ No vv vv'9"(cie� LOCATION OF SIDEWALK clp Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet X-5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches / AREA TO BE REPAIRED a e sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [KNo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. //11 FIRST INSPECTION AND FORM MADE BY : VC LI Date: 3A 0.7 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS S/Z � ;,t7 7'/ cell) - zc z2-1 - e7'V PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F / — I See below for Defect Code G I TRIM VEGETATION 1 1 ❑Yes No r' WATER VALVE ADJUSTMENT REQUIRED ❑Yes [ -No 1 5 1 1 PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes �lkiNo ��6 , l -,' _ _ _ i (6' e d4511 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK [ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes `yWo No.of Squares with Patches CODE G - NOTE :Areas marked with an °F"may be repaired by patching. Ail other areas-repaired p.�eva 19A le.g.l�.11 other QGCdti shall he 6'epeIP'P_N by reconstruction of full sidewalk panels. 7� / FIRST INSPECTION AND FORM MADE BY : i� V1 Date: 3/C,./7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 51 S no,72 J i --2-5-- az& - Uzi PARCEL CODE CONTROL NO. j � CLEAN SIDEWALK Type of Defect V ❑Yes Eflo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes VINo WATER VALVE tC It ADJUSTMENT EQUIRED ❑ Yes O No Nik PARKS DEPARTMENT REVIEW REQUIRED—/_ ❑Yes 4lo (0Q tr4-- ti C- LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK (❑ 4 Feet ❑ 5 Feet ?5.3 Feet ❑ Other DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ANo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : T)& 5 Date: 3/Zei/ PERMIT ISSUED FORMED POURED COMPLETED_ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS ,5J? (-,t 7'I- ,-tcj v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes CNo See reverse side for Defect Codes A-F ( — See below for Defect Code G I TRIM VEGETATION l ❑ Yes VNo WATER VALVE 51g ADJUSTMENT REQUIRED _ ❑ Yes f�No ` PARKS DEPARTMENT _ REVIEW REQUIRED Y\'es ❑ No rc 1)(/ 7 i _ ft-) C :0 074-1 4 ,J LOCATION OF SIDEWALK /Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches _. AREA TO BE REPAIRED 17° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes NNo No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching Al!other areas ell be - -a--� t-+._�.....�. shall repaired by reconstruction of full sidewalk panels. / / FIRST INSPECTION AND FORM MADE BY : 1 1<7 0k Date: 3�� ! /7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 52 c Cou J- )c_ iA - 41=zz - O/Z PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect (71-- ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes 4Io WATER VALVE ADJUSTMENT REQUIRED ��` 5 ❑Yes X.No 4, a PARKS DEPARTMENT _ REVIEW REQUIRED ❑Yes LNo 3( LOCATION OF SIDEWALK 63f Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Y] 5.3 Feet ❑ Other DEPTH OF SIDEWALK 'r 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED �/ sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes L IVo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : pfi Date: �Z / PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 3 7 (- :/ r'f/AiLL> T _ C-s'`!' 13 -Z5 - 7Z-=- o)o PARCEL CODE CONTROL NO. Type of Defect Ff CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑ Yes No f4H110. WATER VALVE ADJUSTMENT REQ'D ❑Yes 0 No _ I PARKS DEPARTMENT REVIEW REQUIRED — _ _ ❑ Yes IN No A J - EI- a ¢it LOCATION OF SIDEWALK .Front Yard C Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1E1\5.3 Feet ❑ Other DEPTH OF SIDEWALK 71 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 'tI 14:, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - NCO:E :Areas marked with an"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 t 3 Date: 3V8 1 7 -- (ci;_,) PJl. 44-- ; - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ! 9 PROPERTY ADDRESS .,: a� a li.,;i' '.Am X' l - zs �`7- ° 1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect )i Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION Yes ❑ No WATER VALVE -C ADJUSTMENT REQUIRED 4_ke)_ ► ❑ Yes No PARKS DEPARTMENT REVIEW REQUJ l<2ED ❑Yes No So _ _ / rz LOCATION OF SIDEWALK f ` Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK LII 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK th 4 inches ! 5 inches ❑ 6 inches AREA TO BE REPAIRED 2O I "r sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes CK No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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 k PA Date: 347 ! 7 PERMIT ISSUED FORMED POURED COMPLETED _ 9 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ] i5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes (No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes INo PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes 'j `,"No ir9 (4 C7,4/a i. c" -- LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1g 5.3 Feet ❑ Other DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 24 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 6No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patchiing Al!other areas shall d by — a r----••.•�^ areas u be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : P�' ()> Date: :WO 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f� r�� sp;(3 - zS-- 2z%- 6 i i I PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect L Yes 1 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes VNo WATER VALVE ADJUSTMENT REQUIRED pN 6 ❑Yes to - I I I PARKS DEPARTMENT REVIEW REQUIRED�f El Yes �-No 4.5 n 0 1+16,n LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 14 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches V5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. Z3.4) sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes YNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. � FIRST INSPECTION AND FORM MADE BY : // 7 6 ! Date: 3/f Z 7/ 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS j I I) V �ii - - 3o - 3 - 0 z ; PARCEL CODE CONTROL NO. Type of Defect s CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes o See below for Defect Code G — TRIM VEGETATION ❑Yes ELf10 WATER VALVE ADJUSTMENT REQUIRED ❑Yes LT No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes allo LOCATION OF SIDEWALK ❑`Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1E-5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑-4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED - , sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0-No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching. area shall be — ._ of full r-__...- .-,v All other areas f�?C3�I�f-?:A PIS/ reuui tracton full sidewalk panels. ' FIRST INSPECTION AND FORM MADE BY : a4>� ' � Date: 3-2- 17 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS j?:3 b c,A"` r ` ., E .... ci(Z- -30 - 3a. - Oz / J 73 7.- -"" PARCEL CODE CONTROL NO. r. e CLEAN SIDEWALK s . � Type of Defect .l -Yes El No , \ See reverse side for Defect Codes A-F GAd � See below for Defect Code G I TRIM VEGETATION ' 1 I CIYes ❑ No — \,,,,,______-----------' Itk:t if WATER VALVE ADJUSTMENT REQUIRED 4-0—* ❑Yes ❑ No I I PARKS DEPARTMENT REVIEW REQUIRED 1 ❑Yes ❑ No r LOCATION OF SIDEWALK ®`Front Yard ❑ Side Yard ❑ Other — . WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet i 15 3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches LI 5 inches ❑ 6 inches — v' AREA TO BE REPAIRED -/I e k, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by .= reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ?° ly°s Date: 3 - z'i 2 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 12-7 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes IN No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION I ❑Yes E No st WATER VALVE i fl ADJUSTMENT REQUIRED l - ❑Yes © No 1 PARKS DEPARTMENT — REVIEW REQUIRED jit Yes ❑ No — /go' LOCATION OF SIDEWALK II Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Ai.5.3 Feet ❑ Other DEPTH OF SIDEWALK %4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 53. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes lNo No. of Squares with Patches CODE G - _ NOTE :Areas marked with an"F"may he patch•.. A other areas — � - repaired by ru�v�iiey.Ali lllllGi el��CS shall fSP repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : iC-3 Date: . -2a-1/ PERMIT ISSUED we_ - ?a.���®tartlet b9 � ,_�.2-i'7 FORMED POURED - COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 i -` ' Ali v./ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ri ❑Yes ElNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes EY o * WATER VALVE 1 if A9JUS S ENT REQUIRED �Q--► r Ries la-No 1 PARKS DEPARTMENT REVIEW REQUIRED � El Yes ["No , 9 I -LL LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK E1-4 inches Cl 5 inches ❑ 6 inches rs AREA TO BE REPAIRED 5r: sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. �. CODE F - PATCHES ❑Yes Li No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ��� Date: •�. ��-� FIRST INSPECTION AND FORM MADE BY : DP PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS )$i ii-, (2P,C _;,/ 02, - ! - 30Z - , ), _ ; - PARCEL CODE CONTROL NO. 9`$ CLEAN SIDEWALK Type of Defect '1 ❑ Yes ErNo See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑ Yes ❑/No t WATER VALVE 1-0--► ADJUSTMENT REQUIRED — ❑ Yes l2J No PARKS DEPARTMENT REVIEW REQUIRED 7 � Yes ❑ No �a Zi+'��L�t� ��1 11 � J - afEiti — LOCATION OF SIDEWALK ,O_.Front Yard Ti Side Yard Ti Other WIDTH OF SIDEWALK Ti 4 Feet ❑ 5 Feet ,stir 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches Ti 5 inches Ti 6 inches AREA TO BE REPAIRED /,%5- sq.ft, 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes a-t o No.of Squares with Patches CODE G - NOTE Areas marked with an°I�':1 . - B may iay be r epaircA by patching.Ali other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 5 P.)-- PERMIT ISSUED FORMED POURED COMPLETED C TY OF WATER_®® SDDEWA:_K REPAID- SURVEY FORM PROPERTY ADDRESS /5 a-J _ 6 , 30 -, ,2_ - 0/3 /98 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I I ❑Yes C'lo WATER VALVE V ifADJUSTMENT REQUIRED �— t --► 1" ❑Yes I I 1 PARKS DEPARTMENT REVIEW REQUIRED jl ❑Yes ( o t1A 5.I LOCATION OF SIDEWALK p'Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet lA 5.3 Feet ❑ Other DEPTH OF SIDEWALK i4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 2-i"D sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Olo No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"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, -77 'u AD p�H1 PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS c r � _ sic PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK — See reverse side for Defect Codes A-F See below for Defect Code G I ❑ Yes 0 No TRIM VEGETATION — C7,Yes ❑ No V--,j WATER VALVE I� N1 I ADJUSTMENT REQ°D ❑ Yes ( No — I �- <` PARKS DEPARTMENT REVIEW REQUIRED — i_ `5. C] Yes ❑ No 1 ri/," LOCATION OF SIDEWALK ID Front Yard .I Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I i 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED iV\-t,5 sq. ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F".may be repaired by patching.Ail other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : V3KDate: — f F x T PERMIT ISSUED — FORMED POURED _ COMPLETED - CITY OF WATER_®• SIDEWALK REPAI SURVEY FORM PROPERTY ADDRESS ZO/ vr16,-,,,k. ;Ave- • -- 10 10 - 007 2 ,C PARCEL CODE CONTROL NO. Type of Defect /dY CLEAN SIDEWALK See reverse side for Defect Codes A-F o �� See below for Defect Code G ❑ Yes -No I tl TRIM VEGETATION ❑ Yeso -0 4 WATER VALVE -- 14, � ADJUSTMENT REQ'D ❑Yes do PARKS DEPARTMENT REVIEW REQUIRED — — — — J 'Yes ❑ No LOCATION OF SIDEWALK %Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet IN.'S Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK yi 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 70'Z- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches _ CODE G - X ff fie)-0- 0.1 n Fsovis fla P ym oemA moo ;b� "3/1�danv r uL 5 t NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : LC-/54/ A"I Date: 30-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS A\fs PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect /I ❑ Yes l J No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes 0 No WATER VALVE ADJUSTMENT REQUIRED 1-0--► ❑Yes p No I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes L No LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet k 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches D 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. _?"7' sq,ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes JNo No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaireri by cat china.Ali the_-araas h ao o__ a - - --j •� ..r.a..�• r a+..i�w rrr ems.i%ie vr.l ace �e runs�o inn�e�:�r raiF�n nsr reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 6° 1---- Date: 3`/O )7 1 — 4gid 4-Z7-I-/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3°./ Di414? ' V 12- -30 - - � ,; PARCEL CODE CONTROL NO. CLEANN,SIDEWALK Type of Defect Q Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ❑ No I I PARKS DEPARTMENT 40 e TorM, REVIEW REQUIRED t �' 5" ❑ Yes ❑ No — D k Q LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0,5.3 Feet ❑ Other DEPTH OF SIDEWALK I.4 inches CI 5 inches ❑ 6 inches AREA TO BE REPAIRED '" '— sq.ft. 4 in. ' -' ' sq.ft. 5 in. sq.ft. 6 in. -.. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -� reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ' 1- Date: -Zo °/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS -50 Aim )p_r L. (1»C LL 0- - 05 4 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect L., ❑Yes VI,No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION l ❑Yes [ ..No - ` if WATER VALVE ADJUSTMENT REQUIRED — 4-0—+ ❑ Yes f ,No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes E No LOCATION OF SIDEWALK q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 15 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK f 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 25-.5 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaireri by patching Ai •• - sal . — u�.e-,[uiiiie:-:n=_°��::a:: ,:'ie ron.�i�r.ri reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Lt- Date: S-I -1 7 (`lI'-i) F51,1" PERMIT ISSUED FORMED POURED COMPLETED CIS ,F WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS yt 4_ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes dNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATI N ❑Yes XNo WATER VALVE ADJUSTMENT REQUIRED ~Q� ❑Yes Fl No PARKS DEPARTMENT — REVIEW REQUI ED a ❑Yes 5 No 141 �dpd Add LOCATION OF SIDEWALK IgFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK ❑ 4 inches 15 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. al) sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes f"No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : "vi Date: -5'2d-11 ay- e.o.iv 5 3/4 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z \ C. -2-.L Z gD\ - -oz- i3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes L'No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes IS No t WATER VALVE ADJUSTMENT REQUIRED fQ� ❑ Yes No PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes ,® No O NZ I5 L c.s�1 LOCATION OF SIDEWALK a Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet © Other I ( DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches R,6 inches — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. -. sq.ft. 6 in. CODE F - PATCHES ❑Yes ® No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — M ,u isu uctio I of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 607 Date: a a ° - — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATELOS SIDEWALK REPAIR SURVEY EY FORM PROPERTY ADDRESS 4-1 , , A? j `-`2/5 - =`- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes NLNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes QNo WATER VALVE ADJUSTMENT REQUIRED � '♦ ❑Yes I) No l PARKS DEPARTMENT REVIEW REQUIRED ❑Yes i13,No MI") LOCATION OF SIDEWALK ©Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet -Other DEPTH OF SIDEWALK 114 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED °J sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes q No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5t3-- Date: 3- Z& \—( PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS '10(2 ELM 61 15 - Z5-Z3 - tr PARCEL CODE CONTROL NO. f.f d Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK — See below for Defect Code G e Yes ❑ No TRIM VEGETATION \� 7 Yes ❑ No WATER VALVE j °gin ADJUSTMENT REQ'D ❑ Yes C.No — PARKS DEPARTMENT foett , �j d REVIEW REQUIRED — a ❑ Yes ,)No I LOCATION OF SIDEWALK ® Front Yard IXSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet yl 5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches J$5 inches/ ❑ 6 inches AREA TO BE REPAIRED t $sq.ft. 4 in. 9 00.1sq.ft. 5 in. sq.ft. 6 in. q — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - — NOTE :Areas marked with an "F"may be repaired by patching.Ail other areas shall be repaired by reconstruction of full sidewalk panels. ,r FIRST INSPECTION AND FORM MADE BY : T d�) Date: e/3/th 7 — 8 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `10L slit � — r,)1 — Z5- Z53 -6F�' !�/7 i'(�.Jfi PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 0 Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes C'No WATER VALVE ADJUSTMENT REQUIRED � � ❑Yes 2/No PARKS DEPARTMENT REVIEW REQUIRED eerrg� :Sc k ❑Yes CI No AA vi LOCATION OF SIDEWALK fl Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 05.3 Feet ❑ Other — DEPTH OF SIDEWALK �MI 4 inche % 5 inches ❑ 6 inches 7 c AREA TO BE REPAIRED �L d 'Vsq.ft. 4 in. L • sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes $ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �p FIRST INSPECTION AND FORM MADE BY : N LI Date: 03/49 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS ' ` ie -Z5 -Z5.5 - COO f' PARCEL CODE CONTROL NO. r ;f CLEAN SIDEWALK Type of Defect d Yes ElNo r See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑ Yes j No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes g-No PARKS DEPARTMENT — REVIEW REQUIRED 551 ! ❑ Yes 7.No m EIC 7 LOCATION OF SIDEWALK .L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 1J 5 Feet XI 5.3 Feet ❑ Other DEPTH OF SIDEWALK fYi 4 inches,, �C ,5 inches d ❑ 6 inches — I AREA TO BE REPAIRED la 3'13 sq.ft. 4 in, 4'4'`c sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas she!! be repaired by — reconstruction of tun sidewalk panels. �� FIRST INSPECTION AND FORM MADE BY : 3I) )f� 6 Date: ' 7 - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1115 ELII - ;II 3 -Z,S- 299. - 0 l PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes ,CNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes allo WATER VALVE of ADJUSTMENT REQUIRED ❑Yes ,f No /104 I PARKS DEPARTMENT 3 A,-,-,l I i REVIEW REQUIRED l Yes ❑ No lug n ui �1 raj k: mg)? 1'/IV LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other -" WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet J 5,3 Feet Other bff:,2\ DEPTH OF SIDEWALK $h4 inches ❑ 5 inches ❑ 6 inches et AREA TO BE REPAIRED& sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES , ❑ Yes ,® No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 3 IC) Date: 03/7747 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS LIZZ, EL/14 T ) -Z5-Z63 -oil PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes 16 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I CI Yes XNo WATER VALVE ADJUSTMENT REQUIRED — '♦' � ❑ Yes %No I 1 PARKS DEPARTMENT REVIEW REQUIRED = 9 I%Yes ❑ No LOCATION OF SIDEWALK ig Front Yard ❑ Side Yard ❑ Other — a WIDTH OF SIDEWALK ❑ 4 Feet Elk 5 Feet D 5.3 Feet 'Other '°� DEPTH OF SIDEWALK 4 inches? ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 12.4 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 74,No No.of Squares with Patches CODE G - — NOTE Areas marked with an err"may be a edby patching.A li other areas shall be repaired by — _ _- _ ;TPA, repaired...� reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 51\3 ! Date: o / 7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - PARCEL CODE CONTROL NO. —• Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F gYes ❑ No See below for Defect Code G TRIM VEGETATION p,Yes ❑ No if Q—► WATER VALVE j,04 I ADJUSTMENT REQ°D ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED _ ❑Yes ® No J LOCATION OF SIDEWALK f® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 115.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches ❑ 5 inches LI 6 inches AREA TO BE REPAIRED e sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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 : -5 Date: 3 7 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS _ /, — 5— Z — 0s7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ®,No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑Yes p No t WATER VALVE ADJUSTMENT REQUIRED ~�� ❑Yes ® No NAk PARKS DEPARTMENT — REVIEW REQUIRED Yes ,I1 N w,Ds vii L32 44 s—r -- LOCATION OF SIDEWALK J Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet J 5.3 Feet ❑ Other DEPTH OF SIDEWALK j:4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED II' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ..7 No No. of Squares with Patches CODE G - — NOTE Arena marked with an OF"L^.Ea;S be repaired by patcivirngs All nth_. shallbe repaired _fir`-_:::::�,.^........... .,.....��shall i-��.i[1ii cii by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : m T a 6,40 Date: 0 !4 7 PERMIT ISSUED FORMED POURED COMPLETED • CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ; 0 , -- (313, -2, -2A. _- I , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes V No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes No f)0 WATER VALVE t)I ADJUSTMENT REQUIRED --► ❑Yes No ,Ok PARKS DEPARTMENT REVIEW REQUIRED L Yes ❑ No i I LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ,2° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : l4-5 Date: 3 V?-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (offs ', , PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑Yes l No See reverse side for Defect Codes A-F See below for Defect Code G � TRIM VEGETATION ❑ Yes [r No _ 1 WATER VALVE ADJUSTMENT REQUIRED _ ❑ Yes E No PARKS DEPARTMENT REVIEW REQUIRED �qy �?ry� Yes No 4lpf/6M,J/g A LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet p Other St 4- DEPTH OF SIDEWALK i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2O sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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 — r econstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : TtS :030> Date: 3-2-3 -t� PERMIT ISSUED FORMED POURED COMPLETED -� CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (-IA PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes li No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑ Yes I No WATER VALVE 1 ADJUSTMENT REQUIRED ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ® No 0 LOCATION OF SIDEWALK 1=1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 -5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -. CODE F - PATCHES ❑ Yes ll No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: 3-Z !�� PERMIT ISSUED -. FORMED POURED COMPLETED_ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d -zs - &Di -6 5= c PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ® Yes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes I] No t WATER VALVE ((�� ADJUSTMENT REQUIRED �`y` ❑ Yes ER 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 14 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED I °S>5 q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall he repaired by "— ca,v i tructior i of-id sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 OA> Date: 3-Z-3 17 PERMIT ISSUED FORMED POURED COMPLETED ij CITY OF WATERLOO, SIDEWA K REPAIR SURVEY FORM PROPERTY ADDRESS i 1/3 — 5—Z 7 - w7 Z2 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect n ( ;:Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION -' I I ❑Yes gNo WATER VALVE ` ADJUSTMENT REQUIRED _ I � ❑ Yes D:No I I PARKS DEPARTMENT REVIEW REQUIRED : ' ❑Yes 1No 97///I 17/ 5.:37 �fr1 f -- LOCATION OF SIDEWALK ;S Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C 5.3 Feet ❑ Other DEPTH OF SIDEWALK I�4 inches LI 5 inches ❑ 6 inches AREA TO BE REPAIRED 7'-�Q sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes jig No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"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 A've-4 lakf PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2.!S— 1-0` 'L- I , \:5 Z/,'2 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 0 No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION CI Yes I1No 4 WATER VALVE ADJUSTMENT REQUIRED ❑Yes ® No ,04 PARKS DEPARTMENT — REVIEW REQUIRED \- ❑ Yes l)No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet CI 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches LI 6 inches — AREA TO BE REPAIRED 23. I sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Vb5 Date: 3 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS CO 3!k fa&&!cr 5+. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ll No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 1y No WATER VALVE l IV ADJUSTMENT REQUIRED � El Yes ANo I j � PARKS DEPARTMENT REVIEW REQUIRED 673 Yes ❑ No VA Ix— LOCATION OF SIDEWALK g Front Yard LI Side Yard ❑ Other _. WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Q'5.3 Feet ❑ Other DEPTH OF SIDEWALK (LE 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ZZ 5sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes © No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R--5 Date: 3"e--- � PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO 41 SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS .:%c ,,a ; PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes p No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION Cl Yes ❑ No 10 if WATER VALVE ADJUSTMENT REQUIRED — FQ� Yes X No l PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes L c7 No LOCATION OF SIDEWALK 2..Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IJ"5.3 Feet ❑ Other DEPTH OF SIDEWALK L .4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 54" sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Cl;No No. of Squares with Patches CODE G - ..... ,'N criP ' 9Arenn rnRrk_ari Imitk HP""rnmcs he rPrJrear?Saar s�ryt..hing ill 61thr- _ ...,ll ti _ ,a.-s by - °`— - ----.._--- - ... i -_' r "- � r _.... :�.;.. ...... ..cam a.,.... .,c,:,}+ iiv., by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3-Z-3- 17 _ AA) `f' & I PERMIT ISSUED FORMED POURED - COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - k3- ?A- - i3 ZZ-. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes 1E1 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes ® No WATER VALVE ADJUSTMENT REQUIRED t—Q"'f► ❑ Yes L1 No 1 PARKS DEPARTMENT REVIEW REQUIRED El Yes ❑ No _ - - 7 ., - - - - I 1, Z L LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK El 4 Feet El 5 Feet 11 5.3 Feet ❑ Other DEPTH OF SIDEWALK l 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED y -9 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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: 4 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 32-1 S3 Z6i4- PARCELCODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G I ❑Yes I No TRIM VEGETATION _ ❑ Yes QNo ♦`ate , WATER VALVE Si \ I ADJUSTMENT REQ'D ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED — — — — ❑Yes No J LOCATION OF SIDEWALK ❑ Front Yard © Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C ..5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches [ 5 inches ❑ 6 inches — AREA TO BE REPAIRED - sq.ft. 4 in. -,I- sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ,'No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. ft - FIRST INSPECTION AND FORM MADE BY : '` Date: 5`z-3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF W',TERL.* SIDEWALK REP,' IR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK • Type of Defect �' ❑Yes ='. No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes i No WATER VALVE JI ADJUSTMENT REQUIRED �—Q--► ❑Yes ® No r I PARKS DEPARTMENT REVIEW REQUIRED I II ® Yes El No rrti� 1C1 I, I \ F` \ --- . LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other — _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet l 5.3 Feet ❑ Other DEPTH OF SIDEWALK ;1 ,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ID -' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes p No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : K\ Date: - %e,7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1 ei Oct r3 -zs- z�a- 01-)-27 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect X Yes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION 1 ❑ Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED L.56 J ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No ry re),)Ler LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 2- ° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 4No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching 11 otherareas shall repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D& De? Date: Y/Z7 /r7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5 7 tr Pr -25 - - t) 3 05 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect / ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes r No E A WATER VALVE �' �� ADJUSTMENT REQUIRED �Ok ► � f ❑ Yes VNo I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes IXNo LOCATION OF SIDEWALK N6ront 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 di°2 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : )G.._ 1) (3 Date: 3/z �i.7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 5z I (3 - Zs'<. i� - 0lz— PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ri No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑Yes iNo WATER VALVE ADJUSTMENT REQUIRED � � 5 'Z I ❑Yes ,C No j PARKS DEPARTMENT REVIEW REQUIRED ❑Yes I.No pc , or- - LOCATION OF SIDEWALK [Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet P15.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED c2-1°k sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ?Yes I No No.of Squares with Patches CODE G - — was TP _ ,�ran marker?with n "Fn xa P.ro d P: s .:n All .n,b€-..-, .e shall ll k.,. -.-. ...:rGd b= .: c .. .........,...,......... ..,�......: .....y :crc...c.. v°7 j:: ..v,n..y.�ii vu.ci�iia.uS SiiCii vc ic�.iuie�ii :;y reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : I)C I) J Date: 3/lif f 7 PERMIT ISSUED — FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS _C u PARCEL CODE CONTROL NO. nn CLEAN SIDEWALK Type of Defect ?`I) ❑Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G i TRIM VEGETATION ❑Yes ' i No 5 32 WATER VALVE ADJUSTMENT REQUIRED 4 ❑Yes VI No - I I PARKS DEPARTMENT _ REVIEW REQUIRED ❑ Yes lNo b..riecJ LOCATION OF SIDEWALK ,f51 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet a 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1R4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 132- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0-No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY :D6— Date: >/Z7 /17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d"�1 - - r ? -7 PARCEL CODE CONTROL NO. — \\`' Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK — See below for Defect Code G ❑ Yes ® No TRIM VEGETATION ❑ Yes 0,No WATER VALVE i j a N ADJUSTMENT REQ'D / j ❑ Yes , No — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes M No LOCATION OF SIDEWALK 0,Front Yard ❑ Side Yard ❑ Other —' WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet E .Other 3-.4- DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED / 7°5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - rvl l&lei; r a.a- A -1A C 1 T- 7v 4 E)vital; i . P9.5; gi — NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D 1 J2Fc Date: 3 _ =-7-1 7(qv-is) T PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 531 0,—'' 'd 2261 - 0142 057 PARCEL CODE CONTROL NO. - d`1 Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes IA No See below for Defect Code G 4111 TRIM VEGETATION ❑Yes 1:7 No 4 F \ AD USTMENT REQ°D ❑Yes a , No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No cdifetr LOCATION OF SIDEWALK ❑ Front Yard VSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet16.3 Feet ❑ Other DEPTH OF SIDEWALK [ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 21 sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes tEt No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : N2. Ph Date: VW/7 PERMIT ISSUED FORMED POURED COMPLETED ��yCI F ATERL*0 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS GO2 FrotAee . E39/3 -2c-23q - 001 2C PARCEL CODE CONTROL NO. — Type of Defect a'" See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G `tea ‘v' ❑Yes C 'No TRIM VEGETATION At it ❑Yes LNo WATER VALVE I \ I ADJUSTMENTREQ'D ❑Yes ® No — PARKS DEPARTMENT REVIEW REQUIRED - - - - ❑Yes LNo J LOCATION OF SIDEWALK ❑ Front Yard XSide Yard ❑ Other WIDTH OF SIDEWALK yi4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,W4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED NZ.0 sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. — CODE F - PATCHES J1Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : PIS Date: .5°z14-tom PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS (0' Lo I3 - ZS- z3y - 00Y PARCEL CODE CONTROL NO. CLEAN SIDEWALK A Type of Defect r\ ❑Yes L.No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes {,No WATER VALVE ADJUSTMENT REQUIRED F©� ❑Yes No 4 PARKS DEPARTMENT _ REVIEW REQUIRED Yes ❑ No 3 ) , fl") LOCATION OF SIDEWALK ;Kl:Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet t "5.3 Feet ❑ Other DEPTH OF SIDEWALK + ', 4 inches/ ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 113. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Al:No No. of Squares with Patches CODE G - NOTE :Areas marked with an"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 i7 '4" Date: 3J2Li if7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c -:lL h-- C;�C -4 - `�t..- f;0 z�5 PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G I ❑Yes ® No TRIM VEGETATION * Yes ❑ No ~Q` WATER VALVE J I ADJUSTMENT REQ'D ❑ Yes No I ` PARKS DEPARTMENT r� );A REVIEW REQUIRED — - ❑ Yes I] No LOCATION OF SIDEWALK _ Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches Cl 6 inches AREA TO BE REPAIRED GL '' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes O'No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.Ali other areas shaii be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY :. f\ .r D3 Date: :5 - ff — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY.ADDRESS 702 ei,J10( 8113 - Zs'- 35 -DO I PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F -1 Yes ❑ No See below for Defect Code G J TRIM VEGETATION ❑Yes I 1 No �—Q--► WATER VALVE ADJUSTMENT REM :T ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ` I No • Lwle/ LOCATION OF SIDEWALK A Front Yard t Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet It 5.3 Feet ❑ Other DEPTH OF SIDEWALK a inches/ ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED gfi sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes pA;No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : fnL DI3 Date: 3/Z-f h7 PERMIT ISSUED FORMED POURED COIVMPLE I ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 7 IC L er- S9 13 --ZS 23/ - oc*" 06, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect )Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes IX,No WATER VALVE �(``: �► I ADJUSTMENT REQUIRED — W`` ❑ Yes 1 ] No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes [ No / /5- LOCATION OF SIDEWALK IF.` ront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet JX5.3 Feet ❑ Other DEPTH OF SIDEWALK W4 inches,/ ) 5 inch, ❑ 6 inches AREA TO BE REPAIRED 02A sq.ft. 4 in. 71.5- sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - — NOTE :Areas marked with a "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)I Date: - /17 -- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 800 glk ‹'k 12 -3o - /O% - OO7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes DI'No WATER VALVE ADJUSTMENT REQUIRED 4-0—* ❑ Yes Ig No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes [ ,No (00 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet IX 5.3 Feet ❑ Other DEPTH OF SIDEWALK i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3166-c) sq.ft. 4 in. sq.ft. 5 in. — sq.ft. 6 in. 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. FIRST INSPECTION AND FORM MADE BY : 6 &'D6 Date: '12741i7 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 60 8c9iz - io6 - coZ .:-7Z-. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes d No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes I No _. WATER VALVE ADJUSTMENT REQUIRED — �0� ❑ Yes /! No j I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes o'No i 39, 5- \ q,23 LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet f5.3 Feet ❑ Other DEPTH OF SIDEWALK '4 inches faI 5 inches ❑ 6 inches ✓ ✓ AREA TO BE REPAIRED 6 ' sq.ft. 4 in. 22. sq. ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes X No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.Ail other areas shall be repaired by reconstruction of full sidewalk panels. ,t r� FIRST INSPECTION AND FORM MADE BY : I L. ��' ` Date: S aih PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t3ib Ire 8Gtia - 30 - ioG - Z-74- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes !No WATER VALVE I it ADJUSTMENT REQUIRED f—Q—► ❑Yes VI No if PARKS DEPARTMENT REVIEW.REQUIRED NYes No LOCATION OF SIDEWALK ,1" Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK C7'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ��'`5-'( sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes COD No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : Ti � PIS Date: $/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 62ti 'owlee 891z - 3D- /O - coG 75. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Ni Yes ❑ No _ See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I 654Yes ❑ No — WATER VALVE ADJUSTMENT REQUIRED — ~Q� ❑ Yes X No I PARKS DEPARTMENT gl:;) 1 REVIEW REQUIRED ❑ Yes jEl Na it CAJ tiJ)e` LOCATION OF SIDEWALK XFront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet D:5.3 Feet ❑ Other DEPTH OF SIDEWALK 01-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 318 a sq.ft. 4 in. sq.ft. 5 in. — sq.ft. 6 in. CODE F - PATCHES ❑Yes ar No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. p ,p FIRST INSPECTION AND FORM MADE BY : oil Date: J2 5/17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -- 6ctrz - 3o - 106 - OO PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes VS1 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I0,Yes 4No WATER VALVE t,( ADJUSTMENT REQUIRED �Q--► ❑Yes X No PARKS DEPARTMENT REVIEW REQUIRED ��;\ ❑Yes DI No Lt,S` 1-1,0 — - — — Gw)e r LOCATION OF SIDEWALK [B Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet lB 5.3 Feet ❑ Other DEPTH OF SIDEWALK la4 inches g5 inches ❑ 6 inches AREA TO BE REPAIRED Zi'2 sq.ft. 4 in. 2-3, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : MS fir- 7h Date: 3/ZL(/f7 PERMIT ISSUED FORMED POURED COMPLETED CITY s.F WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect cEl Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G `�" — TRIM VEGETATION l ,RE ❑ No WATER VALVE ADJUSTMENT REQUIRED I \ ❑ Yes f No — I PARKS DEPARTMENT Ci vd� REVIEW REQUIRED — -)� �� ❑ Yes A No f D,%}— — A 5,3j i t olec LOCATION OF SIDEWALK A Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet ❑ 5.3 Feet JP Other ' ` DEPTH OF SIDEWALK Ais4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes riEl No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by FIRST INSPECTION AND FORM MADE BY : Date: 1 e÷i 7 — PERMIT ISSUED FORMED POURED COMPLETED — -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 87 -L )&'1 -- f c(L - 50 - 106 - Olt( PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ) 1 ❑Yes ri No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes MNo If WATER VALVE ADJUSTMENT REQUIRED 1-0--► ❑Yes 1 No / I PARKS DEPARTMENT REVIEW REQUIRED El Yes JNo LOCATION OF SIDEWALK a Front Yard ❑ Side Yard❑ Other .� WIDTH OF SIDEWALK II 4 Feet t 5 Feet ( 5.3 Feet U-other DEPTH OF SIDEWALK 0 4 inches; ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED a14-\• sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes f'No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. mp FIRST INSPECTION AND FORM MADE BY : + � ' P. Date: V1241I 7 PERMIT ISSUED FORMED POURED COMPLETED _ i OF Z- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS '2ij icgAN 1,!Ai 5r Er S9t3 -A - 34t - ()is./ ,, f 7' PARCEL CODE CONTROL NO. Type of Defect A . C, See reverse side for Defect Codes A-F CLEAN SIDEWALK — See below for Defect Code G ❑Yes © No Lki k TRIM VEGETATION — "z ❑ Yes O No 1-4 —► — Ok 2 WATER VALVE it �, ADJUSTMENT REQ'D }�,� �—,; ❑ Yes N No .: s-c.,, tt N k. PARKS DEPARTMENT REVIEW REQUIRED — 17.1' — ❑ Yes I iNo 4:"(s' 1.'\,\NNIINV c:. LA 6.4,1' (9'3'M 6.1.k ) - 371., le,- 5lbEtA)ALK — E. 5 cr STREET- LOCATION OF SIDEWALK I Front Yard EiSide Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet -® Other VAaiEs DEPTH OF SIDEWALK 24 inches ❑ 5 inches - I6 inches AREA TO BE REPAIRED 3:. sq.ft. 4 in. sq.ft. 5 in. 2!'I•G sq. ft. 6 in. — CODE F - PATCHES ❑ Yes © No No. of Squares with Patches CODE G - — NOTE :Areas marked with an'F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ns D6 Date: 3.30- !1 — PERMIT ISSUED FORMED POURED COMPLETED - 2r 2 _ CITY OF WATE LO0 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c ic. A� a_3FQ 5712.Ec _ 8i1S -2,4 - %a - peg f s 1�' PARCEL CODE CONTROL NO., L•� ,r — Type of Defect A;C, C., CLEAN SIDEWALK See reverse side for Defect Codes A-F -' ❑ Yes ] No See below for Defect Code G I .-` TRIM VEGETATION ��` .. ,- ❑ Yes No E WATER VALVE 4.-0-4. om. — r ADJUSTMENT REM) }�I N. A. 6� Yes ❑ No I ` - — a 7\` PARKS DEPARTMENT e,�} 5-,u =W REVIEW REQUIRED , ir, ;Ll Yes ❑ No W ° i si: • �' ��` ,r ' `�od'. �a sy� far '� TREE C.RAT 6 n �:e ,,,. �y �.. .• �' / AsD.SLA5T roi T"m �. Qq;8S Pats F RANIV,L iM STkE E T S l Dew INL'. 'c — LOCATION OF SIDEWALK K12,Front Yard &Side Yard ❑ Other VAe►es — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet Cl Other DEPTH OF SIDEWALK "Igi,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED % P sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IA No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Rs Date: 3-3°"f l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATER_®o SIDEWALK REPAIR SURVEY F•RIB ROPERTY ADDRESS F.124 LA AA, Y PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I LI Yes _ TRIM VEGETATION 'f ❑Yes lJ No �(� WATER VALVE ADJUSTMENT REQ'D LIYes ❑ No PARKS DEPARTMENT . REVIEW REQUIRED ❑Yes IN No i u LOCATION OF SIDEWALK El Front Yard , C�,Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet JOther DEPTH OF SIDEWALK lJ 4 inches LI 5 inches ❑ 6 inches AREA TO BE REPAIRED 1.., _ sq. Tin. sq 5 in .. •FF y` . • jq. D6. V 11!• CODE F - PATCHES ❑Yes ,® No No.of Squares with Patches CODE G - NOTE:Areas marked With an "F"may be repaired by patching A!!ether areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOG SIDEWALK REPAI SURVEY FORM PROPERTY ADDRESS Pos - rk - ` sS - ✓ z��' . PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ] ❑Yes fIN No l I TRIM VEGEI"ATION ❑Yes El No I • WATER VALVE ADJUSTMENT REQ'D i ❑Yes 1p No 1 PARKS DEPARTMENT REVIEW REQUIRED SAD I .0 _ et ❑Yes l No 1 i KKA A: 1'1 LOCATION OF SIDEWALK El Front Yard I] Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet ❑ 5.3 Feet ® Other _ 4 DEPTH OF SIDEWALK p 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED in a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes El No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : B1).> Date: e)-2k -- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c7 /4 f/1A-UKL/Al 57 '3c) - coS Toy PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G C Yes ❑ No TRIM VEGETATION ❑ Yes C No N _ VL ADJUSTMENTWATERAVE REQ'D ❑ Yes CQ No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ! No 14, LOCATION OF SIDEWALK CFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ©'5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches _ K AREA TO BE REPAIRED L ;9sq. ft. 4 in. .sq.ft. 5 in. sq.ft. 6 in. 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 : � B Date: 3 5 1 a7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS WO 5 1< - °3 'k/i Sf. - - old L PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I iC Yes LI No TRIM VEGETATION ❑ Yes No �— --► WATER VALVE ADJUSTMENT REQ'D W ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED tom: ❑ Yes El No LOCATION OF SIDEWALK r Front Yard rfl Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet XI5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches ❑ 5 inches M 6 inches �' ! . AREA TO BE REPAIRED 951 STO -O sq.ft. 4 in. sq.ft. 5 in. - sq.ft. 6 in. 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 : 5 5 Date: 3 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1 c y C , ‘`' -75 - - Z� PARCEL CODE CONTROL NO. (,a Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G t f Yes ❑ No TRIM VEGETATION ❑ Yes ® No 000 s4 WATER VALVE — I a ADJUSTMENT REQ'D C Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Q No E,-1xqe LOCATION OF SIDEWALK eLl Front Yard g7 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Ca 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches fl 6 inches — AREA TO BE REPAIRED -sq.ft. 4 in. sq.ft. 5 in. 743,0 sq.ft. 6 in. CODE F - PATCHES C Yes ! No No. of Squares with Patches CODE G - NOTE :Areas marked with,an"F"may be reDaire d by patching._re^,_° othG real shall r :i ;d by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : s�-� � Date: 3- f PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l !�--:� , .ct , 59 2 - m„rr- PARCEL CODE CONTROL NO. 0 Type of Defect 3 \ 4 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G r 0.' _--p MI Yes L No — o TRIM VEGETATION _ '� ------ E Yes r No 1-4 ~ `� 7 WATER VALVE — i,, a I —`' ADJUSTMENT REQ'D 71. ❑ Yes ® No 71 - PARKS DEPARTMENT fin' `,y' 4 REVIEW REQUIRED - - - - El Yes pNo I -- ( t J e,iv-`(t:i LOCATION OF SIDEWALK E l Front Yard E Side Yard ❑ Other - . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet 11] Other s A- DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ® 6 inches — AREA TO BE REPAIRED id°(•aF 3s3e2q sq.ft. 4 in. sq.ft, 5 in. s .ft. 6 in. CODE F - PATCHES ❑Yes E No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : , -- CC:5 0 Date: ?-1'1) PERMIT ISSUED FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS a �-3 --33 -cam Alc__LA•°-k �� PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes Er No — See below for Defect Code G I v I TRIM VEGETATION +.3 ❑ Yes © No �0--► 3 WATER VALVE — j S. 7 ADJUSTMENT REQ'D r,; I —‹ .tt ❑Yes No It, _ 4 PARKS DEPARTMENT ' vl REVIEW REQUIRED -1..1 11,`2__ 3,D 3,5 ❑ Yes J No — ..1 ��,tfNN VA VA A aA° A /f ` -(2,A.N A.4 — LOCATION OF SIDEWALK C Front Yard IN,Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet )l Other 5' - DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches Igi 6 inches 7 AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 143.C. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - _ NOTE :Areas marked with an"F"may be repaired by patching,All other areas shall h_repairer: by _ reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : V(3 5 ? 1 Date: 3 p `` -I 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS la-t �� �� � - Z-S- - Oi\ 3i D PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect D Yes El No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes L No r WATER VALVE I ADJUSTMENT REQUIRED CI Yes fi3 No -` PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ,RNo LOCATION OF SIDEWALK I Front Yard Cl 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 V sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes C% No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY It5" Zr) 5 Date: 3-2- "e 1-1 .S <`? �a-_ gym; PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1 S 1 5 r-- t/@1 t5 -z5- Zt1 - Otter Sty PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Yes ❑ No See reverse side for Defect Codes A F -- See below for Defect Code G I TRIM VEGETATION I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED fQ—► ❑Yes ® No PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes IINo '1 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK I:14 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED I ba s0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - — N TE .Aran P.��P �faai evf'eth an 11F➢1 may be repaired ° ' R.,°hen { I other areas shall h d - c.. e ➢ may be by 1J LLs11111U.NI 4J LI3G➢ areas AIIQIi he IICUci 1®I;CI U� reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D*, Date: -3- `/-7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 12 3 t Ai- �M o t> -mac- at - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ci Yes ,®'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes iiNo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes No 104 PARKS DEPARTMENT - ° �e REVIEW REQUIRED 3 , ❑ Yes No le /, A • LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ® 5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK p 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED - °' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes [ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 11,0 Date: 3 -4 - 1- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS Pali FRA LLli Mt; - - z - op& 3 ti ;- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Yes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑Yes ❑ No 1 � WATER VALVE ADJUSTMENT REQUIRED ❑Yes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes ❑ No 13,E _ _ 7b. - - - - % %N f aV — LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK rII 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK A 4 inches , ,K 5 inches ❑ 6 inches fir' AREA TO BE REPAIRED 105• sq.ft. 4 in. 5 ° sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes IX No No. of Squares with Patches CODE G - — i O i :Areas i a ked"i i i way be repaired uy patching.A l other areas 011011 bG repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : `1 Date: 05/1 7 PERMIT ISSUED — FORMED POURED COMPLETED -� CIS OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS j 500 b' zWKl...l� S% PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 0 Yes ILI No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I El Yes 7No " WATER VALVE ADJUSTMENT REQUIRED ~©� ❑ Yes d; ig® No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes L I No e 4-.s ` A_ : • ' LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK i] 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED = sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes y No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 57 Date: 5`�� PERMIT ISSUED 1, FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - 'PROPERTY ADDRESS /5 D 0113 -15- Z53 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK =' Type of Defect A ❑Yes .N No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes i No * WATER VALVE 1 )I ADJUSTMENT REQUIRED — 4-0--► ❑Yes X No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 16' �C kLiAi 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 _Y sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes g No No.of Squares with Patches CODE G - -' . - 1114:nis:,.a 1i•:1.1oo1 uu.. CIi fiiaj iv a:— iiy tio2i.Lol ..:...y_' rill i 1J bLi_1G...1..Gl GC5Si1Gii U G I._G_1 GI 1 G1 Jy ..._ reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : �_ i Date: t / "1 7 — 1 4 PERMIT ISSUED _ FORMED POURED COMPLETED -- CITY OF W/\TIE* L. SIDEWALK REPAIR SURVEY FO M PROPERTY ADDRESS /62 3 flue k/ -- VW -25 -2i2 -oe)? 320 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes I NO See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑ Yes LQ/No ! .f WATER VALVE .` ! / ADJUSTMENT REQUIRED ❑ Yes l iio PARKS DEPARTMENT REVIEW REQUIRED l El Yes XiNo SO' LOCATION OF SIDEWALK C'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ESI 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other _. DEPTH OF SIDEWALK j3'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 32 •® sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 'No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 924 ezt Date: , - 747 PERMIT ISSUED FORMED POURED COMPLETED ge-visi — CITY (IT WATERLOO SIDEWALK REPAIR SURVEY FO ` . — PROPERTY ADDRESS ‘6 j-1 Frcok\ate. Sf.. 69 iS -' - J2 - ©o6 la PARCEL CODE CONTROL NO. — Type of Defect A-C CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G I ,e,S. TRIM VEGETAJION _ ❑Yes A No N •°1 WATER VALVE 1e0k 4 ADJUSTMENT REQ'D — a ❑Yes Az No 1 � PARKS DEPARTMENT 4.0' 4 5-'' ' REVIEW REQUIRED — _ _ _ El Yes (No 4r $ - oa' J F-A„,,..v,, .. LOCATION OF SIDEWALK X Front Yard , %Side Yard ❑ Other — WIDTH OF SIDEWALK xr4 Feet ❑ 5 Feet J'5.3 Feet ❑ Other DEPTH OF SIDEWALK ► 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 40" sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes C` .io No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 0-4 e lh Date: 3'23"91 — PERMIT ISSUED FORMED POURED COMPLETED _j CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM r r- PROPERTY ADDRESS J b O ) i.EP,' k-i,f-_ PARCEL CODE CONTROL NO. l CLEAN of Defect SIDEWALK❑Yes o See reverse side for Defect Codes A See below for Defect Code G TRIM VEGETATION .. I .➢ j Yes ❑No t/11 WATER VALVE ADJUSTMENT REQUIRED , ❑Yes No �1tC-IxqiB'1 I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes [ No I ,� 11,2' - I I . LOCATION OF SIDEWALK ❑ Front Yard .Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet K5.3 Feet ❑Other DEPTH OF SIDEWALK A`4 inches LI 5 inches ❑ 6 inches / AREA TO BE REPAIRED -11 7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes OciNo No.of Squares with Patches CODE G — NOTE :Areas marked with an"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: T/Z7/[7 r PERMIT ISSUED FORMED POURED COMPLE I ED OILfl SF WATERLOS0 d v seJ), SIDEWALK REPAIR SURVEY FORM _ kihtr\ PROPERTY ADDRESS /Ir1Z Fcw,1, Sci r3 - 25- 2�1& - Col 3,? PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect A :C Yes ❑ No See revere side for Defect Codes A-F �C' 4e-fie—t See below for Defect Code G I TRIM VEGETATION ❑Yes 'g No WATER VALVE 1 ADJUSTMENT REQUIRED �.� .� ❑ Yes Cg No I PARKS DEPARTMENT REVIEW REQUIRED 1 ❑Yes No I ! — SI r ro — — — +tom. 8, /reg k j�j'� S O fr 4+ i l i t -. / Palo. f j v-i \ LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK r1a4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches _ AREA TO BE REPAIRED 311'6 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches — CODE G - _ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — 1..0 t:..... f full sidewalk��i ��»� panels. FIRST INSPECTION AND FORM MADE BY : �=j ► 3 7 �} Date: 05 917 — i��y1J13,a.e,, db7 J PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATER L( ,• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Ito 173 I:74.);,.1. ,s.¢13 - ? - 053 - 0'0 szzi PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION l ❑Yes ® No WATER VALVE ADJUSTMENT REQUIRED ~ —* ❑ Yes E No mil\ PARKS DEPARTMENT REVIEW REQUIRED l ❑Yes O No /J ,.1 e sy e�- 11, LOCATION OF SIDEWALK IA Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK 0 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK O 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 _H) sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : a' � Date: 2!`d i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 14AL K 94 - Z5 - 27 - 0E5 9f 7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ©Yes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑Yes R No - WATER VALVE t JI ADJUSTMENT REQUIRED — 41-411 ❑Yes p;No PARKS DEPARTMENT — REVIEW REQUIRED C: " a ❑Yes N.No FAN Kt= O - LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ,LM 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 4 inches IS 5 inches ❑ 6 inches/ — AREA TO BE REPAIRED V 4?-6 sq.ft. 4 in. V' .sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ca No No. of Squares with Patches CODE G - NOTW �V���P :Ares.marked with "P'"rirt �be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /ems Date: r fr a — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS fie bit r:r2RA*1_,/,4.! g`eI -25 -23LI - 0i5 ' -31C) PARCEL CODE CONTROL NO. Type of Defect C See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes IS1 No I ,t TRIM VEGETATION ❑ Yes No WATER VALVE 1 . ADJUSTMENT REQ'D �� ®L Ace ❑ Yes Cal No PARKS DEPARTMENT (_ �' REVIEW REQUIRED ❑Yes 'S7 No V/J'//4I V//Y/V4/1 r/0,l V artiT0t4 STREET LOCATION OF SIDEWALK El Front Yard L1 Side Yard ❑ Other _ WIDTH OF SIDEWALK al 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 19• sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. -" CODE F - PATCHES ❑Yes E No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an OF"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: , © - 1/ R.Ss PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 33/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect `; , ❑Yes ,I 1 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 El Yes II No �*� WATER VALVE f ADJUSTMENT REQUIRED �— --► ❑Yes E,No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes kr No A I - - - - - - LOCATION OF SIDEWALK Front Yard ❑ Side Yard El Other _ WIDTH OF SIDEWALK 0.4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I(�"``f sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an'F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : -T eq - Date: `s`7 PERMIT ISSUED FORMED POURED V COMPLETED CITY OF WA ERA,0 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /7iL -22 -217 -o PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect d ❑Yes 'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes teNo WATER VALVE 1 ADJUSTMENT REQUIRED _ ❑Yes `iNo I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes *go 1:-RA 'u-e i, LOCATION OF SIDEWALK E3 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 6(4.4 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IN/No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by —. reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 'P‘') Date: 3'g PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS P 7 i b riniA k\N- gC(3 - Z5 - Z3L - 011 34 PARCEL CODE CONTROL NO. L\ CLEAN SIDEWALK Type of Defect i ❑ Yes +L7 No 1 _ See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 1l No WATER VALVE it ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes Nr No I{ LOCATION OF SIDEWALK a Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK `C14 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E9.,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED v.) sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 'No No. of Squares with Patches CODE G - — NOTE .Areas marked with i ewc.e�r ;;;,'.ay;;��;�;R;;:;;411""'" guy be repaired by patching.r�iii other areas shall be repaired by reconstruction of full sidewalk panels. '� / FIRST INSPECTION AND FORM MADE BY : �If 1 > T) Date: 3 2`(//7 PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 17ZI /gi4i'JkLi I - Z5 Z34 - P/0 534, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect G ❑Yes [ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED ❑Yes k No PARKS DEPARTMENT REVIEW REQUIRED ID Yes M No 3,7 1Z ion LOCATION OF SIDEWALK L LFront 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 75'Z sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 17I,No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : M6 Date: 3-Z4-17 -- (6/�) ; iQ 5-4-i 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF W,ATERA#0 SIDEWALK REPAI' SURVEY FORM - "ROPERTY ADDRESS /730 f r i/c/it 5/, - e7/5 -2.0-2-77 - cos 336 PARCEL CODE CONTROL NO. — Type of Defect r „ 6- CLEAN SIDEWALK — See reverse side for Defect Codes A-F �� ❑YeS �o See below for Defect Code G I Lh.. �� \f TRIM VEGETATION — ❑Yes X.No 4—(;) ,- IM WATER VALVE \ I s ADJUSTMENT REQ'D — Icr. tZ ❑Yes 1No PARKS DEPARTMENT REVIEW REQUIRED — I, A ❑Yes /10o gN' -it-. — LOCATION OF SIDEWALK Front Yard p.tide Yard ❑ Other — WIDTH OF SIDEWALK '4 Feet ❑ 5 Feet A-5.3 Feet ❑ Other T DEPTH OF SIDEWALK %4 inches ❑ 5 inches CI6 inches AREA TO BE REPAIRED /O S.Z sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes , f No No.of Squares with Patches CODE G - k_ ealC . 'e NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1\6 5 Date: .3-Z 5-17 - Yl-- ✓19-P 7 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WKTERLO• SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l7iSl I y,k)„7 gefJ3 -25 -008 3_7 PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ��- ❑ Yes 4'No -67 TRIM VEGETATION ❑ Yes ,4'No WATER VALVE 1� ADJUSTMENT REQ'D ❑ Yes g No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes j1No 1. LOCATION OF SIDEWALK ❑ Front Yard igSide Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet . [ 5.3 Feet ❑ Other DEPTH OF SIDEWALK i,''4 inches,/ ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ‘5•(() sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. g FIRST INSPECTION AND FORM MADE BY : LU d EJ3 Date: -3'/2 i//7 — -- —PERMIT ISSUED - - --------- _ ___ FORMED POURED COMPLETED CITY SF WATE':__0 SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS o bite— fovok.-61 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A F — I See below for Defect Code G I TRIM VEGETATION I ) ❑Yes No WATER VALVE JI ADJUSTMENT REQUIRED `g � F f •—► II Yes 4 No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes JA`No KZA .I ,Faynktyi. -- LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK i r4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK x(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 11-@`4 sq.ft. 4 in. ® sq.ft. 5 in. — sq.ft. 6 in. CODE F - PATCHES ❑ Yes I 'No No.of Squares with Patches CODE G - E p ay berepaired by patching__rA-•_ii_�ii'E=! areas shall be repaired by �p gT` 'y aY'Ra�PYiv4'�eF�withan II�3A�A.>sF i+ �.. . reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : P113 Date: '2 ai7 1514 5-31-11 PERMIT ISSUED FORMED POURED - COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f&?o K I� - Z ✓- 27 - 00 PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAFSIDEWALK See below for Defect Code G s Yes ❑ No TRIM VEGETATION At ❑Yes ❑ No ' WATER VALVE ADJUSTMENT REQ'D / ..,0 ❑ Yes ❑ No Z PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ❑ No Fe,,AsVitIV ,Jf LOCATION OF SIDEWALK 0 Front Yard E Side Yard 7+ ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LI 6.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches Q 5 inches ❑ 6 inches AREA TO BE REPAIRED ' 'a° sq.ft. 4 in. 4 S sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches _ CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : j Date: 3. 11'7 PERMIT ISSUED FORMED POURED COMPLETED CITY SF WAfER_�•O SIDEWALK REPAIR SURVEY FIRM -- PROPERTY ADDRESS 62 Off' a-- F . A) 9 - Z5- vie - 5' PARCEL CODE CONTROL NO. • CLEAN SIDEWALK 3 ❑Yes N Type of Defect o — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes Io WATER VALVE �'t J/ ADJUSTMENT REQUIRED — 4„- N .♦ +Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes (NNo — Ka IeZA LOCATION OF SIDEWALK lOront Yard ❑ Side Yard ❑ Other ._ WIDTH OF SIDEWALK tgi.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK J 4 inches ❑ 5 inches ❑ 6 inches L. c AREA TO BE REPAIRED - sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes gNo No. of Squares with Patches Ge e- - 646)- Ate-i e AA,— OW CArsv ' �s v Wti CArrtl - S e-✓d.�. She 1 — ari-- / l).)-1=x ed 6- dt-ty, re-kt . ? ' - A — Areas marked with a . iFi , ,y"v,vpw,vu by p u vviny_,.Ail other-areas u. r-prGn7 jllali be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : d K'S Date: .5-7A-1 i _ 1"4 ,J 5 11cii PERMIT ISSUED FORMED _ POURED COMPLETED - CITY OF WATERLO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS gp� z,;,4 /14, / -2S- 278 - ?.- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes fl' o See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes El-o At if VALVE \,% ADJUSTMENT REQUIRED ❑ Yes ,gfNo PARKS DEPARTMENT REVIEW REQUIRED ❑Yes F I f S LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK EA 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Finches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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 : ,l' ; Date: 3"217 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I gd 3 -�-, y'''c l i3 - z5 - Z35 - Oiz 32441 PARCEL CODE CONTROL NO. - Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F —2 El Yes No See below for Defect Code G n _ . 0 1S — T TRIM VEGETATION El Yes I�,No 0 if .-__. WATER VALVE �,► 1\ 1 d ADJUSTMENT REQ'D ❑Yes t No — �.1Nam. 5, Sl �. PARKS DEPARTMENT REVIEW REQUIRED — ,:z_s >,� [— — ❑Yes No I NI r \ — ---I ... W-1 e., 1 _ I LOCATION OF SIDEWALK %Front Yard K Side Yard ❑ Other — WIDTH OF SIDEWALK tg 4 Feet ❑ 5 Feet E '5.3 Feet ❑ Other T DEPTH OF SIDEWALK p;4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ,AA-'```' sq.ft. 4 in. <�`'sq.ft. 5 in. — sq.ft. 6 in. _ CODE F - PATCHES ❑Yes C31No No.of Squares with Patches CODE 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� ! J FIRST INSPECTION AND FORM MADE BY : ���S a- g /Z /Date: /7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /80H FKA t4.1-1k1 ST .r -zS - 603 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes ❑ No 4 WATER VALVE ADJUSTMENT REQUIRED A-0—* '.Yes ❑ No I PARKS DEPARTMENT REVIEW REQUIRED — ❑Yes ?I No 3 111' re_Poki,4 ikS S e Rt5--.E i LOCATION OF SIDEWALK ? Front Yard ❑ Side Yard ❑ Other _— . WIDTH OF SIDEWALK M 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other. DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED M/' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I^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 : Date: " R 15 I`12 - �� PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS / of ,CizAhlk0A1 57; 09/3 -Z5- Z? - 0(94- 3 r PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect / ❑Yes ® No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑Yes RI No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Cgl,No vrV:_ PARKS DEPARTMENT — REVIEW REQUIRED =5Av-1- ❑ Yes CA No LOCATION OF SIDEWALK Fl.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 0\4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK [s 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4' .Zsq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - — NOTE :Areas marked with an F- may be repaired by patching.Air other areas shaii be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : F Date: ?,-7.2 7 (qui 4-74-17 - PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATER=41O S DEWA_K REPAIR SURVEY FORM PROPERTY ADDRESS 8\l F-ektn kk.\ 3 yt. s+. _ g9l3 -z5-Z35 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 l ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ~Liam ❑Yes o if 04 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 'No LOCATION OF SIDEWALK J 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK %4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )f4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED da •0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ,CNo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : r1 j ÷ Date: r3A/ ( . 7/7 PERMIT ISSUED FORMED POURED COMPLETED_ CITY Y OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS )900f i k rraftk 9q 9l -30 - foto _ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ti Yes LI No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION i ❑Yes tlti No WATER VALVE ADJUSTMENT REQUIRED 0,C Yes ❑ No — I I PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes 6 No LOCATION OF SIDEWALK tiL Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IN 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2`/°`° sq.ft. 4 in. — sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes :+No No.of Squares with Patches CODE G - -- NOTE:Areas markedd with an"F"may be by patching.Ali other areas shall be repaired . ...� repaired ..� - a,c-+�c�Qcu by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : 111 4-S) Date: 312 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 9 t 9 Fr w'a k j; Grz - - to( - Ozo 3 t� PARCEL CODE CONTROL NO. / CLEAN SIDEWALK Type of Defect ❑Yes a'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes yl]No WATER VALVE ADJUSTMENT REQUIRED f�--► ❑Yes No 404 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes WI No LOCATION OF SIDEWALK d Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK t® 4 Feet ❑ 5 Feet ❑ 5.3 Feet r Ito e.vi6 DEPTH OF SIDEWALK ❑ 4 inches C 5 inches 7 ❑ 6 inches - AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑Yes if No No. of Squares with Patches - CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : rolD 0 Date: 3/IL//I 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ` : re-Wqs` a,F 3 CP PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes Er No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION 1 ❑ Yes E No WATER VALVE ADJUSTMENT REQUIRED N ❑Yes -0 No I � PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes ❑ No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK (] 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK [] 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3k.' q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes LI 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: — PERMIT ISSUED FORMED POURED COMPLETED — E SE--;; CITY OF '.S'.ATER='* SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9'75 Fr i, . 691z - 3D-/ -as- a,e,5 PARCEL CODE CONTROL NO. — Type of Defect A; 4 D E See reverse side for Defect Codes A-F _` CLEAN SIDEWALK See below for Defect Code G I ❑ Yes ( No TRIM VEGETATION ❑ Yes [ No — Nl - -C.' -, WATER VALVE 1 ADJUSTMENT REQD A ❑Yes leNo I__ "Ca;V PARKS DEPARTMENT REVIEW REQUIRED I ❑ Yes 1-No I \ LOCATION OF SIDEWALK -Front Yard C'Side Yard ❑ Other — WIDTH OF SIDEWALK Q 4 Feet ❑ 5 Feet ®'S.3 Feet ❑ Other DEPTH OF SIDEWALK p•4 inches ❑ 5 inches i-inches — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. _ sq.ft. 6 in. - CODE F - PATCHES ,®Yes ❑ No No. of Squares with Patches E313E--03--- — _ - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : M13,4 IN15 Date: 3.2q. 17 - PERMIT ISSUED FORMED POURED COMPLETED ,eet,o.5S-4 CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Proms eM 8114 3o 105 -i92 3147 PARCEL CODE CONTROL NO. Type of Defect A? 6-p 6- CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G TRIM VEGETATION �' ❑Yes /No t E. —► WATER VALVE — I° ADJUSTMENT I,EQ'D ♦ LL ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED I�.� Mee?. 4.1 X Yes ❑ No &lo ) er. LOCATION OF SIDEWALK ,[ Front Yard Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet %5.3 Feet ❑ Other DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 0-9 sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑Yes ,No No.of Squares with Patches CODE G - "X„peole4 - p,;bit ,Y/2/4sf,wn7L % e caUL NOTE E.Areas marked larked withan"F"may be repaired by patching.Ail ether areas.Snail be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � � Date: 311-17 _. PERMIT ISSUED — FORMED POURED COMPLETED CI 1 V OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d . )®neAc 8917 - ,30- /33 a1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes ®oNo See reverse side for Defect Codes A-F • See below for Defect Code G TRIM VEGETATION ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 1;kf o PARKS DEPARTMENT REVIEW REQUIRED �3 ❑Yes tgi.No French LOCATION OF SIDEWALK t3 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet VI 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK to 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED X °0 sq.ft. 4 in. sq.ft. 5 in.. sq.ft. 6 in. CODE F - PATCHES ❑ Yes RNo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ow) Dg Date: _ 3.h girl PERMIT ISSUED FORMED POURED COMPLE I ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS ) Frenc _ 5ct)z -3° - 133 - 613 `372 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect p ❑Yes kl7No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION 1 ❑Yes IA No A WATER VALVE ADJUSTMENT REQUIRED '— 411-0� ❑Yes �1 No I PARKS DEPARTMENT REVIEW REQUIRED �a ❑Yes IX No _ 4Aj LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet [g5.3 Feet ❑Other DEPTH OF SIDEWALK Z4 inches, ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7" sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Y'1 4- :g Date: 3i/Z B/r7 '- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS TI . Frek 8912 - 55 - t33 -OIZ PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect A. ❑Yes 'j No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes cl,No WATER VALVE \ ADJUSTMENT REQUIRED fQ� ❑Yes l No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes kNo LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet p 5.3 Feet ❑ Other DEPTH OF SIDEWALK l 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 '. q.ft. 4 in. sq.ft. 5 in.. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : rtig 4' . Date: 3h-i 1/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS di 61►z - - '53 - 011 PARCEL CODE CONTROL NO. _ Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G j ❑Yes trflo TRIM VEGETATION — +� -3 ❑Yes p.No WATER VALVE Ott1 ADJUSTMENT REQD ❑Yes 1.4 No I� j I PARKS DEPARTMENT REVIEW REQUIRED �' _ ❑Yes No t-rfilCh LOCATION OF SIDEWALK M Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 11 5.3 Feet ❑ Other DEPTH OF SIDEWALK ki 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED g%'nk sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes KNo No.of-Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Y a 6 ' Date: 3/2 1197 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 20 - 8cn - 3o - )77 - Ool 37• PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C. ❑Yes ' KI No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION I ❑Yes Mr No * WATER VALVE 1 if ADJUSTMENT REQUIRED ~4� ❑Yes No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Igs No 42.21 rrevich LOCATION OF SIDEWALK Cla Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet J 5 Feet ❑5.3 Feet ❑ Other _ DEPTH OF SIDEWALK D 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED t211 ' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ]No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by — reconstruction of full sidewalk panels, FIRST INSPECTION AND FORM MADE BY : Pig 'C'DE0 Date: 3121117 PERMIT ISSUED FORMED POURED COMPLETED 'MY Y OF WK ER_OO S DEWA_K REPAIR SURVEY FORM PROPERTY ADDRESS 2:kt o FirevOt befit -3 - r77 377 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect F ❑Yes �L ilo See reverse side for Defect Codes A-F 1 See below for Defect Code G 1 TRIM VEGETATION 1 l ❑Yes ,Milo WATER VALVE ADJUSTMENT REQUIRED — ❑ Yes � \ 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes to tsA FimviN 54. _ LOCATION OF SIDEWALK )'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 lg°1) sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES % es ❑ No No.of Squares with Patches CODE G NOTE:Areas marked with an°F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : bs Date: 1°Z0 M M1 — . J 7- l7 PERMIT ISSUED _ FORMED_ POURED - COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z , , _ 891 Z - 3O- 177 - oo PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F — See below for Defect Code G J ❑Yes C No TRIM VEGETATION — ❑Yes 1No ~ WATER VALVE ADJUSTMENT REQD ,Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes /&No s1 j LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet NI 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK l '4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED A'- sq.ft. 4 in. sq.ft. 5 in. sq.it 6 in. CODE F - PATCHES ❑Yes gf No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : OS 'D 1 Date: 31 Z t/ 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t‘ `, .ref\O 891z - 3o- 134/ - oil 3 `) PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑Yes ' cX,No — See reverse side for Defect Codes A F { See below for Defect Code G I TRIM VEGETATION { ❑Yes WATER VALVE r/ ADJUSTMENT REQUIRED — ~ � ❑Yes Di No • I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes In No VA ® — 5 b tl rretrOn LOCATION OF SIDEWALK I.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 -IC•. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Iyt No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ill( ` 1D. Date: 3)2 if/) 7 PERMIT ISSUED -- FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS S cfrAIC,V1 89rZ - 3c3 - i 3yf - Gt° PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G ❑Yes No TRIM VEGETATION _ ❑Yes C.No \ WATER VALVE j • I ADJUSTMENT RECYD u G ❑Yes a No PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No • LOCATION OF SIDEWALK A.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 03,5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 014 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED vIS.0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes r]No No.of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: '11 G @ 1, PERMIT ISSUED -' FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 3cE) 6/e14,„Lie-- Otit - - 0 2.- .--03 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect X,Yes 0 No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION El Yes 0 No _ \t, WATER VALVE ADJUSTMENT REQUIRED — 0 Yes 0 No 11\ PARKS DEPARTMENT L....... 5.4) Clegvk tal lit ): REVIEW REQUIRED Li Yes Li No __ — r / , LOCATION OF SIDEWALK ,g Front Yard 0 Side Yard D Other _ WIDTH OF SIDEWALK 0 4 Feet 0 5 Feet g 5.3 Feet 0 Other DEPTH OF SIDEWALK /175,4 inches CI 5 inches 0 6 inches AREA TO BE REPAIRED 45.° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 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. CA yh FIRST INSPECTION AND FORM MADE BY : 1---N k L j -C--" Date:(.9 /9t4 _ P ° PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS A , l - - - 17 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect /i Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑ Yes } No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 0 No yOk I PARKS DEPARTMENT _ REVIEW REQUIRED ❑Yes 0 No — A- — 1 5 ®/ _ d k kiA4 LOCATION OF SIDEWALK ,gf Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,,Cj 4 inches 5 inches ❑ 6 inches � - AREA TO BE REPAIRED ` �''�, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: e. PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS c,. , . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect -{ Yes ❑ No d See reverse side for Defect Codes A F — See below for Defect Code G I TRIM VEGETATION I I ❑Yes ❑ No WATER VALVE ADJUSTMENT REQUIRED 0- ❑Yes ❑ No v PARKS DEPARTMENT REVIEW REQUIRED t‘‘ ® L ❑Yes ❑ No O�' � 01 t LOCATION OF SIDEWALK C ,Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,11,5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ta 5 inches ❑ 6 inches ? AREA TO BE REPAIRED 0 sq.ft. 4 in. ,1°Z.Jsq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - — NOTE :Areas marked with an°°E` may be repaired by patching.All other areas shall be repaired ed by - reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : L' Date: ,Kid/Kid 17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATEl,,L00 SIDEWALK REPAI�' SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. f _ CLEAN SIDEWALK Type of Defect ❑Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes O'No t WATER VALVE ADJUSTMENT REQUIRED --4--► ❑ Yes El No I j I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes E7 No LOCATION OF SIDEWALK 0 Front 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 IT tc sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes El No No. of Squares with Patches — CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ° "'`'`' Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 31K# PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect LI Yes I No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION D Yes flNo t WATER VALVE ADJUSTMENT REQUIRED 0 Yes ID No NJek PARKS DEPARTMENT REVIEW REQUIRED 0 Yes El No re; 062' Kl;';17/tA LOCATION OF SIDEWALK 0.h.ont Yard E Side Yard E Other WIDTH OF SIDEWALK E 4 Feet LI 5 Feet _0 5.3 Feet LI Other DEPTH OF SIDEWALK LI 4 inches ,I=1 6 inches 0 6 inches AREA TO BE REPAIRED 0 sq.ft. 4 in. 4 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES 0 Yes D No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.Ail other areas shall be repaired by reconstruction of full sidewalk panels. , FIRST INSPECTION AND FORM MADE BY : Date: ' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS g oo 64. of l t -3° - x51 - oaf s9 6 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes IN/No See reverse side for Defect Codes A-F a. See below for Defect Code G TRIM VEGETATION ❑Yes WNo WATER VALVE ADJUSTMENT REQUIRED =Q-•-► ❑ Yes ►xi No PARKS DEPARTMENT r REVIEW REQUIRED I ❑Yes jrNo 'f I \ ;•1' i ti4 fY - fear' 5 3' r5S 69.410 LOCATION OF SIDEWALK xi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet i-5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 12gr4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES of 'Yes ❑ No No. of Squares with Patches 2 CODE G - it n a- ddeepeire lnl /erne,/ ati Mere/ �C3 via mei 1 9eike nv, NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 6 Date: 5—V 7 7 5-- -/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /00 ETL-W 1niD P tbe- i Avg 43 -26' -12 - 047,3 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes I No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 1 ❑Yes ® No _. WATER VALVE ADJUSTMENT REQUIRED — N ❑Yes IN No I 1 i 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes U)No ABC — LOCATION OF SIDEWALK n Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet [ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED e.5 /sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Cl Yes ® No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: 3 -1e -I 1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G ❑ Yes l No ® TRIM VEGETATION _ ❑ Yes ® No 1 WATER VALVE ADJUSTMENT REQ°D ❑Yes RI No �e� , PARKS DEPARTMENT REVIEW REQUIRED ` ii ❑Yes F No VA LOCATION OF SIDEWALK e.Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet p 5.3 Feet Other S DEPTH OF SIDEWALK [ 4 inches ❑ 5 inches ❑ 6 inches iL AREA TO BE REPAIRED IW el sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CI No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3-a""i1 PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERLOO SIDEWALK REPAI" SURVEY F•RM PROPERTY ADDRESS Z ZO )r3,. -ectr-k,. ,A,k4 ✓ PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect Yes ' ® No — See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION El Yes ® No At ir WATER VALVE ADJUSTMENT REQUIRED f --► ❑Yes El No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes (g No -- to LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet jg'5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES El Yes Il No No. of Squares with Patches- CODE G NOTE:Areas marked with an"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. 1 67 Date: - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 5- 66-- . - O PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G I ❑ Yes No TRIM VEGETATION * ❑Yes L No I � 1 WATER VALVE ADJUSTMENT REQ'D ❑Yes O No ' PARKS DEPARTMENT REVIEW REQUIRED S ❑ Yes No V/ LOCATION OF SIDEWALK )J Front Yard ❑ Side Yard ❑ Other _ -- WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Hi 5.3 Feet ❑ Other DEPTH OF SIDEWALK R4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 27 G sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ' ` °) Date: 3 —1 f PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 31L, �� , ,c m 3 - - ' 3 - 4-0 - - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes I No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes ® No WATER VALVE ADJUSTMENT REQUIRED 41-0-00. ❑ Yes 11 No i �4)7\ I PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes giNo LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®`4 inches ❑ 5 inches ❑ 6 inches I, AREA TO BE REPAIRED 33.`I sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes M No No.of Squares with Patches CODE G - — NOTE :Aromas marked with an'-:F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ) W? Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 4 -O - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Ca No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes ® No WATER VALVE if ADJUSTMENT REQUIRED 40- 4-00. ❑Yes Liz No I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No VA LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet It [S5.3 Feet ❑ Other DEPTH OF SIDEWALK ;C 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 30• sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑Yes 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: 3- (7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS C1 Z 11d p 2Zir>- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK - See reverse side for Defect Codes A-F See below for Defect Code G Yes ❑ No TRIM VEGETATION LI Yes COIo WATER VALVE 0 - I ( ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 'No vr. LOCATION OF SIDEWALK ❑ Front Yard (Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 6.3 Feet LI Other DEPTH OF SIDEWALK 44 inches <5 inches ❑ 6 inches — AREA TO BE REPAIRED • sq. ft. 4 in. / '6 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 7No No.of Squares with Patches CODE 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 : > PPDate: 3 /7 / - PERMIT ISSUED — FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM °-' PROPERTY ADDRESS (gC n, -4,71&-c e.e gii3 - 2-27 - 00�- � Of PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes K.No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I 1 ❑Yes No WATER VALVE ADJUSTMENT REQUIRED � � ❑ Yes No y PARKS DEPARTMENT REVIEW REQUIRED ❑Yes IN,No Ltt LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet IK5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1E14 inches ❑ 5 inches ❑ 6 inches '— AREA TO BE REPAIRED -2-0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El 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 : D 13 Date: 3I27 J!7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t2 fZ (1,Mef7Ot '2 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A" ❑Yes f No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes ES?No f WATER VALVE ADJUSTMENT REQUIRED 4-07* ❑Yes kNo I l PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes rof - - - LOCATION OF SIDEWALK `E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ff❑I 4 Feet 165 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ai 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 2 L1 i5— sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 4 No No.of Squares with Patches CODE G - NOTE ._ :fir nrksd with sr;e!Feo:runt ha pr-Ar...d by ps hi All n h it€, r.d P y - rA E!1_ian�_A ;1l��1�Ilt�i�ll/a�b rea � reconstruction of full sidewalk panels. }� ,� FIRST INSPECTION AND FORM MADE BY : Fl % (3 Date: _5/z 2/7 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2-27- O 5 E PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C ❑Yes [INo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes \;No WATER VALVE ADJUSTMENT REQUIRED 4-0—* ❑Yes NNo z i I PARKS DEPARTMENT REVIEW REQUIRED LI Yes [ -No - - - - - - Sit - - - f -W,01 f_erLah.n ce 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 Z-t 0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes rClo No. of Squares with Patches _ CODE G - NOTE:Areas marked with an"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/9 Date: 3 7 / f 7 c PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 /2 /&rz — gt13 - zs ZZ7- 6 07 PARCEL CODE CONTROL NO. — Type of Defect A See reverse side for Defect Codes A-F CLEAN SIDEWALK —. See below for Defect Code G ❑ Yes f to TRIM VEGETATION -' ❑ Yes tlo ( 33 D %, WATER VALVE e♦ �� ADJUSTMENT REQ'D❑ Yes ` No — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes t No f.) 5+' LOCATION OF SIDEWALK ZFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ` 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK )X4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 9-5+5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes C6No No.of Squares with Patches CODE G - — NU I t:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 0 C� Date: 54 7//7 — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS O r, 43e1A, S41Z -30 - /C J - CO 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 0 Yes 0 No See reverse side for Defect Codes A-F J See below for Defect Code G TRIM VEGETATION J ❑Yes +NNo WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT .. +_, ' REVIEW REQUIRED ❑ Yes No ,9'� ` LOCATION OF SIDEWALK OZ. Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet I(5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK 24 inches '❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED C I, 5 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ®-No No.of Squares with Patches CODE - X re. s az "� �T r , ` NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : V 1. S Date: 3 Z 3)97 ) - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS CIO(P J��j t4e_ — B�C i z - 30 - l01 - ac 1i 'c\Le PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect EYes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes ►L No — if WATER VALVE ADJUSTMENT REQUIRED *"`4 k ❑ Yes No I I PARKS DEPARTMENT A )41 REVIEW REQUIRED � 0 ��, � ❑Yes El No 26.E - a LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK 4 Feet S'5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK tq4 inches ,r2'5 inches ❑ 6 inches AREA TO BE REPAIRED �`�� ° sq.ft. 4 in. SO(O sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes tallo No. of Squares with Patches CODE - — NOTE :Areas marked with an"F may be repaired by patching.Aii other areas snail be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 0,1) c}' Date: 312-7)G7 _ PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / � q Ift ne y-c.e Ritz - SO - io -CO PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes 11 No See below for Defect Code G 7 I TRIM VEGETATION ❑ Yes gs,No WATER VALVE � I 4V ADJUSTMENT REQ'D ❑Yes �No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No j :nnoleatAclevice LOCATION OF SIDEWALK ❑ Front Yard N'Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK R 4 inches/ p"5 inches / ❑ 6 inches J AREA TO BE REPAIRED 62° sq.ft. 4 in. /7° sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes l ,No No. of Squares with Patches _ CODE G - NOTE;Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : p l J g Date: _ J27J87 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 120fi 1\ e'vCe v 61112 - !OZ - O2 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect 4, ❑ Yes RI No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes 11No WATER VALVE N ADJUSTMENT REQUIRED ❑Yes ANo I I _ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes I .No — 53 _Lylele fie, LOCATION OF SIDEWALK Q_Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I5.3 Feet ❑ Other DEPTH OF SIDEWALK .4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 010° J sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes (0.No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : P16 +OS Date: 30 ) 17 — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -LAAe &ace- 89 - 1.0Z. - o03 r PARCEL CODE CONTROL NO. ACLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes g No WATER VALVE �/'i ,% ADJUSTMENT REQUIRED ~W—* eGa Yes Q No\\*:%:\ _ I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No 5 1' LOCATION OF SIDEWALK dLFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K5.3 Feet ❑ Other DEPTH OF SIDEWALK A4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED A?-O sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes p(No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 0 • FIRST INSPECTION AND FORM MADE BY : ` Date: 3/7-2-/9 7 PERMIT ISSUED FORMED POURED COMPLETED_ CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I TA 1 O — d - 3O- ) - col 4- PARCEL CODE CONTROL NO. d CLEAN SIDEWALK Type of Defect 1 0 Yes No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes V No o WATER VALVE ADJUSTMENT REQUIRED 441-0-0. ❑Yes ‘No PARKS DEPARTMENT REVIEW REQUIRED ,Yes ❑ No — b ro LOCATION OF SIDEWALK CE1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 0\5.3 Feet ❑ Other DEPTH OF SIDEWALK Cizl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED .28'' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. � J FIRST INSPECTION AND FORM MADE BY : ��p' '�10�;� Date: 3 11 A,7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOR`.y PROPERTY ADDRESS 5 0 e fz -3 - 3Z- - rvz 4 S PARCEL CODE CONTROL NO. Nor %; Type of Defect A. See reverse side for Defect Codes A-F ; CLEAN SIDEWALK See below for Defect Code G ❑ Yes .I No � TRIM VEGETATION ❑ Yes .0 No � \ xj WATER VALVE t ADJUSTMENT REQ'D I 4r, ❑Yes In No PARKS DEPARTMENT REVIEW REQUIRED El Yes 'No . LOCATION OF SIDEWALK ❑ Front Yard LSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I,5.3 Feet ❑ Other DEPTH OF SIDEWALK )4 inches I f 5 inches ❑ 6 inches AREA TO BE REPAIRED v-2' 7 sq.ft. 4 in. 15Z,5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El 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 : 1 , Date: _I l PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2- 1a \ v+ b 0 - - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 1.No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION 1 ❑ Yes (L7 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes 5S,No I I PARKS DEPARTMENT REVIEW REQUIRED Yes ❑ No LOCATION OF SIDEWALK I Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet M 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 15�,f 6n sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes I No No.of Squares with Patches CODE G - -• � {}_h6S 0 F 4? b:l% 374(G74v1 Cris)/1(P'_tq i f h NOTE :Areas marked with an"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 ad'7 Date: 3 Ida 17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Sq M/ 0/45 -2,5- 2W- 00 44Z PARCEL CODE CONTROL NO. CLEA N AN SIDEWALK Type of Defect A ❑Yes "gf No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION Cl Yes I0No WATER VALVE ADJUSTMENT REQUIRED "'5 INC, ❑Yes g No ,01 PARKS DEPARTMENT REVIEW REQUIRED IDYes gi No S.z a 11>1 LMYt LOCATION OF SIDEWALK ❑ Front Yard )Side Yard ❑ Other WIDTH OF SIDEWALK II 4 Feet El 5 Feet CI 5.3 Feet .©Other � s DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches )s 6 inches, AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. Sy° sq.ft. 6 in. CODE F - PATCHES ❑Yes FE No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. , FIRST INSPECTION AND FORM MADE BY : 8/0 Date: I)4/707 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS I 1 $; '3 -Z-S- 2-ll - 6\3 ;q PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes No See below for Defect Code G I 612 TRIM VEGETATION — Yes ❑ No N WATER VALVE — ADJUSTMENT REQ'D ❑Yes [ No I - PARKS DEPARTMENT °� � REVIEW REQUIRED 4 aee ❑Yes (N)No 25.E Sc 57_D 1 LOCATION OF SIDEWALK ❑ Front Yard II Side Yard ❑ Other — WIDTH OF SIDEWALK p 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®'4 inches ❑ 5 inches ❑ 6 inches — 7, AREA TO BE REPAIRED -5 7.c.3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - -- NOTE Areas marked with an"F"may be repaired by patching.All other areas A eit be rGJn°lGU by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 11-17)) Date: 3- e� _ PERMIT ISSUED FORMED POURED COMPLETED REV s CITY OF MERU.° S�*EWALK REP ku 111 SU-VEY FORM PROPERTY ADDRESS 2bO b LA/re- - 2O? - L wi 8 PARCEL CODE CONTROL NO. Type of Defect A See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G CI Yes p'No TRIM VEGETATION ❑ Yes p'No N� WATER VALVE ADJUSTMENT REQD • ❑ Yes %No PARKS DEPARTMENT REVIEW REQUIRED - - - - ❑Yes J2-No a> LOCATION OF SIDEWALK ❑ Front Yard jg Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X5.3 Feet ❑ Other —. DEPTH OF SIDEWALK ,l 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 55 t sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes )No No. of Squares with Patches CODE G -- NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : r6 5 Date: 7-2s A PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zc ' - 6\0 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F CI Yes 0 No See below for Defect Code G TRIM VEGETATION -- ❑ Yes No [V WATER VALVE 3 ADJUSTMENT REQ'D ❑ Yes (] No ate, ( 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 ❑ Other DEPTH OF SIDEWALK 0 4 inches El 5 inches ❑ 6 inches 1' AREA TO BE REPAIRED 2c -S sq. ft. 4 in. sq.ft. 5 in. sq.ft, 6 in. CODE F - PATCHES ❑ Yes pt No No.of Squares with Patches CODE G - NOTE :Areas marked'_ark.ed with "I'may b repaired by pet_hi___: NOTE a- ,Y,ni n�u inui�an � ,�IQy he � 70.i1���Il�..%111 V U ICf ale-as shah1 be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : BPS Date: 3 "2-1 ® 1 PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WM-Enn®. SIDEWALK REPAIR SURVEY FOR PROPERTY ADDRESS S[3 - - 1- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect j7 Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes ® No 1 WATER VALVE ADJUSTMENT REQUIRED ❑Yes ® No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ,IS°No LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,® 5.3 Feet ❑ Other DEPTH OF SIDEWALK [1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 43-D sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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 : R-5 sb Date: 3-Z- [7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOR`. PROPERTY ADDRESS 3 2-S , - � - z--6 5 ✓ PARCEL CODE CONTROL NO. Type of Defect .— See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G J ❑Yes D(No TRIM VEGETATION ❑Yes ® No Ae � E WATER VALVE ADJUSTMENT REQ'Dtxa _ 4 ❑Yes CI)No PARKS DEPARTMENT — €� REVIEW REQUIRED ❑Yes Il No j LOCATION OF SIDEWALK 1f Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®5.3 Feet ❑ Other DEPTH OF SIDEWALK I8 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 1 q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes fp No No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 % 5 Date: PERMIT ISSUED -FORMED POURED COMPLE!ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS LP oO &PK 1411 F AY0 ge. . a27 's _ l -ems_ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ® No I i1 I PARKS DEPARTMENT REVIEW REQUIRED El Yes `INo Sic) 4c, (2, 11- 2 S S. I 1,11 ® C. e 9 113E sus Llk S LOCATION OF SIDEWALK ,0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet p Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 g 5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes E No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : " Date: 5m2``` ® r7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS "(2.3 T� .-;.r 3s`5 - - 133 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes ® No - WATER VALVE ADJUSTMENT REQUIRED ❑Yes ® No I I _ PARKS DEPARTMENT REVIEW REQUIRED 410° ( ❑Yes ® No 1,1 ba4 ° /V1/1 Vi I LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L °5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches 1. ❑ 6 inches AREA TO BE REPAIRED .� sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ® No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : t) Date: ®(1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY 0R`. PROPERTY ADDRESS-. ( a_K. C ;A\/ & r F . . 33 - S-t a -as 49 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' N No See reverse side for Defect Codes A-F • See below for Defect Code G I TRIM VEGETATION I ❑Yes 11 No WATER VALVE \At ADJUSTMENT REQUIRED 11-0-410- El Yes 0No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes i] No . • LOCATION OF SIDEWALK ® Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet „IN 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 9 7°•8 /sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No. of Squares with Patches- CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D Date: 3 48-I I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes M No — WATER VALVE ADJUSTMENT REQUIRED ❑Yes No � I ' I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ® No sA- z�, t L Aom® "s — LOCATION OF SIDEWALK 7 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches M 5 inches ❑ 6 inches AREA TO BE REPAIRED I511 sq.ft. 4 in. ,de).( sq.ft. 5 in. sq.ft. 6 in.CODE F - PATCHES ❑Yes p No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3— `°1- — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLc•,0 SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1` . ' / -15 - k33 -ate PARCEL CODE CONTROL NO. Type of Defect -- See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G J ❑Yes El No J TRIM VEGETATION ❑Yes I] No WATER VALVE k ADJUSTMENT REQ'D A ❑Yes 1=] No PARKS DEPARTMENT REVIEW REQUIRED - - - - Yes ❑ No • VV4 (1-0 51 LOCATION OF SIDEWALK ❑ Front Yard ta Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK Et 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2-5A ' sq.ft. 4 in. sq.ft. 5 in_ sq.ft. 6 in. CODE F - PATCHES ❑Yes Il No No.of-Squares with Patches ... CODE 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: I 1 PERMIT ISSUED FORMED POURED COIMPLE I ED CITY OF WATERLOO SIDEWALK REPAQ" SURVEY FORM PROPERTY,ADDRESS-.. to . , erte 114 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A C ❑Yes ' [alio — See reverse side for Defect Codes A F • See below for Defect Code G I I RIM VEGETATION ❑Yes ®Ao — WATER VALVE 1 / ADJUSTMENT REQUIRED ❑Yes El o if04 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes C7"No 4,5 141 LOCATION OF SIDEWALK Er Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IK 4 Feet ❑ 5 Feet g5.3 Feet Other DEPTH OF SIDEWALK I(4 inches E5 inches ❑ 6 inches AREA TO BE REPAIRED - a3 sq.ft. 4 in. c23 `sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes lE/No No. of Squares with Patches- CODE G NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : es a Date: 3 '`� — PERMIT ISSUED FORMED POURED COMPLE I ED . ... .-__. ____.. . CITY OF WATERLO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS IQ-c: - ! ! - / /. PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes Q No TRIM VEGE 1 ATION ❑Yes 171 No N ~ --/► WATER VALVE 4,\ ° ADJUSTMENT REQD • ❑Yes allo PARKS DEPARTMENT REVIEW REQUIRED — — — — ❑Yes L No LOCATION OF SIDEWALK @ Front Yard ❑ Side Yard Ej Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet ISI5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 sq.ft, 4 in. sq.It 5 in_ sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: a- � �'l PERMIT ISSUED FORMED POURED COMPLE l ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /Ix aid_ &APAC-7T ; PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect P `� " —yp � ❑ Yes ❑ o N See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes ❑ No — WATER VALVE ADJUSTMENT REQUIRED © I ❑Yes D No I l I I PARKS DEPARTMENT REVIEW REQUIRED []Yes ❑ No � 1 15.+•r i LOCATION OF SIDEWALK La`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 1 "e l sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes El No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : <'z . Date: .- 6 — • - 7 PERMIT ISSUED -" FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ;= s` f. / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect E P., ❑Yes ❑ No See reverse side for Defect Codes A-F " See below for Defect Code G TRIM VEGETATION ❑ Yes (] No t WATER VALVE ADJUSTMENT REQUIRED ICY+ ❑Yes ❑"No 1 PARKS DEPARTMENT REVIEW REQUIRED fYes ❑ No LOCATION OF SIDEWALK 0:Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L15.3 Feet ❑ Other DEPTH OF SIDEWALK L44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /374 9 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —' CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : • a Date; •,.oE`.` ./ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I171 iFrn `T re 03 -7f - /yr - Of) ,i 473 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect — ❑Yes rf-No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 171-No -- WATER VALVE ADJUSTMENT REQUIRED (V ❑ Yes E.No I � _ PARKS DEPARTMENT REVIEW REQUIRED o ('7 ❑Yes ZNo 4,9 L6k _ - - - LOCATION OF SIDEWALK E T Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches 2-5-inches ❑ 6 inches AREA TO BE REPAIRED I•a Vsq.ft. 4 in. gi2A sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑Yes [ to No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY a'�) Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS l ZOO f FXye TE 577- 3\3 _Z,c- c -ar• ea 4 PARCEL CODE CON1ROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I El Yes No 'alp -_ TRIM VEGETATION ❑Yes El No N~ `•'� WATER VALVE I� i I ADJUSTMENT REQ'D v- ❑Yes El No — I PARKS DEPARTMENT REVIEW REQUIRED — — ❑Yes ® No — , r--9 LOCATION OF SIDEWALK I Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet El 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches ❑ 5 inches 12 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes D No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � ' Date: 3 - PERMIT ISSUED - FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS la-a la — i — ✓' 4142 PARCEL CODE CONTROL NO. —. CLEAN SIDEWALK Type of Defect ❑Yes IE No See reverse side for Defect Codes A-F I See below for Defect Code G I TRIM VEGETATION I I ❑ Yes El No — WATER VALVE ADJUSTMENT REQUIRED N ❑Yes Q No I 1 _ PARKS DEPARTMENT � 5 ®� REVIEW REQUIRED ❑Yes ® No Icy `ha — z"1 VA A LOCATION OF SIDEWALK J Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet a 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 52'5 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. ._ CODE F - PATCHES ❑ Yes p No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 9-5 Date: 3— 0 I-1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i1i4 4-(- rP1�� get i 3 - - - q© ✓ 4-17 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes [Ao See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes DNo WATER VALVE ADJUSTMENT REQUIRED El Yes L7No 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes LJ No 3.1 z 04-i t LOCATION OF SIDEWALK ❑`Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Efig.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED � se� sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CI No No.of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : J Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 17-z-0 1.3 - o - /I! PARCEL CODE CONTROL NO. -" CLEAN SIDEWALK Type of Defect ❑Yes C? No See reverse side for Defect Codes A-F See below for Defect Code G ( TRIM VEGETATION 1 ❑ Yes I ] No 1 WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ® No 1 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 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED s 1 ✓sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -- CODE F - PATCHES ❑ Yes lr No No.of Squares with Patches CODE G - NOTE :Areas marked with an"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-12 3 i 5 Date: 3^v-t l PERMIT ISSUED FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ! 3 a_3 L A F ; 1 �JI -&3 - 2-S - tk, 45 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED El Yes y No \ PARKS DEPARTMENT REVIEW REQUIRED El Yes No LOCATION OF SIDEWALK 1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ® 5.3 Feet ❑ Other DEPTH OF SIDEWALK pi 4 intes ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 'f2.9 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes © No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D Date: 3 a -L 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 132-- ti t t 3 -2c -ZS' l - L 4 Z- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ig No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes [ l No — WATER VALVE ADJUSTMENT REQUIRED n] ❑Yes No I I PARKS DEPARTMENT REVIEW REQUIRED iYes ❑ No (444 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 (0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CRI 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 : _ t:51) Date: 3 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1�� Zt4.Lf9i=,q 4 -rU 3 i PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes RI No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes ,® No WATER VALVE ADJUSTMENT REQUIRED ❑Yes rig No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes r LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .14 5.3 Feet ❑ Other DEPTH OF SIDEWALK j i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED a a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IN No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : if Date: 0" PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 8 - 'PROPERTY ADDRESS fz© E - Y�l O i Z5 Z91 - OOP 4,34k. PARCEL CODE CONTROL NO. Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A F ❑ Yes [ �No See below for Defect Code G I TRIM VEGETATION El Yes ® No WATER VALVE ADJUSTMENTyEQ'D ❑6% Yes ® No PARKS DEPARTMENT — REVIEW REQU JRED ❑Yes 0`No IAA 6 LY / LOCATION OF SIDEWALK ®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 as.1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ["No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: O5/I 47 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WAT ERL•O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 16,490 ( =A V .?E, ef3/3 /EA -��1 ;r � PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION El Yes No — t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ® No ip I r PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 111 No 4,4- VA LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ( 5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 3=3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes C4)No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : '2' e-7 Date: S'Z.2® I PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK SURVEY FORM PROPERTY ADDRESS I c ®JGO - _ e PARCEL CODE CONTROL NO. Type of Defect GLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes ® No See below for Defect Code G ) _ TRIM VEGETATION E1 Yes IN No \tI Q ►— WATER VALVE Ie ADJUSTMENT REM) aYes ❑ No PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes 0 No LOCATION OF SIDEWALK pt Front Yard ❑ Sid'e\Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet D .3 Feet E Other • — DEPTH OF SIDEWALK I 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 412-3 sq.ft. 4 in. sq.it. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ? FIRST INSPECTION AND FORM MADE BY : $°`> 0.9> Date: 3 deed PERMIT ISSUED FORMED POURED COMPLE l ED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ZAM Y rir PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect /11 ❑ Yes ( 'No See reverse side for Defect Codes A-F — I See below for Defect Code G I TRIM VEGETATION ❑Yes !;No i WATER VALVE ADJUSTMENT REQUIRED I I ❑Yes yiNo PARKS DEPARTMENT REVIEW REQUIRED �� a ❑Yes ,JI No - - - za ll� OK A V` is 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 �4 / AREA TO BE REPAIRED 66• L sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes fig No No. of Squares with Patches CODE G - — NOTE :Areas marked with an "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&) T1 Date: "44- 7 - Y of PERMIT ISSUED FORMED POURED COMPLETED C OF WATERLOO / SIDEWALK REPAIR SURVEY FORM -- I ADDRESS / k� i7 PROPER-N. P z 4' PARCEL CODE CONTROL NO. / T V9 CLEAN SIDEWALK Type of Defect A • ❑Yes )Zi7 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes „® No WATER VALVE 1 ADJUSTMENT REQUIRED _ ♦..(2).♦ ❑Yes A No ♦ PARKS DEPARTMENT REVIEW REQUIRED ❑Yes g No 9 VA / - \ — / Mit il7eAV — LOCATION OF SIDEWALK ❑ Front Yard ❑ Side Yard l4,Other = - WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet )5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches A 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. (>®Ssq.ft. 6 in. — CODE F - PATCHES ❑Yes A,No No. of Squares with Patches CODE G - i'tl lO G .Areas marked with an lrG may be repaired by patching,/i"l other areas _Gm5 J-all be rep—aired by reconstruction of full sidewalk panels. / FIRST INSPECTION AND FORM MADE BY : s,��f Date: 62/47 Y PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM vf PROPERTY ADDRESS I1 "-11-71V e � PIO -25 - 071 - 6 � PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK �' See reverse side for Defect Codes A-F El Yes C No See below for Defect Code G TRIM VEGETATION ET Yes ❑ No 1 JI WATER VALVE 1-0_„♦ ADJUSTMENT REQUIRED I( El Yes A;No PARKS DEPARTMENT -- I REVIEW REQUIRED ❑ Yes Q No ZOE YF° I)PAYS'"i Y+� J LOCATION OF SIDEWALK ) Front Yard ❑ Side Yard ❑Other _ WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet L 5.3 Feet ❑ Other DEPTH OF SIDEWALK (XI 4 inches, ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 0 1° sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑Yes fC No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : T3i0 Date: 03/Wt:( PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS VA 2-- A1 0-t _ P5k5 - ZS-Zs3 - c . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes iI No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes I No WATER VALVE \'t ADJUSTMENT REQUIRED _ tea--► ❑Yes El No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ® No _ - A / z7 y f`l A LOCATION OF SIDEWALK LI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2ii•q sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - _ NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 7/5 17 Date: '3-L. 4 " 1 i _ PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERL•O SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ik 1 L ' Its:; n -z.5- •a7 - or6, PARCEL CODE CONTROL NO, Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes RrNo TRIM VEGETATION JI ❑ Yes ,© No WATER VALVE ADJUSTMENT REQ'D ❑ Yes )No ,�µ1)'�1� Ir /` PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No VA f j ta V are LOCATION OF SIDEWALK ,`q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ! 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches g6 inches/ AREA TO BE REPAIRED sq.ft. 4 in. sq,ft. 5 in. a�.5sq.ft. 6 in. CODE F - PATCHES ❑Yes ,IIK No No.of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. / FIRST INSPECTION AND FORM MADE BY : FA t. Date: 03/71t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS n ` a k3 - 2-5- Z 3 -oko yq9 q� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes I No See reverse side for Defect Codes A F '— See below for Defect Code G TRIM VEGETATION ❑Yes ® No WATER VALVE t�( ADJUSTMENT REQUIRED CI Yes 9 No � I j PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No / A A 9 ' LI F LOCATION OF SIDEWALK 1E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K1 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED CzSa7 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes C No No. of Squares with Patches CODE G - NrITP _ ,.,a with•=lri 17" ,ha h. ,__ nili.,n Ali ry:ec. .::Y :. .b reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED • CITY OF WATERLO., SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 8 l Z-4 o f lc_ L PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G ❑Yes [ Na TRIM VEGE I ATION ❑Yes 0 No WATER VALVE ADJUSTMENT REQD ; ❑Yes I] No PARKS DEPARTMENT REVIEW REQUIRED — — — — ❑Yes I9,No Ifi, LOCATION OF SIDEWALK ❑ Front Yard ® Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet 15.3 Feet ❑Other -- DEPTH OF SIDEWALK 1 4 inches ❑ 5 inches ❑ 6 inches I AREA TO BE REPAIRED / ( sq.ft. 4 in. sq.ft. 5 in. sq.ff. 6 in. CODE F - PATCHES ❑Yes d No No.of Squares with Patches CODE G '- NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 17'5 5)'7 Date: 3—2-- ' — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS t 7 4f4-41ie "a _ (3 to- 019 , L ; PARCEL CODE CONTROL NO. Type of Defect C— CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G I TRIM VEGETATpN -- ❑Yes E No N WATER VALVE c ADJUSTMENT RQ'D ❑Yes IKNo PARKS DEPARTMENT REVIEW REQUIRED _ ❑ Yes No J LOCATION OF SIDEWALK 1;2'Front Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4nches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED f s q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yeso No. of Squares with Patches CODE G - NOTE .Ara-as marked With an"F"may b- rep-aired Ly-patching.rII ULICI areas shall be repaired' by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ` Date: 'Z 17 PERMIT ISSUED -- FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS gi Z-4 i1, 3. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ❑f\lo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 2No WATER VALVE ADJUSTMENT REQUIRED 1-0—+ ❑ Yes Er No PARKS DEPARTMENT 0 ,' ,t1 REVIEW REQUIRED ❑Yes 0 No 01. _ _ 14Ff e- LOCATION OF SIDEWALK f 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 �U� � sq.ft. 4//in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes L4 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 : 6 t -Z. "/7 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /ate T l Of ✓ 4 E 13 -2 -Z,0 - 0 ,/ 500 PARCEL CODE CONTROL NO. Type of Defect A,G' CLEAN SIDEWALK _ See reverse side for Defect Codes A-F ❑Yes �No See below for Defect Code G TRIM VEGETATION -- _ ❑ Yes No -k c- WATER VALVE � ADJUSTMENT�R-EQ'D CI Yes I No PARKS DEPARTMENT REVIEW REQUIRED It.r ,} ❑ Yes o C /2 t Kii / \ L ) .._ LOCATION OF SIDEWALK Front Yard amide Yard ❑ Other -- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (].3 Feet ❑ Other T DEPTH OF SIDEWALK 04 inches ❑ 5 inches El6 inches AREA TO BE REPAIRED !"II-0., I sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CYNo No. of Squares with Patches CODE G - — t-In"v .... . vvu3.e,µ„`ye,;;;;;4ee � "may a-!G`i GlacatiGU vy IJULaol III ey.III Lill ICI aI Gaa al'lan UG IC�JQII GU uy reconstruction of full sidewalk panels. ,, Date: f"21; e FIRST INSPECTION AND FORM MADE BY : gel)� pe, � PERMIT ISSUED FORMED POURED COMPLETED • CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ` }"' ` " '' - PARCEL CODE CONTROL. O. i 4 7 -" Type of Defect . D --- .�`: ' CLEAN SIDEWALK See reverse side for Defect Codes A-F '\ See below for Defect Code GI ❑ Yes No I TRIM VEGETATION ❑ Yes ErNo • ~Q`� WATER VALVE ,1 a ADJUSTMENT REQ°D ❑ Yes El No — PARKS DEPARTMENT REVIEW REQUIRED I C ' — — ❑Yes Ef No /K4t • „OF- ' LOCATION OF SIDEWALK [] Front Yard _Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1144 inches E 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. —' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑No No. of Squares with Patches — CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : i(7 ) e> ` Date: �€ 2=� 1 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,; Y ` L A'I `U7, )1 2,_ -3c - - .` : t PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G I ❑ Yes .0'No TRIM VEGETATION El Yes 0No WATER VALVE u- _'°, ADJUSTMENT REQ'D ❑ Yes 0No PARKS DEPARTMENT REVIEW REQUIRED ❑ 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 El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Ps sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes (] No No.of Squares with Patches CODE G - -- NOTE •Areas markers with an"F"may bC repaired by patching.A!!other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY :. _ ' LL 's Date: - } PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS :', ,:.774f: _v PARCEL CODE CONTROL NO. — Type of Defect ' CLEAN SIDEWALK See reverse side for Defect Codes A F ❑ Yes ❑`No See below for Defect Code G i TRIM VEGETATION `- - ❑Yes li No --Q--► y7- WATER VALVE ADJUSTMENT REQ'D _ *44\ I -ri.: ❑Yes ❑No I — PARKS DEPARTMENT 3 o REVIEW REQUIRED z r ❑Yes Li No // LOCATION OF SIDEWALK ❑ Front Yard 0`Side Yard ❑ Other — WIDTH OF SIDEWALK CI 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ES inches ❑ 6 inches 1 IL/ AREA TO BE REPAIRED w sq.ft. 4 in. ��' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I]No No.of Squares with Patches — CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : - 'ft, L•=-3 Date: — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ' `1 A 471t - � - ..,;, -on `/ 55 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ❑`No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes -CI No WATER VALVE N ADJUSTMENT REQUIRED ❑ Yes E No I ! PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes El No LOCATION OF SIDEWALK El Front Yard ❑ Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet 0•-5.3 Feet ❑ Other DEPTH OF SIDEWALK EJ 4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED Z7,0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I] No No.of Squares with Patches CODE G - NOTE :Areas marked with an`i-;may be repaired by patching.Aii other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : U Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS - - 3c: - - , 50 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect + <` ❑Yes 1 `No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION l ❑Yes Ld No WATER VALVE ADJUSTMENT REQUIRED _ �-'Q—► ❑Yes 1 1 No I k I I PARKS DEPARTMENT REVIEW-REQUIRED • s C7 Yes i r No LAPk-i LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet []5.3 Feet ❑ Other DEPTH OF SIDEWALK E14 inches ❑ 5 inches ❑ 6 inches f AREA TO BE REPAIRED sJ sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 121 No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 3 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 t`'2 / �1 ` i I I. - `'' - 3 L'( - ' PARCEL CODE CONTROL NO. CLEANsS1DEWALK Type of Defect es ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes El No WATER VALVE ADJUSTMENT�QUIRED — ❑Yes No I I I PARKS DEPARTMENT — o ir; °l l L, REVIEW REQUIRED `5°') 141 ❑ Yes No F\ LOCATION OF SIDEWALK 2 Front Yard ❑ Side Yard ❑ Other A,- - WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches L15 inches ❑ 6 inches AREA TO BE REPAIRED - - -sq.ft. 4 in. 7 f_7 'sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE _ ,q�_ '�-._e with _.- e_ec-p> ..e- •. e IYV 1 C J'11 CC(J marked GI I r may UC I C�QIICU by (JGLI;I lIl ly.I111 ULf IC1 b-I('dll be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 'm Date: '` Z``"/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 4-J r PROPERTY ADDRESS , ' 67 -1- ? - 3si- 3E - 00 zi 1 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C ❑Yes .'No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑ Yes 1.,No * WATER VALVE — I ADJUSTMENT REQUIRED �--0,. ❑Yes 11No 1 PARKS DEPARTMENT REVIEW REQUIRED El Yes © No — 1/ 1/i� i" a Li r: "dam LOCATION OF SIDEWALK r ,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 116° ! sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : bk) Date: 2/ /17 PERMIT ISSUED FORMED POURED COMPLETED r CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z Iz- - 3 -ocz PARCEL CODE CONTROL NO. Type of Defect a' CLEAN SIDEWALK ❑ Yes AiNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes .No - I I PARKS DEPARTMENT -- REVIEW REQUIRED ❑ Yes .�,No E LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK JJ4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes X No No. of Squares with Patches CODE G - NM-P.,FtnQ cnrifh�rx°F" �❑�,t rzav,2F€� r! reconstruction of full sidewalkpanels.l by r-rAtnhing.Ail - areasr shall 'vr4y d 'j FIRST INSPECTION AND FORM MADE BY : 3 � � Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERL•S, SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z8 5 441 Via -30 -333 -00 5l PARCEL CODE. CONTROL NO. Type of Defect C r CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes EC] Na See below for Defect Code G 6 TRIM VEGETATION ❑ Yes 'No -44 WATER VALVE I I 0 ADJUSTMENT REQ°D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ,,� N/0.0 NN�.�p _ _ ❑Yes o LOCATION OF SIDEWALK reFront Yard Af Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet5.3 Feet ❑ Other DEPTH OF SIDEWALK K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ZMS sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 'No No.of Squares with Patches CODE G - simposi 4a7 ave);A ait r *ea hon ea- 5 0, NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3'9-t 7 14 5-1/- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS Di t 6 i 41-10./e-..-fte / — F iiiZ -cam- -0- 5Z4 PARCEL CODE CONTROL NO. - Type of Defect See reverse side for Defect Codes A F CLEAN SIDEWALK — See below for Defect Code G I 'Yes ❑ No �Z I TRIM R M VEGETATION — ❑Yes ❑ No AS?)1/4 tg:' 4 .4-0,-.0. ;,°J `. WATER VALVE �e� , 4 I ' ADJUSTMENT REQD Ea ' - ❑Yes ❑ No - ICico ‘ PARKS DEPARTMENT +' ° �+0 "t�_ Lk-WI ,6!d f��- 7� �� REVIEW REQUIRED V4 - - - - � ❑Yes ❑ No to I I J WA rkj / Z5 \ _ i,ti 10 rgC1)0 - LOCATION OF SIDEWALK :Li-Front Yard / ' Side Yard ❑ Other _, WIDTH OF SIDEWALK /`q4 Feet 0 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK %IN 4 inches 1 .5 inches ❑ 6 inches — AREA TO BE REPAIRED 5C(1 0 sq.ft. 4 in. 11700° sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - NO i E :Areas marked with an `F'°may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 46.)X i•6.-` Date: 3/6 0 7 PERMIT ISSUED FORMED POURED COMPLETED 1 • CI I Y.. OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 130f &A r e g PARCEL CODE CONTROL NO. Type of Defect 5 CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G j ❑Yes L i No TRIM VEGETATION • ❑Yes CNo — WATER VALVE -a ADJUSTMENT REQD ♦ ❑Yes ®'No PARKS DEPARTMENT REVIEW REQUIR -D ❑Yes ❑ /4titiCiVera- - 1 / p LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet ]5.3 Feet El Other DEPTH OF SIDEWALK [ 1 inches ;° P El 5 inches ❑ 6 inches AREA TO BE REPAIRED 210 sq.ft. 4 in. sq.ft. 5 in. sq.ff. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 5 s -1 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 7 JO? /--q , s - . gq i 2 - 30- 3 -6 03 5Z-7 A. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ` J No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I ❑Yes I No — 1'it WATER VALVE `( ADJUSTMENT REQUIRED ~`�+� ❑Yes El"No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes li No . LOCATION OF SIDEWALK 1g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Eyr 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches g15 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. Z°1 sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes l No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FARM PROPERTY ADDRESS 2 3 iZ 3o Sig a °Ls PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect A Yes ` No • See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes 7 No * WATER VALVE i if ADJUSTMENT REQUIRED Pe \ ❑Yes C No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes JeNo Lek Ca.1 4 4-t. S4 . LOCATION OF SIDEWALK 'ZFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑4 inches %5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CT< No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS t.cLca,,.,e,41-e gft - ® - 329i - �i� :f PARCEL CODE CONTROL NO. Type of Defect - CLEAN SIDEWALK See reverse side for Defect Codes A F — See below for Defect Code G I ❑ Yes g No TRIM VEGETATION — A. ❑ Yes j No ~4� s WATER VALVE — i 1\ I t ADJUSTMENT REQ'D ❑ Yes t<No PARKS DEPARTMENT 9 J� I REVIEW REQUIRED — — ❑ Yes ❑ No LOCATION OF SIDEWALK Er Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet <1 5.3 Feet ❑ Other DEPTH OF SIDEWALK -'4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED 7c1'5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes S No No.of Squares with Patches CODE G - — NOTE E :Areas marked with an 7--, may be repaired by patching.Ail other areas snail be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2:5-C-f%7 , : il-c rc-A}%2}j=- `s 99a- -10 - - &of 36 PARCEL CODE CONTROL NO. CLEAN SIDEWALK e` Type of Defect ®Yes ' ❑ No See reverse side for Defect Codes A-F • See below for Defect Code G I TRIM VEGETATION i I0�Yes n io WATER VALVE Viz, ADJUSTMENT REQUIRED + Q—* ❑Yes I21'No le,,\ I PARKS DEPARTMENT REVIEW REQUIRED ® , ❑Yes D No J ' I 9 _ 1 LOCATION OF SIDEWALK ( rontYard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 0-5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 0020 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : btir Date: e 7 • PERMIT ISSUED • FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY F••RM — PROPERTY ADDRESS Z5oo Air .R;e. L PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes lilo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes jiNo - t WATER VALVE ADJUSTMENT REQUIRED �— E_ —► ❑Yes !/► o 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes t ``No o � — LOCATION OF SIDEWALK ,N1 Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ,lk3 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ,® 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1-5'1) sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches CODE G - C.Tb4S Sk)Ipe d'th c 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 : It Jvca Date: 3 " PERMIT ISSUED FORMED POURED COMPLETED d CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS / - ra 16n - lL -3 - - Ok PARCEL CODE CONTROL NO. Type of Defect if CLEAN SIDEWALK See reverse side for Defect Codes A F — See below for Defect Code G ❑Yes t No TRIM VEGETATION * q ❑Yes I No WATER VALVE •— ADJUSTMENT REM) ❑Yes I No PARKS DEPARTMENT REVIEW REQUIRED - - - - ❑Yes °i No Km. LOCATION OF SIDEWALK LI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet [ ( Feet ❑ 5.3 Feet ❑ Other - DEPTH OF SIDEWALK L24 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 55 sq.ft. 4 in. sq.ft. 5 in. sq.ff. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : AfJ Date: 34 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPA1!" SURVEY FORM - PROPERTY ADDRESS 0 0 1 I 2 -3o -37g PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes NO No See reverse side for Defect Codes A F — See below for Defect Code G TRIM VEGETATION I ❑Yes No — t lf WATER VALVE ADJUSTMENT REQUIRED ~4� ❑Yes M No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes M No i \ 54' La s�-���+ — r 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 5°° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No.of Squares with Patches CODE G - NOTE :Areas marked with an'F` may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR. SURVEY FORM PROPERTY ADDRESS 7372 �� .� y e S/ree4 12 - -379 -Oil 53Z , PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect /; ❑Yes s 7 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes .l 1 No WATER VALVE Olt ADJUSTMENT REQUIRED 44"" -00. ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes .1No 5.gg .r 0, L+a.-V vP 4-ke S4cea4 LOCATION OF SIDEWALK cgFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet a5 Feet ❑ 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK �°4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z 5 5 sq.ft. 4 in. sq.ft. 5 in_ sq.ft. 6 in. CODE F - PATCHES ❑Yes .INo No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �l� L4 f4- 54- gqi -30 - qii - 01( 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ,G ❑Yes ®No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION I ❑Yes 'J No WATER VALVE ADJUSTMENT REQUIRED ~4� ❑Yes 17 No I PARKS DEPARTMENT — REVIEW REQUIRED illYes ❑ No - - __ 53 /0.2 — 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 SO` sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes V) No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be rep-aired by patching.Aii other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS i ► q4 �� S gcI2 -3 - i i - Qi w . . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ! c ❑Yes 7 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION 1 ❑Yes X No _ WATER VALVE 1.1 ADJUSTMENT REQUIRED t—Q--►• ❑Yes TKI No PARKS DEPARTMENT REVIEW REQUIRED — I K7 Yes ❑ No — — tt ��E — — —\— 177/72(47/ 11/2(477 ,77A - LOCATION OF SIDEWALK ik1 Front Yard LI Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet -15.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches LI 6 inches AREA TO BE REPAIRED 2 u •0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes X1 No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2446. r'ac..E14e &I.. , $t(2 -3o' - 1454 -ooq 5 1 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes ' No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes t'No WATER VALVE ADJUSTMENT REQUIRED I I ❑ Yes Isf No PARKS DEPARTMENT _ REVIEW REQUIRED El Yes .14No 3C< s.d° S.E 1-0,1-cre44 P S- . LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet X5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 04 inches ley inches ❑ 6 inches _ AREA TO BE REPAIRED 25 O sq.ft. 4 in. Z s,5 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes g No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SU /EY FOB!M PROPERTY ADDRESS 2624 L 891a -3c -L154 -005 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A; ❑ Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes 'INo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes 1K1 No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No 1©d/ ` LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet `Kr5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 50 06 sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS Z".7 .= c ;'; ,i iE: -4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Ef No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION 1 1 ❑Yes Q No WATER VALVE ADJUSTMENT REQUIRED — ~ ❑Yes ii No l PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes LJ No k X it/// LOCATION OF SIDEWALK kFront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet [3,5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED J' e L5 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - NOTE E:Areas markedwith an"tom"may repaired patching i other areas shall repaired . with u . may be repaired cu by patching.ll,.Ail other areas A11Q11 be by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : F 6 .° LLL Date: _ ' I — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO`S SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2-71ck Lc , - s! . g9(Z - 3®- 41CZ - � �� 5 . PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect ❑Yes `iZl No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes 'DNo WATER VALVE — ADJUSTMENT REQUIRED ❑ Yes No Ij\ PARKS DEPARTMENT REVIEW REQUIRED 1,24 <O7:3— ]Yes ❑ No L� "�`'.„e t4 e 5 . LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet TS'5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK al 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2 F 0 sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes )Z1 No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS- if:4 0 ` ga t' -E t Dr- 4 PARCEL CODE CONTROL NO_ A CLEAN SIDEWALK, Type of Defect 5 'Yes (]No See reverse side for Defect Codes A-F • — See below for Defect Code G TRIM VEGETATION ICJ Yes Er ; WATER VALVE ADJUSTMENT REQUIRED ❑Yes JO_No vpl PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes INo - - - _ _ 0t. 5,7 1: - LOCATION OF SIDEWALK i Front Yard ❑ Side Yard Cl Other WIDTH OF SIDEWALK ❑4 Feet fL 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 4 inche ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED J 2.sq.fL 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No. of Squares with Patches- CODE G - — NOTE Areas marked with an"F" may repaired patching Ali r ._d --- -- - be by patching.r»I other areas shall be(Cpol(Gl! by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .h-'S ' Date: 31 agh 7 — s PERMIT ISSUED 77. • FORMED POURED COMPLE t ED _ CITY OFWATE*LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7,000 £4r. g& ; - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect G A ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes >6 No — r �o WATER VALVE 23 G V,a ADJUSTMENT REQUIRED L 6 Xi No rl,0& PARKS DEPARTMENT REVIEW REQUIRED ;f 3 Yes ❑ No 5,0' 5.01 Lai €.- e. S4 . LOCATION OF SIDEWALK I-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 50`D sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Al No No.of Squares with Patches CODE G - NOTE : Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS So 3 La Lie_4-1-e S�. g91z. -30 - 453 - 020 PARCEL CODE sue" CONTROL NO. — o Type of Defect A,G See reverse side for Defect Codes A-F `� CLEAN SIDEWALK — See below for Defect Code G ) ❑ Yes 'K No TRIM VEGETATION �➢ ❑ Yes XI No �t, WATER VALVE I� \ I ADJUSTMENT REQ'D I �I ❑ Yes 4No PARKS DEPARTMENT REVIEW REQUIRED — a Yes ❑ No EVD 16e lk lrliI4 S# 6 — LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet X8 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK .'K4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 63°5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes Q No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2 'yr f Lo cleAd-e 89iZ-JQ - 4S3- O20 5-LP A PARCEL CODE CONTROL NO. Type of Defect A See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes 4�No TRIM VEGETATION -- ❑Yesl No h WATER VALVE "- ADJUSTMENT REQ'D ❑ Yes T7No Iv PARKS DEPARTMENT REVIEW REQUIRED 0' ❑Yes I1 No • ai° e S4 . LOCATION OF SIDEWALK 10ront Yard ❑ Side Yard El Other _ WIDTH OF SIDEWALK ❑ 4 Feet l<5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK X(4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5°'' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS iC - i'5 a) - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes 0 No See reverse side for Defect Codes A-F '— See below for Defect Code G I TRIM VEGETATION I ) ❑ Yes Cl No — WATER VALVE ADJUSTMENT REQUIRED — 44-0--00. ❑ Yes li No PARKS DEPARTMENT REVIEW.REQUIRED ks 1 ID Yes ❑ No LOCATION OF SIDEWALK C Front Yard ❑ Side Yard El Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet fl 5.3 Feet ❑ Other DEPTH OF SIDEWALK O'4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED Poo 5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes L'No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : %y`j -t L-1- Date: ` PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS // I ci f 3 -i J€i -z3--262- - 00 / ` ) PARCEL CODE r CONTROL NO. _ CLEAN SIDEWALK Type of Defect A ❑ Yes IN`No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes ❑"No ♦ WATER VALVE [ s, ADJUSTMENT REQUIRED /1 � tl — (I3 ❑ Yes Colo ,0 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes CNo ITAP LOCATION OF SIDEWALK N4 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet Qr5.3 Feet ❑ Other DEPTH OF SIDEWALK 7 4 inches ❑ 5 inches El 6 inches V' AREA TO BE REPAIRED 2 1. 7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Y-No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : AK-- 4 ✓ Date: 3 of yif 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS '' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 0 ❑Yes Cl-No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 2-No - WATER VALVE ADJUSTMENT REQUIRED — fQ—* ❑ Yes Li No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes QNo LOCATION OF SIDEWALK 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 j AREA TO BE REPAIRED i.a sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes 0-No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : >s �' If" Date: _ 2. PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7 PARCEL CODE CONTROL NO. Type of Defect rl �= CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ( ❑ Yes El No TRIM VEGETATION ❑ Yes ©-No WATER VALVE -7 ADJUSTMENT REQ'D ❑ Yes L-`No -- PARKS DEPARTMENT REVIEW REQUIRED El Yes QNo LOCATION OF SIDEWALK 0 Front Yard El Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK D 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 44®0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes f No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ;Az, = c Date: `` /2 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS /z7 L- tit_✓ vs (3 -23T- z. - 'o3 :-' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect r1 ❑ Yes [g�No See reverse side for Defect Codes A-F — See below for Defect Code G I • TRIM VEGETATION I ❑ Yes INo — WATER VALVE �/ ADJUSTMENT REQUIRED — /L / ❑Yes 7-No � I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes CviNo Zekcibi LOCATION OF SIDEWALK /iFront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet5.3 Feet ❑ Other DEPTH OF SIDEWALK (s4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑Yes IT No No. of Squares with Patches CODE G - -- w i E ;Areas marked with an"F may be repaired by patching.Aii other areas shaii be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1'c "tip Date: .312 y/l 7 — PERMIT ISSUED _ FORMED POURED COMPLETED CIS OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ) :` la,.l -2 - 4 - :°D z_ •, PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect r ❑Yes Do See reverse side for Defect Codes A-F — I See below for Defect Code G I TRIM VEGETATION ❑ Yes C"No — ! WATER VALVE `t_ ADJUSTMENT REQUIRED ❑Yes E No PARKS DEPARTMENT REVIEW REQUURED 4,0 k ❑Yes ❑ No / LOCATION OF SIDEWALK 2'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet LJ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 0/5 inches ❑ 6 inches i, Z. AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes .1 No No. of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. zi FIRST INSPECTION AND FORM MADE BY : ��'""` 0W ItT Date: �' �" PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS � -- -i of ' ^F PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect p ❑ Yes p'No See reverse side for Defect Codes A-F '— See below for Defect Code G I TRIM VEGETATION ❑Yes C No WATER VALVE ADJUSTMENT REQUIRED — r ❑ Yes !'No I I PARKS DEPARTMENT / REVIEW REQUIRED 12-Yes ❑ No y yr ) f 1 d , FFF — f i 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 Ids,3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes VI.o No.of Squares with Patches CODE G - RPR Tr— Ar=== ..9....d with HFee..,. .:R... .,..1 A,,,...,-.tthi.A.:. Ali ..6n a. - sh...i9 repalfed b. reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ,`' ` f Date: '3r 22'17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK ':EPAIR SURVEY FORM — � r PROPERTY ADDRESS 2 ¢'5 gq,�3 2 -2i> - Z(d . 5 44 © PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect o A ❑Yes "No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes L(No WATER VALVE I ADJUSTMENT REQUIRED i 5 ❑ Yes �[ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes bflo j5,�° 4 Li1c LOCATION OF SIDEWALK p.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED r` ° 1 c,'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. r� // FIRST INSPECTION AND FORM MADE BY : 41- P�y �N -VIZ Date: I `r`J'7 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO S DEWAIK REPAIR SU VEY FORM PROPERTY ADDRESS 2 2_ L: l Ave- - PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect A. ❑Yes Milo — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑Yes Milo — �t WATER VALVE — ADJUSTMENT REQUIRED ❑Yes ANo I PARKS DEPARTMENT REVIEW�r REQUIRED �L "Yes ❑ No — . LlAai,v1 Ave-- LOCATION OF SIDEWALK %Front Yard ❑Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ` 5.3 Feet D Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED � °`` sq.ft. 4 in. sq.ft. 5 in. sq.ft. B in. — CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPFrTION AND FORM MADE BY : SDI 4a Date: 34241 -Z 7 ` PERMIT ISSUED -- FORMED POURED - COMPLETED 1 -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 21/1- 010itul g'i i - - iZte 5 5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect rI ❑Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes Er No t WATER VALVE ADJUSTMENT REQUIRED fQ--► ❑Yes lEr No \ I PARKS DEPARTMENT REVIEW REQUIRED IF Yes ❑ No 19,0 � 54 4114c12 Tws LOCATION OF SIDEWALK Fr 1ont Yard ❑ Side Yard� ❑ Other WIDTH OF SIDEWALK p 4 Feet ❑ 5 Feet C�fi5.3 Feet ❑ Other DEPTH OF SIDEWALK [❑4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 104.° `sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes © No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : C C:> d /- Date: Z Z _/7 PERMIT ISSUED FORMED POURED COMPLETED_ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 22 Gei,u )/:, '' PARCEL CODE CONTROL NO. CLEAN SIDEW�LI< Type of Defect ❑ Yes ❑ No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑ Yes E21 Jo — WATER VALVE 'f ADJUSTMENT REQUIREDR ❑ Yes El No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes © No 141 1,4PO41 LOCATION OF SIDEWALK ETFront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5I.3 Feet ❑ Other DEPTH OF SIDEWALK E`4 inches' ❑ 5 inches ❑ 6 inches r , AREA TO BE REPAIRED ' sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑ Yes 1 No No. of Squares with Patches CODE G - NOTE E:Areas marked with an"F" may be repaired by patching.Ail other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : "' � Date: Zi-f 7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 Z'h'JOCi/ V PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I � ❑ Yeso TRIM VEGETATION ❑ Yes LI''No t fQ '� WATER VALVE ADJUSTMENT REQ'D ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes I No LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet fr'5 3 Feet ❑ Other DEPTH OF SIDEWALK Q4`44 inches ❑ 5 inches ❑ 6 inches / AREA TO BE REPAIRED i® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes El- 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 : PC Date: 3,22 17 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 2 2 fro 611 3 -ZS - j - oil- , 5 53 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect �� ❑ Yes , i No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETAyON ❑Yes =❑ No 10 At WATER VALVE ADJUSTMENT REQUIRED _ \ CIYes iEl o PARKS DEPARTMENT — REVIEW REQUIRED ETYes ❑ No LOCATION OF SIDEWALKront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Q 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ifi inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ( 4- sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes 'No No. of Squares with Patches CODE G - . ��e.S ry-r7rL ari_Ath._ee "F"c--_.� r ha r .t..7 1..ne tching Ali ether areas shall be.. e ir-d b.. .'_ .=._ ..___ .... ........ ....,..�.. .....j .......:�.:�...... .+� t:..w... :y..w..u.�.. areas shall be i�Fiaiii;ii by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Old 0� fL Date: 7..2_4-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO4# SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .200 £31<4/-- �iA zDeAi g /3 Lf - -013 / PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect / ❑Yes p'fqO See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION l� I ❑ Yeso WATER VALVE ADJUSTMENT REQUIRED (]Yes LI1 o - I I PARKS DEPARTMENT ) �u i R EWEQU,IRED `�C,;� a �.� � C�'Yes 5 3 ��,` , LOCATION OF SIDEWALK ❑,-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Ei.3 Feet ❑ Other DEPTH OF SIDEWALK ❑`4 inches inches ❑ 6 inches - , F AREA TO BE REPAIRED `14 sq.ft. 4 in. 55_ ' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes l No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Pi1' 06 Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 30 i ►-�;iocal 9,113 -zc -2r - 01Z_ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes C�No See reverse side for Defect Codes A-F See below for Defect Code G I • TRIM VEGETATION I ❑Yes O No WATER VALVE �//;;� ADJUSTMENT REQUIRED _ ~�V-10- ❑Yes 2 No 1,04 l PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes E1 No 4.• li i-Itu the LOCATION OF SIDEWALK pFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK �❑ 44 Feet ❑ 5 Feet C 3 Feet- ❑ Other DEPTH OF SIDEWALK L�'4 inches ❑ 5 inches ❑ 6 inches 1,1 b AREA TO BE REPAIRED 1. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Eiii No. of Squares with Patches CODE G - _ !1[�'!T� •Fa:uo marked with an[rn iioy uc repaired by patching. Ai:tither areas shad; be- rep-eke-Lie - vy reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : w" ° ' T Date: 3 Z4-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 317 /i, b I - Zc1 - O�� . � PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4 ❑ Yes 01Go See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION i I ❑Yes LSNo * WATER VALVE 1 1 ADJUSTMENT REQUIRED 1— Yes LI4 o \ PARKS DEPARTMENT REVIEW REQUIRED ii7 ❑ Yes 12-No 1741 L1il)0 I/J LOCATION OF SIDEWALK eFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Ir 5.3 Feet ❑ Other DEPTH OF SIDEWALK 124 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED •2 LI sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes L No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �' AJ Date: 2-4-1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 3 zr Liru'j Al ` gif3 - f -2 i -/)f/7 , ., PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ; 6- ❑ Yes Zi-No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION�- ❑ Yes I�"No itry WATER VALVE ADJUSTMENT R�-QUIRED �:V� ❑Yes Cs7 No PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes [ o 9 19ig - LOCATION OF SIDEWALK front 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 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I'No No. of Squares with Patches CODE G - NfTF Arr7s rnm•kprd with pn"F"mmi ha rrApctir:mr1 h;r pntr•htnre All a shl! repairerl her - reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �' Date: 2+ i PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 40 - tj1'eld _ -24 - 2 8 - 0t'7 v •SZ2- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F c'^ � / See below for Defect Code G I El Yes ® No TRIM VEGETATION ❑ Yes El No c WATER VALVE - ADJUSTMENT REQ'D `M. ❑ Yes E l No PARKS DEPARTMENT REVIEW REQUIRED 4,61 ❑ Yes ❑"No 1/4 pal ULZl;'/(2) LOCATION OF SIDEWALK Li Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK EI 4 Feet ❑ 5 Feet El 5 3 Feet ❑ Other DEPTH OF SIDEWALK p'4 inches E l 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. g1 t-C sq.ft. 5 in. sq.ft. 6 in. .f' 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 : 131J 14- Date: 3-Z2"/7 PERMIT ISSUED FORMED POURED COMPLETED __ CITY OF WATERLOO — SIDEWALK REPAIR SURVEY FORM WI PROPERTY ADDRESS z` t p4n J 'V �'� C�.I3 -25 -V'*� C - C — PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect ❑Yes 0--No See reverse side for Defect Codes A-F _ See below for Defect Code G TRIM VEGETATI9.N ❑ Yes O No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ❑`No PARKS DEPARTMENT — �;! REVIEW REQUIRED , � 3 ❑Yes ©No ` xi ( �I 3 fry 1cti � Li�;hrjV LOCATION OF SIDEWALK C --Front Yard ❑ Side 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 " P P sq.ft. 4 in. '-'-° ( sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Et No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by_ — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : °7 Kos Date: 5 2 747 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOS SIDEWALK REPAIR SURVEY FOR`.` PROPERTY ADDRESS 'Ili?? t t°iTYE J _ gm -25 - 2'1€- o017 PARCEL CODE CONTROL t O. CLEAN SIDEWALK Type of Defect ❑ Yes J-No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes PNo Aq WATER VALVE ADJUSTMENT REQUIRED \ ❑ Yes [ `No PARKS DEPARTMENT REVIEW REQUIRED '_:j ❑ Yes ,g No i tit .z I LOCATION OF SIDEWALK Q-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq. ft. 5 in. *VI" ) I" ) sq.ft. 6 in. CODE F - PATCHES ❑Yes 6-No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : b6 i3/W (- Date: ✓ '/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS? v PARCEL CODE CONTROL NO. a" CLEAN SIDEWALK Type of Defect ❑Yes El'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 0 No WATER VALVE ADJUSTMENT REQUIRED Q ❑ Yes [7 No ,04 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ❑ No LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑-5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches �- AREA TO BE REPAIRED sq.ft. 4 in. • sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - — NOTE : /F Fcas A write iF/ith an CIF'k'E may k-. p.wpaired by patching.Ail oth r areas shall be.. paire_4 i_. - .i„vCaJ Iuu,l��+V vl,u,UII , Il/ay IJG Iv Jauc U by FJQLt,l IiIil�../1u JUIGI ai al. Auau UG IC})c IIGU by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ,, Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1 yf._'. =v v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 0.No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION l ❑Yes O No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes i] No °y1,� , I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes PfNo LOCATION OF SIDEWALK El 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 J AREA TO BE REPAIRED 1'1 & sq.ft. 4 in... sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes CI No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by _ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: f` PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 5C L/A/ A/ ge)It -30 -IDlo - 605 566 PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK _ See below for Defect Code G I ❑ Yes ® No TRIM VEGETATION ❑ Yes �r7 No ` ,_ u -11111,. WATER VALVE ADJUSTMENT REQ'D ❑ Yes [ No Q I PARKS DEPARTMENT REVIEW REQUIRED — ❑ Yes ® No LOCATION OF SIDEWALK ❑ Front Yard MSide Yard ❑ Other — WIDTH OF SIDEWALK 71.4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 11,0,0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes p No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Mt5 Date: 3"Z4'17 C -V-11 PERMIT ISSUED FORMED. POURED COMPLETED se h CITY (OF WATER_®® SIDEWALK REPAIR SU'VEY FORM PROPERTY ADDRESS 52 LivvieAti Avezwc- 091Z -3 - 2ao 51 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A c!F ❑Yes ! No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes �,No �'t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes re No ,04 I PARKS DEPARTMENT REVIEW REQUIRED I � 'Yes ❑ No f._F e JV 3.9 e i I 9'.1 7.1 .L- M/ L LOCATION OF SIDEWALK ('Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet g5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED • sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in, CODE F - PATCHES " Yes El No No. of Squares with Patches I CODE G - fr)0 ',WIf. ,replAsewt - a . 40 -five_ NOTE :Areas marked with an"F"maybe repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : rn s Date: a°z -'7 6- 7. f7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 6700 604 t/j ,-V PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4 ❑ Yes V.No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑Yes tNo * WATER VALVE I V G��+ ADJUSTMENT REQUIRED �0= 1 D ❑ Yes 9Llo PARKS DEPARTMENT -- REVIEW REQUIRED ❑Yes •No I, � LOCATION OF SIDEWALK KFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 45.3 Feet ❑ Other DEPTH OF SIDEWALK 117c4 inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED al is sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes o No.of Squares with Patches CODE G - - — NOTE -Arens mnrked with a B"F"mr-v be rppnirpri y patch& _All o h'r,er areas she!!he repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : V 0 Date: 3/z ' /7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS h - , /3 - Z 2.31 -c c 3 PARCEL CODE CONTROL NO. �� CLEAN SIDEWALK Type of Defect ❑ Yes ' No See reverse side for Defect Codes A-F 7 See below for Defect Code G TRIM VEGETATION Yes ❑ No * WATER VALVE { ADJUSTMENT REQUIRED 114'� (�/ � ❑ Yes tNo ,0 I PARKS DEPARTMENT REVIEW REQUIRED r res ❑ No 11c2r\ LOCATION OF SIDEWALK 44 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ij 5.3 Feet ❑ Other DEPTH OF SIDEWALK f4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches - CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS bZi &2. 3 -� � Q Z31 -oaf 274 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect n ❑Yes V'No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I l ❑Yes "No _ WATER VALVE )� ADJUSTMENT REQUIRED — �" _ �:LI„�,L� ❑ Yes No I I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes C ,No i� 4‘Z ( — A — LOCATION OF SIDEWALK 17t Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet I 5.3 Feet ❑ Other DEPTH OF SIDEWALK LXinches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED a• sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ilo No.of Squares with Patches CODE G - l NOTE :Areas marked with "F" be repaired ed _t_s_I_ Ail NOTE_ . .;:�..-......:.....anmay i i;yu c�a by}.rawi �y.�-:��other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Pv Date: . /zs, 1 - _ PERMIT ISSUED FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 70,0 ikK (-Ir/I)LAf Q Ve- t - Zc- zzfS - U� S PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑ Yes pNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes VNo 1` 1 JI WATER VALVE ADJUSTMENT REQUIRED _ /CA.(!_ + ❑ Yes f No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C(No a_p 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 ,2 - q s .ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by ._ reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : /E Date: -3/Ze /( 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS WO Elk fi i1 kcvi Piz -30 - /0z - dig ' PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION =0 i I I ❑Yes i No WATER VALVE JI c41 ADJUSTMENT REQUIRED 4.411—► * ❑Yes 2i.No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes IN No r — NoA vl — LOCATION OF SIDEWALK VI Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Dt,5.3 Feet ❑ Other DEPTH OF SIDEWALK IN 4 inches J ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z4-(3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes iN No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. AA 22 FIRST INSPECTION AND FORM MADE BY : Fii) i`P! Date: Vifi 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM too i/k PROPERTY ADDRESSi��b�®� c 12_ - - i0 L - 02,4 580 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ANo See reverse side for Defect Codes A-F o I See below for Defect Code G I TRIM VEGETATION ❑Yes lNo WATER VALVE • ADJUSTMENT REQUIRED ❑ Yes rkNo PARKS DEPARTMENT _ REVIEW REQUIRED (V\ LIkLC ❑Yes ®�Io f T LOCATION OF SIDEWALK in Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet p..5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches l + 5 inches ❑ 6 inches J AREA TO BE REPAIRED sq.ft. 4 in. 013,, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: -3< Z-Z117 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS 101 VI� 8(Iz -so - IOZ - Oz5 Eat PARCEL CODE CONTROL NO. Type of Defect C See reverse side for Defect Codes A-F CLEAN SIDEWALK — See below for Defect Code G ID Yes 111,No TRIM VEGETATION At ❑ Yes �No � � _ - ---- ;51 WATER VALVE —6 ADJUSTMENT REQ'D ❑ Yes ok No — PARKS DEPARTMENT q,7° z° P7 �/ REVIEW REQUIRED — I�'��}� — — ❑ Yes A'No Nevaclet - LOCATION OF SIDEWALK ! Front Yard V Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 75.3 Feet ❑ Other DEPTH OF SIDEWALK $4 inches, ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED (C12 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IC;No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patchinn,All other areas she!! be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : 'I"�/� �l5 Date: 5)22/1 /7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 105 o so 4gI7 - 3D- iO - 0,2q 58� PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 1'Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes No WATER VALVE ADJUSTMENT REQUIRED 4— � �I ❑Yes , \No PARKS DEPARTMENT _ REVIEW REQUIRED ❑Yes KNo �z h 361 (e) 9 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ^ 5.3 Feet ❑ Other DEPTH OF SIDEWALK c-4 inches 1 5 inches ❑ 6 inches AREA TO BE REPAIRED Z0''Li sq.ft. 4 in. tP3•6 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 10 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ,� 1 FIRST INSPECTION AND FORM MADE BY : '�J Date: 3/)20 l7 PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 8or i Z - 30 - iO2 - o 23 ' ``�"- v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect AYes ( No _ See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes Et No — WATER VALVE ADJUSTMENT REQUIRED El Yes tONo I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes r21 No 4,0 4, 1 itroA ;To-IA LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK gli:4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 140'(-'2 sq.ft. 4 in. sq.ft. 5 in. — sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - — a__ .Areas msrksri with sill u- its y ie rep aired b ia^a�r-¢ ing All oSthe areaas shall repaired by —J ram....... ..J .......:.....may. be by reconstruction of full sidewalk panels. r� FIRST INSPECTION AND FORM MADE BY : 9 Date: 5)21]1 6 — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS O 7 Motot 30 - 3O- JOB - z5 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect AC.Yes D No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes be No WATER VALVE 10if ADJUSTMENT REQUIRED 4--0—* ❑Yes akNo PARKS DEPARTMENT _ REVIEW REQUIRED 4-' 5` ❑Yes tgilo LOCATION OF SIDEWALK a] Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK LI 4 Feet ❑ 5 Feet 45.3 Feet ❑ Other DEPTH OF SIDEWALK d 4 inches ifK5 inches ❑ 6 inches AREA TO BE REPAIRED ' "A' sq.fL 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - : i‘`r o •� . NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : d- DB Date: 312 2/1-7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS Z.67 t'f€ d 80()Z - 30 - toy - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes A No WATER VALVE ADJUSTMENT REQUIRED — ❑Yes No — PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes V No — 50 /I) ifr lad"so ir7 LOCATION OF SIDEWALK k Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet fl 5.3 Feet ❑ Other DEPTH OF SIDEWALK I4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 265`O sq.ft. 4 in. — sq.ft. 5 in. — sq.ft. 6 in. — CODE F - PATCHES ❑Yes No No. of Squares with Patches CODE G - NOTE :Areas Y f YarkA 7 with an.11FA1 may a repaired by patching All ether areas be .7 �"�" patching.e� ether Cal VCJa'a shag repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 01 4` 0 Date: 3 laz P ✓7 — e PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK "EPAIR SURVEY FORM PROPERTY ADDRESS 1 AA. t - . PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect - ❑Yes 0 No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes 4 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes p No 1 I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes d,NO ""}j.5 i n± JI pf. 1/2 a \`\ t LOCATION OF SIDEWALK I1.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0:5,3 Feet ❑ Other DEPTH OF SIDEWALK E-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5Z S sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - d ,a i 1-4VP", s '' TOrl Lf NOTE :Areas marked with an"F"may be repaired by patching.All otherareas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � DE Date: - l 7 ►' ) 12)r°.1 -17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS lid PilgAi.lon 8gIZ -30 - Iz8 -003 59Z, PARCEL CODE CONTROL NO. _ Type of Defect CLEAN SIDEWALK ❑Yes ' [�� No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes At WATER VALVE ADJUSTMENT REQUIRED 1 ❑Yes Mo I PARKS DEPARTMENT 9615 REVIEW REQUIRED Yes ❑ No 11,/20 I c sSo - LOCATION OF SIDEWALK afront Yard ❑Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet .3 Feet ❑ Other DEPTH OF SIDEWALK ar',4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5-6 sq.ft. 4 in. sq.ft. 5 in. sq.ft. gin. — CODE F - PATCHES ❑Yes I tNo No.of Squares with Patches CODE G - NOTE E :Areas marked with an"F" may be repaired by patching_All other areas shail be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3J207 PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WA ER2®® SIDEWALK REPAIR SU*NEY F �RMI PROPERTY ADDRESS z2® V ••e i l- - g,1Z -3o -iZ6 - c.4,5 5'93 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes aN0 See reverse side for Defect Codes A-F — I See below for Defect Code G I TRIM VEGETATION 1 I ❑Yes ,,IN'No WATER VALVE ADJUSTMENT REQUIRED Yes ❑ No Ie PARKS DEPARTMENT REVIEW REQUIRED . El ANo q -6.1 lu _ v LOCATION OF SIDEWALK 0'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 04 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED " 5.5. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes J"No No.of Squares with Patches CODE G - � J 144 ni + prAna FlAteriv,n4. ,ram feriVik 1 s>sue . • v NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : rfi' Date: S'alm17 -RAJ -12--1 ' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS SCE ZlK Nzso 8912_ IV( - C Z8 PARCEL CODE CONTROL NO, CLEAN SIDEWALK Type of Defect ❑Yes iM No See reverse side for Defect Codes A-F — See below for Defect Code G TRIM VEGETATION ❑Yes IN No WATER VALVE ADJUSTMENT REQUIRED — 1-0—+ ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes l No 6.9' P7,6E 11,8' — GiSvs1 LOCATION OF SIDEWALK Ig Front Yard ❑ Side Yard ❑ Other _ WIDTH OF SIDEWALK ❑ 4 Feet X 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED I`17.5 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes l No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 4r I)13 Date: 3/2 ,JI% - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 300 * H tIo-, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect .. ❑Yes ' J No See reverse side for Defect Codes A F • See below for Defect Code G I TRIM VEGETATION J J ❑Yes l-No - \ 1 if WATER VALVE ADJUSTMENT REQUIRED 411"411"" ❑Yes L2,No J I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes tlNo tI,'I 153D • 77) - - - - LOCATION OF SIDEWALK el Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet7'5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK .4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED if$°) sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes la No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : M8 B Date: -/24/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATE1L00 SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 100 AuZ`t 3 - 26- Zf2 - 7 (00Z- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect /4 ❑Yes ®\No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes ? No lr WATER VALVE — ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes UNo S i /j.:r? ( 7 - - - MO 5l LOCATION OF SIDEWALK d Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (M5.3 Feet ❑ Other DEPTH OF SIDEWALK (g,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED r -`1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I\No No. of Squares with Patches CODE G - — NOTE .Areas marked with an"Ft1 may be repaired by patching o1.Ail her er she!!be repaired hy reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: : - 7"17 PERMIT ISSUED FORMED POURED COMPLETED RethsE _ CITY SF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2Z7 H66;k _ &'1 - Z5- o8 - O0E CO90 PARCEL CODE CONTROL NO. Type of Defect nr See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G } ❑Yes No TRIM VEGETATION txt_ ! Yes ❑ No a WATER VALVE I ADJUSTMENT REQ'D ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED _ _ II Yes ,No ii,, LOCATION OF SIDEWALK jgt Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet tfid 5.3 Feet ❑ Other DEPTH OF SIDEWALK xt 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ``lo sq.ft. 4 in. s' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes Tg,No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3-2÷�� _ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS >0 ,A1 _:14 --> 0 7/3 -2 -0'o4- - 00"1 1 j PARCEL CODE CONTROL NO. r CLEAN SIDEWALK Type of Defect LI Yes E No See reverse side for Defect Codes A-F -- See below for Defect Code G TRIM VEGETATION ❑ Yes 0 No WATER VALVE ADJUSTMENT REQUIRED FQ ❑ Yes I ] No PARKS DEPARTMENT REVIEW REQUIRED ay_es ❑ No LOCATION OF SIDEWALK E,Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ®,5.3 Feet ❑ Other DEPTH OF SIDEWALK I,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 7.` sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I J No No.of Squares with Patches CODE G - :e 9 ;s,6ca_, p:-ap, --5 — NOTE :Areas marked with an"F"may ha.repaired by patching A!!othsr"areas she!! be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ,1-5 Date: 5-Z4-1 T — 0/w ..cam../7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 30 Z. ��in//,e - i - 22.6, - 1 ()z PARCEL CODE CONTROL NO. 0 Type of Defect IF 9 \\ �, CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G I ❑ Yes io TRIM VEGETATION ❑ Yeslo AD--* 502- WATER VALVE \1 N ADJUSTMENT REQ'D ❑Yes 1po PARKS DEPARTMENT REVIEW REQUIRED - - - - (es No /711) or le LOCATION OF SIDEWALK ❑ Front Yard V Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 'i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 57' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 1 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: T/z*// 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 36 6 /14d.?//e xq o -' 22,E - p2 17 /3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect e% ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I l ❑ Yes l$lo. WATER VALVE ADJUSTMENT REQUIRED — 3° (47 ❑ Yes i No I I I I PARKS DEPARTMENT REVIEW REQUIRED { ❑Yes "MNo -I r C/V /0G. //e. LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1L04 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ^ sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 1610 No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D6> PI3 Date: PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS AIllrbe, 107 - © ( (�1 7 ior PARCEL CODE CONTROL NO. Type of Defect A fir, CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G j ❑Yes / l No TRIM VEGETATION ❑Yes No WATER VALVE _ �( F m ADJUSTMENT REQiD Fra NI Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED - - - - ❑Yes 'No LOCATION OF SIDEWALK IN Front Yard Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 15.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches k6 inches AREA TO BE REPAIRED sq. ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -- CODE F - PATCHES ❑ Yes q`No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 141) Q 11 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 154oe 1Z -30 - 105 -0Z1 C G'3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes No See reverse side for Defect Codes A-F — 1 See below for Defect Code G I TRIM VEGETATION ❑ Yes �,i.No — WATER VALVE ADJUSTMENT REQUIRED — ❑ Yes [ i\No PARKS DEPARTMENT REVIEW REQUIRED tZT�o o ,Yes ❑ No 4 Rfiktrae LOCATION OF SIDEWALK i Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ri 5.3 Feet ❑ Other DEPTH OF SIDEWALK i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes VI No No.of Squares with Patches CODE G - — NOTE 'Arens marked with ara"F"may he repaired by patching A!!other areas she!! be repaired hor reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 016 �J' Date: -12-h7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 56 Monroe, elI1 -3o - i07 - 009 .- PARCEL CODE CONTROL NO_ � CLEAN SIDEWALK Type of Defect ❑Yes ' ki No • See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes F No f WATER VALVE ADJUSTMENT REQUIRED �Q"'♦ ❑Yes oil No PARKS DEPARTMENT REVIEW REQUIRED gYes ❑No 1114A° VA XI Mon LOCATION OF SIDEWALK g Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet" ❑ 5 Feet IX 5.3 Feet ❑ Other DEPTH OF SIDEWALK R-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 53 - sq.It. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 0 No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : U"�/�f +" Date: 5/21 /17 PERMIT ISSUED FORMED POURED COMPLETED_ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS in Y 8912 - - /OS' - 0/5 Z 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED - ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED "Yes ❑ No 11 I () LOCATION OF SIDEWALK gi Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet K5.3 Feet ❑ Other DEPTH OF SIDEWALK i°4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ET No No.of Squares with Patches CODE G - _ NOTE Areas marked with an"F"may he repaired ber r — r�Rt�°�S@rae� IR D`[.�a'�r�a��!-��;R h:�arr.�e�ti..h°by reconstruction of full sidewalk panels. n �f FIRST INSPECTION AND FORM MADE BY : �'✓/� 10S V D Date: 3102 7/7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FO'"M — PROPERTY ADDRESS Di Ovine S—. c&q - 3O-I z0 -Olt (gag PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑Yes X No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes $iNo WATR VALVE r AD USTME T REQUIRED 4� ❑ Yes K No I l PARKS DEPARTMENT REVIEW REQUIRED dYes ❑ No VA WA X �.� Cr.') elf) fol. 4. LOCATION OF SIDEWALK IR Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet 05 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED i aq•5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - X., ?o5!-`; Ye96i- 1- Jac- +-f e- NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : fir a Date: S°21-k 7 13N 5 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS Z 9 7 or r t g71Z - 3O - fZ6 - C'I (Z5 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect A ❑Yes D_°No See reverse side for Defect Codes A F .— See below for Defect Code G TRIM VEGETATION ❑Yes , Lallo —, ' WATER VALVE ADJUSTMENT REQUIRED — ~�� ❑Yes T23,No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes CG No q'�` — \ 0 _ a�roe - LOCATION OF SIDEWALK F Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Fee iv 5 Feet I L5.3 Feet ❑ Other DEPTH OF SIDEWALK 1 ...4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED a�° f sq.ft_ 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes K.ry No No.of Squares with Patches CODE G - — NOTE Areas. married with an''F1e may be repaired by patching „thei a.__._._shall r [ •_ •`" :, •�•..`• y F' patching.All�u�ci a�cas�i t�iu u�i��du eu by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : t 6 4-D5 Date: )Z I/i-7 - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z 37 el ail roe- _ 8a12- - 3O- izB - 015 (z�� PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect ggYes ❑ No See reverse side for Defect Codes A F • See below for Defect Code G I TRIM VEGETATION ❑Yes f,No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ' No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes L ;No 381 IZi \ - Hari LOCATION OF SIDEWALK +°.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet LII 5 Feet dg 5.3 Feet ❑ Other DEPTH OF SIDEWALK iEt 4 inches 5 inches ❑ 6 inches AREA TO BE REPAIRED )�l a,0 sq.ft. 4 in. v-.� sq.ft 5 in_ — sq.ft. 6 in. CODE F - PATCHES ❑Yes d-No No_of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3)01/17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS '� BUc Maw,-ee 891z. —30 — — IZ 6,Z7 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' I Na See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes el No -- 10- WATER VALVE ADJUSTMENT REQUIRED Pf ❑Yes g No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes gNo VA LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet PS 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK 0 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED .7', sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ckr No No. of Squares with Patches CODE G - — NOTE :Areas marked with an eFe may be repaired by patching_ g_Ail other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : 11 4y D g Date: .S/20,47 — PERMIT ISSUED FORMED POURED COMPLETED O I TY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3 o 9.k. MotAroe gqf2 - 129 - (31, ZZ PARCEL CODE CONTROL NO. _ CLEAN SIDEWALK Type of Defect C ❑Yes ' i] No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION ❑Yes C No 4 WATER VALVE ADJUSTMENT REQUIRED .44—Q� ❑Yes .t l No I j I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes IN,No Morn Ibe LOCATION OF SIDEWALK cgi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet tr7. 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK IR 4 inches It 5 inches ❑ 6 inches AREA TO BE REPAIRED'u sq.ft. 4 in. (03 0 sq.ft 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes I4'No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels.FIRST INSPECTION AND FORM MADE BY : Pig 4-D5 Date: *di 9 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS '3 1 9 .Monroe, 89Iz - 30 - lzq - ozl (3f PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ( No See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes [I No — 1 WATER VALVE ADJUSTMENT REQUIRED ❑Yes I No \ PARKS DEPARTMENT — REVIEW REQUIRED 640 Yes ER No - - - M lJ Zo,z' / - yoi - riot/woe LOCATION OF SIDEWALK Lg Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 5 Feet ❑5.3 Feet ❑ Other DEPTH OF SIDEWALK c`4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1 .® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES ❑Yes t?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 : M5 ,VD.g Date: 3/2-0/0 - - PERMIT ISSUED _... FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 3S0 .Mort roe, &`l - - JO- )31 - OO7 63 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes 'd No See reverse side for Defect Codes A F • See below for Defect Code G TRIM VEGETATION ❑Yes SSI No `t WATER VALVE ADJUSTMENT REQUIRED — 411-0-110- ❑Yes CIHt No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes OK No Florwo e- LOCATION OF SIDEWALK CM Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet C®,5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK f14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED c2C•® sq fL 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes tN No No. of Squares with Patches CODE G NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : +- Date: 3/Z/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 `Motu SIZ — — l3/ — ©Oc 1,P 34 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect Ai ❑Yes No — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes Z. No -- t WATER VALVE ` ADJUSTMENT REQUIRED �Q---► ❑Yes No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 7 No — r JIxq' tU' dIWD Mon me- LOCATION OF SIDEWALK I Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet irgs 5 Feet ❑5.3 Feet • ❑Other DEPTH OF SIDEWALK cf4A,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 79-•6 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes (.No No. of Squares with Patches CODE G - — "F"NOTE :Areas aas marred with a i t may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. p FIRST INSPECTION AND FORM MADE BY : ti V� Date: 3/ /i7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 6,1 s ! � -� 5-7-4 B i3 -2, — 7--ate- 3°7 6735 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes ®No if WATER VALVE ADJUSTMENT REQUIRED �`� "� ❑Yes ® No �(4:11. I PARKS DEPARTMENT ,, gr- *� REVIEW REQUIRED z7S ❑ Yes No g - cab= LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES Yes ❑ No No. of Squares with Patches b CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 0-5 Go'? Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS NZ Z- S�IB� -2$ - 17-&d - 602---- v 6936, PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F — See below for Defect Code G I CIYes 2'No TRIM VEGETATION — ❑ Yes ©'No .11-42)-1 ccf46 WATER VALVE ADJUSTMENT REQ'D E ❑Yes KNo PARKS DEPARTMENT REVIEW REQUIED 5.(p El Yes El No LOCATION OF SIDEWALK ❑ Front Yard 2rgcle Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet ❑ 5.3 Feet Mother S: 1 DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches 13V6 inches — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 3O'� sq.ft. 6 in. CODE F - PATCHES ❑ Yes Z7 No No.of Squares with Patches CODE 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 : RC) Date: /7 _ PERMIT ISSUED — FORMED POURED COMPLETED CITY OFW'K-CRLOO SIDEWALK REPAIR SWWEY F•RIV PROPERTY ADDRESS N "lb arr y . - 39u - 2S- 6z1 - oaa 403 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C'; F ❑Yes )4No See reverse side for Defect Codes A-F See below for Defect Code G J TRIM VEGETATION J 1 ❑Yes Nlo t WATER VALVE ADJUSTMENT REQUIRED \44— ❑Yes X/No J 1 PARKS DEPARTMENT — REVIEW REQUIRED /Iltes ❑ No • LOCATION OF SIDEWALK ,Front Yard ❑ Side Yard ❑Other WIDTH OF SIDEWALK LI 4 Feet ❑ 5 Feet f, 5.3 Feet ❑ Other DEPTH OF SIDEWALK A4 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED n.5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES 'Yes ❑ No No.of Squares with Patches_ / CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : n Date: 3-9-4 7 hie- 6-Z3-1 PERMIT ISSUED FORMED POURED - COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 ✓ ;3 - . - \al - 5k1 ' 450 PARCEL CODE CONTROL NO. - Type of Defect: — CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G J ❑Yes ,I l No TRIM VEGETATION 11/4 A ❑Yes Q No 1 ~ WATER VALVE ADJUSTMENT REM) — g ❑Yes l5I No PARKS DEPARTMENT — REVIEW REQUIRED • No ❑Yes ® — - V/ol - -k LOCATION OF SIDEWALK ❑ Front Yard ll 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 94 sq.ft. 4 in. sq.it. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes d No No.of Squares with Patches CODE G - NOTE :Areas marked with an'FF"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_ E I T PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ✓ _ ()13 - 24-1 o - 00L.. / PARCEL CODE CONTROL NO. CLEAN SIDEWALK — Type of Defect 7•1' ❑ Yes 2-go See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes Colo 10 if WATER VALVE ADJUSTMENT REQUIRED ❑Yes ❑-No X PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes CrNo LOCATION OF SIDEWALK [ ront 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 b- 'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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 : t3 Date: 3'9'/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS { i I MF; s / - - -12 7 - of k ' 640 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ® No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 0 No WATER VALVE ADJUSTMENT REQUIRED r 'TYes l 'No I I 1 PARKS DEPARTMENT — REVIEW REQUIRED Yes ❑ No A-.t L LOCATION OF SIDEWALK ®,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 17 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ii 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 4 No No. of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : !}c)/ Date: 3 w 9—i1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /10 m,ia.ea - el/3 - r30 - 065V PARCEL CODE CONTROL NO. -- CLEAN SIDEWALK Type of Defect A ❑ Yes ErNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ®'No I PARKS DEPARTMENT REVIEW REQUIRED IIYes 01 Jo CP rt9 NAA t4E401 LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK W_4 inches gf 5 inches ❑ 6 inches AREA TO BE REPAIRED &4° '/sq.ft. 4 in. d6°C sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes e-No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : (2 5 a- Date: 3 9-/0 PERMIT ISSUED FORMED POURED COMPLETED CITY IF ' ;`DER=OO SIDEWALK REPA➢• SURVEY FORM PROPERTY ADDRESS .927 I016..ecl -. - 0715 -zc- szi - 001 Co&H-A PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F See below for Defect Code G ❑Yes kl<lo . TRIM VEGETATION ``ri ❑ Yes -No 1.4—. 6�� —► WATER VALVE \ 4; ADJUSTMENT REQ'D E ❑Yes ! No d � PARKS DEPARTMENT — REVIEW REQUIRED _�� _ — ❑Yes ."No TYivflaercep V . LOCATION OF SIDEWALK 0ront Yard , ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet Li 5 Feet X5.3 Feet El Other DEPTH OF SIDEWALK , ir4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches G413E=G- - 411 & 101 owInti Pe '1', NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: Co -ZS'e7 PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS koo... �L, b.3 - 2- 13 —Oki..._ PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G ❑ Yes No TRIM VEGETATION ID Yes ® No ~ N 4 WATER VALVE _ s ADJUSTMENT REQ'D Io 143 ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED — — — — ❑ Yes IgNo LOCATION OF SIDEWALK C Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Cg 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK C 4 inches ❑ 5 inches ❑ 6 inches -- AREA TO BE REPAIRED 2'7`G sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ©.No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �5 �5 Date: - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 1O\T L AU Sr; 1,3 - - ae>3 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect A ❑ Yes i] No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I 1 ❑ Yes IN No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes IN,No iy04 PARKS DEPARTMENT — REVIEW REQUIRED ❑ Yes j 1No i ":„A p\ LOCATION OF SIDEWALK [L Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 12 5.3 Feet ❑ Other DEPTH OF SIDEWALK Ct 4 inches ❑ 5 inches LI 6 inches AREA TO BE REPAIRED m27 d 1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes L No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : C3DDate: 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /0 2,40 rvii LAB- _ l$ -25 -134 - 005 / l zl PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN/SIDEWALK See below for Defect Code G I C Yes (]No TRIM VEGETATION _ Yes ElNo iN N WATER VALVE ADJUSTMENT REQ'D 5 s,=ik,. El Yes l4 No .i; �; PARKS DEPARTMENT — ' REVIEW REQUIRED , rri , ,Yes ❑ No I LOCATION OF SIDEWALK Zr-Front Yard I Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Z5.3 Feet ❑ Other DEPTH OF SIDEWALK 2'4 inches C 5 inches ❑ 6 inches •AREA TO BE REPAIRED . =-`` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - .X , 7L 1 15 NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — FIRST INSPECTION AND FORM MADE BY : ' Date: 31 - 17 n PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Mt) 5LX MciaSMY 31 03 -tc - I3 - ac / PARCEL CODE CONTROL NO.CLEAN SIDEWALK Type of Defect ❑Yes INo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes ErNo WATER VALVE ADJUSTMENT REQUIRED - N ❑Yes N-No I l PARKS DEPARTMENT REVIEW REQUIRED�!! ❑ Yes I19`tvo 4,, 7,/,1 LOCATION OF SIDEWALK atront Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet CYO 3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 15 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 4° sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes L I-No No.of Squares with Patches CODE G - pR OTE _Areas marked with an!Fn may be repaired by patching ,A.11 other onset;oho!i be repoired has reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ie5 /CT Date: 5-' .17 — PERMIT ISSUED — FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK !'EPAIri': SURVEY FORM PROPERTY ADDRESS 1‘01, °YI 01/0,2 d1 . — 09 o 3 - 2$ - r 35 -On (,Si PARCEL CODE CONTROL NO. — Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F— ❑Yes No See below for Defect Code G TRIM VEGETATION .11,:jri.. — ❑Yes ,IZ'No N < WATER VALVE 2 ADJUSTMENT REQ'D • 1� 7t TYes IDNo -J4)(--) i 1 J PARKS DEPARTMENT + REVIEW REQUIRED . _ _ XYes ❑ No ) \ L. 94h Gk.. LOCATION OF SIDEWALK cOront Yard . ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet f5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches El 6 inches AREA TO BE REPAIRED 80°® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes pAFlo No.of Squares with Patches CODE G - .. .- p& 9 Ye., Ofte m- Ave.iv +me_ do)+4 (OM-t o 4f e) — ..A' -Qom bile. .flt.4Q.@st � v 6.rA3.ice- we, d ALL (P..a.+ 0 - 4 1.e.) NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by -- reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : T 5 Date: i-Z0-17 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF '.`'`y A ER sO SIDEWALK REP, .1R SURVEY FO :1.1 - PROPERTY ADDRESS 110 5 Ali 06,2,r,,,, S4 8983 -2c - 035-- 02.0 (05Z PARCEL CODE / CONTROL NO. — — m � Type of Defect e I _ See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes JKNo 0\\06 I _ TRIM VEGETATION 0, ❑Yes XNo .4-- �� c. WATER VALVE �► 1 1 -1 ADJUSTMENT REQ'D El Yes %No — 1 1 \\,0 1 PARKS DEPARTMENT — — — REVIEW REQUIRED — ❑ Yes No s" 11.7 ' // — £ LOCATION OF SIDEWALK ❑ Front Yard , Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet X./5.3 Feet ❑ Other DEPTH OF SIDEWALK ,I (4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED g'• 2 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes )'No No.of Squares with Patches CODE G - 'AI .21e/teri deo't/>ind 4t4;itwo" * r('tl €einir31, 9'7sel4 te&?er, — /446 4r b-c.. ri•eeIe. NOTE :Areas marked with an "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: 3•2O•r 7 Sit/ &-12-/7 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I t - NA-are-All '. , PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A ❑ Yes II No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED ~ —+ ❑Yes ® No Ie PARKS DEPARTMENT REVIEW REQUIRED ❑Yes © No A 5�iiY� "1 LOCATION OF SIDEWALKCci Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 4 5.3 Feet ❑ Other DEPTH OF SIDEWALK ffl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED '( 1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 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 : i,ZS �`� Date: 3"2 PERMIT ISSUED FORMED POURED COMPLETED C1T •F ',''ATER_00 S8 tEWALK 4,11' SURVEY FORM - PROPERTY ADDRESS 112 0 "Wherry — 8 13 -25W- /3 - C3°(' "L PARCEL CODE CONTROL NO. - Type of Defect A CLEAN SIDEWALK See reverse side for Defect Codes A-F El Yes /No See below for Defect Code G TRIM VEGETATION . ❑ Yes No +Q—► WATER VALVE ADJUSTMENT REQ`) ❑Yes No — yl PARKS DEPARTMENT REVIEW REQUIRED • _ •P0 _ — ❑Yes j'No LOCATION OF SIDEWALK 11ront Yard , 12/Side Yard ❑ Other — WIDTH OF SIDEWALK LI 4 Feet LI 5 Feet K5.3 Feet ❑ Other DEPTH OF SIDEWALK '4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7 A sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G NOTE :Areas marked wiih an "F`°may be repaired by patching.Aii other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Ka Date: 5'9'V- — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS !Zoo i- , acu_ ,-fl' / 1 "25 "f.2c -Ox)/ f 'f7 PARCEL CODE CONTROL NO. Type of Defect A C- See reverse side for Defect Codes A-F v` CLEAN SIDEWALK See below for Defect Code G El Yes LiNo TRIM VEGETATION ❑Yes 121'No ® WATER VALVE ADJUSTMENT REQ'D ❑Yes E2'No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes LNo LOCATION OF SIDEWALK ❑ Front Yard g'Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ZA.3 Feet ❑ Other DEPTH OF SIDEWALK I24 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 11,a I sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes CZ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "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 ter Date: 34-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS /Z i / - - 110 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑ Yes ❑ No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes ❑110 _ WATER VALVE ADJUSTMENT REQUIRED �] ❑ Yes ( o I I _ PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes 1114:ro cI 117/1 LOCATION OF SIDEWALK 14ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 21.3 Feet ❑ Other DEPTH OF SIDEWALK Cel<el inches ❑ 5 inches ❑ 6 inches — AREA TO BE REPAIRED Pd° ✓sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑, o No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may he repaired by patchinn.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ?-4 k ` Date:3'q``l 7 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /Soo &Ll i 1a4(5c Ey �i- - ®� PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑Yes ® No TRIM VEGETATION ❑Yes [5 No WATER VALVE g ADJUSTMENT REQ'D ❑Yes No I � ' PARKS DEPARTMENT REVIEW REQUIRED - - - - ❑Yes ® No A L. LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet LI 5 Feet I 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 29',z sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3-1 1`11 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS /300 et4 5 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ® No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑ Yes L No — t WATER VALVE ADJUSTMENT REQUIRED fQ� ❑Yes ® No PARKS DEPARTMENT - REVIEW REQUIRED L IJ ET Yes ❑ No 7 4 l LOCATION OF SIDEWALK Ii Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ® 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK C'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Zo'`1 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - — NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : D`.1 Date: _1 — 71'11 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS U31,1 u PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F Yes (] No See below for Defect Code G TRIM VEGETATION ❑ Yes DNo JI WATER VALVE ,% ADJUSTMENT REQUIRED �(� I ❑ Yes LI No PARKS DEPARTMENT REVIEW REQUIRED Oft. E.Yes ❑ No - - 04-c .ik drY LOCATION OF SIDEWALK E Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK C,4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED S 20 q s .ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes IV No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : v-5 i'stb5 3- -( 1 Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS f5 \3 -Zic.; -z -c � t'oL- PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑ Yes No WATER VALVE ADJUSTMENT REQUIRED i -Yes ❑ No I I — PARKS DEPARTMENT REVIEW REQUIRED ❑Yes p No 4sQcoo.e_ c.43esier - - - A I(1/4-3 LOCATION OF SIDEWALK p Front Yard ❑ Side Yard ❑ Other -- WIDTH OF SIDEWALK ® 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches `fF�.3 � ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED sq. CODE F - PATCHES ❑ Yes © No No. of Squares with Patches CODE G NOTE;Areas marked with an nF" be repaired by patching.All other areas shall be repaired by may r ,4 reconstruction of full sidewalk panels. 3 pi FIRST INSPECTION AND FORM MADE BY : ' 5 Date: — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO / SIDEWALK REPAIR SURVEY FORM / PROPERTY ADDRESS VI Akitexcli _ ; l9 -25- - PARCEL CODE CONTROL NO. i r \a / (64.: RK`� /of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑ Yes I No TRIM VEGETAT ON * '� ❑ Yes iNo 1111 ( �0 ,3 WATER VALVE�j � ADJUj$.TMENT REQ'D li Yes ❑ No _ PARKS DEPARTMENT REVIEW REQUI ED ❑ Yes QNo V/V4 / \_ ) LAC / LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 14 Feet ❑ 5 Feet 4.3 Feet ❑ Other DEPTH OF SIDEWALK ,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 73.q sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : B\) le Date: 615/2'o7 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO - SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1' i kW,be.IN I PARCEL CODE CONTROL NO. T f` Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F �es ❑ No See below for Defect Code G 0 I R TRIM VEGETATION ❑Yes © No \tit 1 - -44 0—* X \ WATER VALVE ADJUSTMENT REQ'D .� ❑ Yes 0 No PARKS DEPARTMENT _ REVIEW REQUIRED �J, Ili Yes ❑ No \ ,4.--„1"--3 ___J _ AllUt i 17aTo �F� - LOCATION OF SIDEWALK J Front Yard ,M,Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [I 5.3 Feet ❑ Other DEPTH OF SIDEWALK JJ 4 inches/ ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 5.5 '8sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes X No No. of Squares with Patches CODE G - NOTE:Areas marked with an OF"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. �!�`� / (�! FIRST INSPECTION AND FORM MADE BY : i( �" Date: 03/ak 7 _ PERMIT ISSUED FORMED POURED COMPLETED �- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 1106 /U ,r• -i 7,51/ - 1- 1 PARCEL CODE CONTROL'N0. VHF CLEAN SIDEWALK Type of Defect MI/Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes ©'Tlo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes Lo I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes C�7 No 4/1 re barttl LOCATION OF SIDEWALK $1 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet p°5.3 Feet ❑ Other DEPTH OF SIDEWALK M 4 inche p 5 inches f ❑ 6 inches AREA TO BE REPAIRED 1 ®°G`sq,ft. 4 in. 3 ° 8 sq.ft. 5 in. sq. ft. 6 in. ., CODE F - PATCHES ❑ Yes ;q No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ��//,, FIRST INSPECTION AND FORM MADE BY : ei Date: 'j3/4f 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM / 'PROPERTY ADDRESS i 10 iii(Jbaciti ' _ PARCEL CODE CONTROL NO. r / CLEAN SIDEWALK Type of Defect In Yes ❑ No _ See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ElYes EiNo _ 1 i WATER VALVE ADJUSTMENT REQUIRED 4143:0--► ❑Yes Ce1 No PARKS DEPARTMENT r o-P L4' REVIEW REQUIRED �i,/+- yq,Ig. ❑Yes ®//No _ - / \ L 1. / 1 LOCATION OF SIDEWALK `A Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet m 5.3 Feet ❑ Other zio.0' go T DEPTH OF SIDEWALK A 4 inches IX 5 inches ❑ 6 inches r AREA TO BE REPAIRED 1°b.°sq.ft. 4 in. ga` '�sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes t No No. of Squares with Patches CODE G - Nn P rs rk ed wn th "P" - [ems r.hir i 1 -' nhrsl v..ver by r��� •• •�' :�!:: r�P r h^����«�r�' ..r�+afi... . ..nkE Cr�r r:l L' :i -: reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ►U Date: that/fit 7 - PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ' PROPERTY ADDRESS'?- 15 tU hUbacv PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect M9 C--, ❑Yes 71 No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION El Yes © No * WATER VALVE 1 ADJUSTMENT REQUIRED 4"'0-410- ❑Yes fl No PARKS DEPARTMENT REVIEW REQUIRED 4 ❑Yes 1l No VA I//%A LOCATION OF SIDEWALK NI Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK J 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK C4 inches ) 5 inches ❑ 6 inches + O `P I AREA TO BE REPAIRED 01 .• sq.ft. 4 in. ° sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes A No No. of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. rz FIRST INSPECTION AND FORM MADE BY : � r Date: alr a u PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS I( r . �A,f l I F , \\ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ®,No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION ❑Yes ® No t WATER VALVE �� �' ADJUSTMENT REQUIRED ❑ Yes 13,No a PARKS DEPARTMENT REVIEW REQUIRED ❑Yes `,No f �'rr''I; — — LOCATION OF SIDEWALK O Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK IN 4 Feet ❑ 5 Feet LI 5.3 Feet ❑ Other DEPTH OF SIDEWALK NI 4 inches ❑ 5 inches []6 inches AREA TO BE REPAIRED -(-7-1 L)sq.ft. 4 in. sq.ft. 5 in. ae, k)sq.ft. 6 in. CODE F - PATCHES ❑Yes 1:1 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"►h'hay be repaired by patching.Al!oer th areas shall be repaired by reconstruction of full sidewalk-panels. FIRST INSPECTION AND FORM MADE BY : Iq Date: 45-261 7 _ 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO, SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS !'7 2Sy' &kii-Gs' ' - Z-vU - Oo v �f PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ❑,NNo See reverse side for Defect Codes A-F See below for Defect Code G 1 • TRIM VEGETATION i ❑ Yes o \'t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes [AO I PARKS DEPARTMENT REVIEW REQUI ED ❑Yes C1No 3 6' LOCATION OF SIDEWALK ❑'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK �❑ 4 Feet ❑ 5 Feet Q 5.3 Feet ❑ Other DEPTH OF SIDEWALK IIX inches ❑ 5 inches LI 6 inches AREA TO BE REPAIRED L` sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes 2'4o No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : FIN) A(,9 1 Date: 3 i-/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /773 Z fi4ptil31'd 4' V _ Fla ,-' -2 a - 1)04 . F. &ca l PARCEL CODE CONTROL NO. -.-- Type of Defect / t CLEAN SIDEWALK — See reverse side for Defect Codes A F ❑ Yes II No See below for Defect Code G TRIM VEGETATION — ❑ Yes 12 1 YVo 140:-/ ,j.. 41--0--10- n WATER VALVE Ie 4\ I - ADJUSTMENT REQ'D ❑ Yes ❑ No PARKS DEPARTMENT REVIEW REQUI 'D — ji7, �C ❑ Yes No / \ ) _ LOCATION OF SIDEWALK ❑ Front Yard Side Yard ❑ Other — WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 174.3 Feet ❑ Other DEPTH OF SIDEWALK 0, inches/ 5 inches ❑ 6 inches — AREA TO BE REPAIRED -26 .01 sq.ft. 4 in. , sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes /No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by r�- reconstruction of full sidewalk panels. ; Z i7 FIRST INSPECTION AND FORM MADE BY : OW 00 I4T Date: - PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ( CI itCh th PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK_ See reverse side for Defect Codes A-F See below for Defect Code G I ❑ Yes No TRIM VEGETATION ❑ Yes E2 o WATER VALVE 1 r ADJUSTMENT RRE/EQ'D ❑Yes ® No PARKS DEPARTMENT 0 4o REVIEW REQU�ED 8 � ❑ Yes El No _JA — LOCATION OF SIDEWALK front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK f t'4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2° sq.ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes o No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : "' Date: -3"24' PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS q Y ‘,, s LL _ ",V _ g'� _�.�I v PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes -No See reverse side for Defect Codes A-F — See below for Defect Code G I TRIM VEGETATION I 1 ❑Yes 0 No WATER VALVE ADJUSTMENT REQUIRED ❑Yes Ili No I I PARKS DEPARTMENT — REVIEW REQUIRED ❑Yes IL No . ,t >1' LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [ 5.3 Feet ❑ Other DEPTH OF SIDEWALK CI 4 inches ❑ 5 inches ❑ 6 inches j AREA TO BE REPAIRED Z3®/ sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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 : ="` F r: 1 1 Date: -`' — PERMIT ISSUED FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2O'b2., Mk ,,/ ''//.. - ;C? - i Z - eP.0p/ / r i PARCEL CODE A CONTROL NO. „ . -.. Type of Defect 4 k`__d �V' See reverse side for Defect Codes A-F , CLEAN SIDEWALK See below for Defect Code G I , ❑ Yes I]`No TRIM VEGETATION -- 11/4�' E Yes ❑ No il--07-0. 1 " WATER VALVE Ie 1 t ADJUSTMENT REQ'D 14o '' ❑ Yes RI No — PARKS DEPARTMENT r1-1 4 A REVIEW REQUIRED ❑ Yes ❑ No 141 _ j LOCATION OF SIDEWALK ❑'Front Yard 0`Bide Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet II`5.3 Feet ❑ Other DEPTH OF SIDEWALK 0'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 4 .� sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : l(, KJ /SA) Date: %z/-. E/ PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM — PROPERTY ADDRESS ,,f 7 f;v � i2`'`I ,/ 5( i 2 - 30- /O s -0' (I--',, PARCEL CODE CONTROL NO. Type of Defect I CLEAN SIDEWALK`` _ See reverse side for Defect Codes A-F ❑Yes O`'No See below for Defect Code G •/I TRIM,a/EGETATION — in Yes ❑ No / WATER VALVE `{, ADJUSTMENT REQ'D ` `=2 ❑Yes 0"No kr AC` ` . PARKS DEPARTMENT I REVIEW REQUIRED _� f_ ❑ Yes LI No '``y all./ --\1 — -:° — LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet El 5 Feet LI 5.3 Feet ❑ Other DEPTH OF SIDEWALK a4 inches ❑ 5 inches ❑ 6 inches Y AREA TO BE REPAIRED Go 0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes E No No.of Squares with Patches CODE G - — NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : h 1{1 Date: 3`- Z .e/ 7 — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATTERLOO SIDEWALK REPAIR SURVEY F•RM )PROPERTY ADDRESS Akv Oft —30 -3DZ. 707 PARCEL CODE CONTROL NO. Type of Defect r CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes o I See below for Defect Code G I I TRIM VEGETATION ❑Yes kNo 1 WATER VALVE �-- 't —► ADJUSTMENT REQUIRED ❑Yes ' I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes , A/ *voile 4- LOCATION OF SIDEWALK (Front Yard 0 Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet J:r 5 Feet ❑5.3 Feet 0 Other DEPTH OF SIDEWALK 04 inches ❑ 5 inches 0 6 inches AREA TO BE REPAIRED 3- sq.ft. 4 in. sq.ft. 5 in. sq.ft. in. CODE F - PATCHES 0 Yes 0 No No.of Squares with Patches r ok whin 14 ti NOTE:Areas marked with an"F"maybe repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : IsmK3 Date: g°Z9-9`f Tzkot PERMIT ISSUED �'u-r FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS `=tIt - ,/JO- ' to - 00( f 7/2 PARCEL CODE CONTROL NO. Li Type of Defect ' CLEAN SIDEWALK — See reverse side for Defect Codes A F Yes o See below for Defect Code G TRIM VEGETATION — ❑ Yes No c WATER VALVE ADJUSTMENT REQ'D 5 ❑Yes 0 No — I PARKS DEPARTMENT REVIE -REQUIRED Si P,`,1 5,3 0-Yes ❑ No %.,,Trp, E_ :U! LOCATION OF SIDEWALK ❑ Front Yard Aide Yard ❑ Other t WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2 5.3 Feet ❑ Other T DEPTH OF SIDEWALK Cinches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 110, 2- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ©N No.of Squares with Patches CODE 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 _ s �ti 1 FIRST INSPECTION AND FORM MADE BY : 13/ ICI Date: — PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 01 i c t -34:'- - - a t r2d PARCEL CODE CONTROL NO. Type of Defect 11 See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes C7`No TRIM VEGETATION ❑ Yes E No y WATER VALVE T ADJUSTMENT REQ'D ❑Yes El No !f� PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes, El-NO — r ra a LOCATION OF SIDEWALK 13 Front Yard I Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet LI 5 Feet 3 Feet ❑ Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ' s ft. 4 q in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 'C io a Date: 3"21 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS a:° k)&VAOA ''' Ic - r, - Ice) - 009 7/5 - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ,- CT Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION❑Yes ❑ No — WATER VALVE ADJUSTMENT REQUIRED — ❑Yes ❑ No I I -4 PARKS DEPARTMENT REVIEW REQUIRED f11, ❑Yes ❑ No -- / \ 1 i'1 LOCATION OF SIDEWALK a Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 6.3 Feet ❑ Other DEPTH OF SIDEWALK ❑`4 inches ❑ 5 inches ❑ 6 inches e II AREA TO BE REPAIRED 250.7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —• CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - r__ ' ith _-- "ssr -- r _ _-_- An other areas small be- repaired by i.r patching. w�i.Areas marked ail � iiia�i be repaired'by reconstruction of full sidewalk panels. a f _ FIRST INSPECTION AND FORM MADE BY : 3� Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS _ ; 6� PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes CI FNo See below for Defect Code G TRIM VEGETATION ❑.Yes 0-NO \tog WATER VALVE ADJUSTMENT REQUIRED Ie \ ❑ Yes ET No I � PARKS DEPARTMENT REVIEW REQUIRED T.: ❑ Yes ❑.--No M4 LOCATION OF SIDEWALK []``Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 3 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. c- a sq.ft. 5 in. sq.ft. 6 in. -- CODE F - PATCHES ❑ Yes 0 No No. of Squares with Patches CODE G NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : =' � ; ( r i Date: `� ;�'-°_ `g" PERMIT ISSUED FORMED POURED COMPLETED CITY OF W TErti LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ',f1)E-0 NA AS�n:l,�--.. PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G I TRIM VEGETATION ❑ Yes [ No WATER VALVE toADJUSTMENT REQ°D ----f. ❑Yes 0 No PARKS DEPARTMENT REVIEW REQUIRED — — — — — ❑ Yes No 4'' ti LOCATION OF SIDEWALK ; ,,,Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C 5.3 Feet ❑ Other DEPTH OF SIDEWALK 14 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 3 /'sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — d��.l r °. FIRST INSPECTION AND FORM MADE BY : Date: 8 ��!i s PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY Y ADDRESS 9. . 21k evz - 30 - 107 - at& 7 PARCEL CODE CONTROL NO. Type of Defect j CLEAN SIDEWALK See reverse side for Defect Codes A F ❑Yes No See below for Defect Code G • TRIM VEGETATION ❑Yes L" No a6 J/ WATER VALVE ♦.Q.—* ADJUSTMENT REQUIRED I j\ ❑Yes 14 No I PARKS DEPARTMENT REl/lEW REQUIRED Yes ❑ No 66 VrA c.) LOCATION OF SIDEWALK LFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet JX5.3 Feet ❑ Other DEPTH OF SIDEWALK Z4 inches ❑5 inches J ❑ 6 inches AREA TO BE REPAIRED ‘16'v9 sq.ft. 4 in. sq.ft. 5 in. s .ft. 6 in. q CODE F - PATCHES ❑Yes CI] No No. of Squares with Patches CODE G - • NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : MiS Date: 3k �d PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Lk), PA e9 - 3O - ISZ - 002_ PARCEL CODE CONTROL NO. A CLEAN SIDEWALK Type of Defect ❑Yes KNo See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes if,d,No WATER VALVE ADJUSTMENT REQUIRED _ ❑ Yes 7,No I I _ PARKS DEPARTMENT REVIEW REQUIRED 111 Yes ❑ No \ CO' PO k LOCATION OF SIDEWALK gLFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (z5.3 Feet ❑ Other DEPTH OF SIDEWALK tli<4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 12$.9 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES LA es ell No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may he repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. /j� �j FIRST INSPECTION AND FORM MADE BY 11 i 0D 4� Date: ',1211/7 PERMIT ISSUED FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS J t l ecitz - ( o3 7. PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑Yes KNo See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑ Yes QNo WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ,51 No PARKS DEPARTMENT REVIEW REQUIRED 516, 1 g Yes ❑ No P A. VAlX 11 Prl k LOCATION OF SIDEWALK (Front Yard ❑ Side Yard ❑ Other ` WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet V, 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches k5 inches ❑ 6 inches AREA TO BE REPAIRED 71•z sq.ft. 4 in. .2,6-> sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Q'No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : t.OA Date: 3/4th 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM. PROPERTY ADDRESS t 91 Fol �< - 30- p3 -0Ot4 "7 � PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect AA ❑Yes iN No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes Et No WATER VALVE 1CO Nif ADJUSTMENT REQUIRED -- ♦..©...� ❑Yes No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes g No — Pot k LOCATION OF SIDEWALK N.Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet CJ 5.3 Feet ❑ Other DEPTH OF SIDEWALK :4 inches ❑ 5 inches ❑ 6 inches s ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED ��'' .q — CODE F - PATCHES ❑ Yes No No.of Squares with Patches CODE G - NOTE °Areas marked with an"F" may be repaired by patting_Ali other areas shall be repai -d b y reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Mg Date: 3/221/7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Rik 89Iz -so - is, - 005 77 PARCEL CODE CONTROL NO. Type of Defect a`� CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No _ I See below for Defect Code G TRIM VEGETATION ❑ Yes A No J/ WATER VALVE 4—©_� ADJUSTMENT REQUIRED ❑ Yes Ti No 11 PARKS DEPARTMENT REVIEW REQUIRED 7aZP ❑ Yes NI,No Palk LOCATION OF SIDEWALK IR Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet N.5.3 Feet ❑ Other DEPTH OF SIDEWALK g,4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 35- 2 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES AAD iL�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 : 4;% � Date: r, i 'Zz� /i 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ssZ1 Benz_ - so - 107 - 013 2 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ►i.!Yes ' ❑ No — See reverse side for Defect Codes A F I See below for Defect Code G I TRIM VEGETATION I I ❑Yes ;jgNo WATER VALVE — �' ADJUSTMENT REQUIRED 411.-0—* ❑Yes ja,No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes INo 1Z 3O� — — — — (P6* LOCATION OF SIDEWALK OFront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet .3 Feet ❑ Other _- DEPTH OF SIDEWALK it'4 inches A 5 inch ❑ 6 inches AREA TO BE REPAIRED Za►'a sq.ft. 4 in. 63 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes 1-( No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. q� �� 9� — FIRST INSPECTION AND FORM MADE BY : 4-1,� Date: PERMIT ISSUED • FORMED POURED COMPLE I ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /63 -Polk S1(2 - 3o - /67 - -?O PARCEL CODE CONTROL ND. Type of Defect A See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes kNo _ I TRIM VEGETATION q ❑ Yes 1KI No ~©� a WATER VALVE �,► I `0 ADJUSTMENT REQ'D , 4" I V. El Yes QNo PARKS DEPARTMENT �o� REVIEW REQUIRED Yes ❑ No MAXI PvJk LOCATION OF SIDEWALK I1 Front Yard SSide Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet j 5.3 Feet ❑ Other DEPTH OF SIDEWALK J,4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /&Z 3 sq.ft. 4 in. sq.ft. 5 in. q sq.ft. 6 in. CODE F - PATCHES ❑Yes 14 No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 11/3 I De Date: •il2t//7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO S DEWA=K 'EPAL SURVEY FORM PROPERTY ADDRESS Lou' Polk- Si- - 30 -13-5 - ooz 732- PARCEL CODE CONTROL NO. - • CLEAN SIDEWALK Type of Defect ❑Yes [ No -- See reverse side for Defect Codes A-F See below for Defect Code G l TRIM VEGETATION ❑Yes j `�No WATER VALVE 1 JI ADJUSTMENT REQUIRED --► ❑Yes [ No - 1 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 2I No 14,0 LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet N'5.3 Feet ❑ Other — DEPTH OF SIDEWALK A-4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z.5-4 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes )l No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : 1' V Date: 'Z I- N (.0- 5°-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO S 'EWALK 'FPA!R SURVEY FORM PROPERTY ADDRESS ZIT Pails -, -36 - /33 .- ao 3 /35 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A F -- See below for Defect Code G I TRIM VEGETATION I I El Yes I'No �At if WATER VALVE ADJUSTMENT REQUIRED ❑ Yes J21No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes leNo LOCATION OF SIDEWALK %Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches iN1/5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 341 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes [ (No No. of Squares with Patches CODE G - "it/>r, dFkr L (Paine)pp r '�4131N- o'Y,I(14 t-40 ,r Kur. l & l t/ill\ '?,damp) NOTE:Areas marked with an"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: 3- -y 1 C p M-➢1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z 30 of k gg17- - 30-133 - e0-1 -73 PARCEL CODE CONTROL NO. 1� CLEAN SIDEWALK Type of Defect aril ❑Yes ' Psi No • — See reverse side for Defect Codes A F I See below for Defect Code G I TRIM VEGETATION I I ❑Yes 7 No WATER VALVE ADJUSTMENT REQUIRED �—a--► ❑Yes Et No I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes P3I-No LOCATION OF SIDEWALK ag Front Yard El Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet 21.I.5 Feet El 5.3 Feet ❑ Other ,— DEPTH OF SIDEWALK fai 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED • 7V_ sq ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes d No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY g Date: 3k1/17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Gil lam& -3 9- 16o - o// 7 -0 PARCEL CODE CONTROL NO. Type of Defect )1 , (i See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes Pi No _ I TRIM VEGETATION ❑ Yes I No WATER VALVE ADJUSTMENT REQ'D [ix Yes ❑ No _ I PARKS DEPARTMENT REVIEW REQUIRED CI Yes [ tNo - 150' iLW 1 ;1' LOCATION OF SIDEWALK IX Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [ 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED f �� sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes xi,No No.of Squares with Patches CODE G - 22 C77D,i NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : fin3 i Date: 5-zi-17 ( ek.1 s-4-i 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 501 '.o1 k — Scl12 - 3a- 131 - al 7 PARCEL CODE CONTROL NO_ CLEAN SIDEWALK Type of Defect ❑Yes ° pi No — See reverse side for Defect Codes A F See below for Defect Code G ( TRIM VEGETATION ( ❑Yes 'j No WATER VALVE ADJUSTMENT REQUIRED �Q"♦ ❑Yes cx No Off\ ( ( PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ElNo LOCATION OF SIDEWALK Li Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet t 5 Feet ❑5.3 Feet ❑Other DEPTH OF SIDEWALK ❑4 inches (JI 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 021. sq.ft. 5 in.. sq.ft. 6 in. CODE F - PATCHES ❑Yes No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. �� FIRST INSPECTION AND FORM MADE BY : 'Mk Date: 3/ 11' — PERMIT ISSUED FORMED POURED COMPLETED Rem szl, CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7 P k S d 5%/z -30 -vs/ -®/5:' 7171 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4 ❑ Yes to See reverse side for Defect Codes A-F See below for Defect Code G -' TRIM VEGETATION ❑Yes No �` ` WATER VALVE ADJUSTMENT REQUIRED �Q"--► ❑Yes [/No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes ,( No /41)Q r p0) t S LOCATION OF SIDEWALK j'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet Zr5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches A-5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 21.Z) sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes -No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching_All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : -`' ''G Date: 5.ZO i7 6N 5 J5-i7 PERMIT ISSUED FORMED POURED COMPLETED ap lz- SIDEWALKCITY OF WA`TE4'LOO ? `REPAIR SURVEY FORM PROPERTY ADDRESS °'-c'`-- 3co ' ,i` RAA I ...... 0/3 -2.5"- Zi.4o - ® 746, 4 PARCEL CODE CONTROL NO. Type of Defect C . 1 CLEAN SIDEWALK — See reverse side for Defect Codes A F ❑Yes El,No See below for Defect Code G TRIM VEGETATION ❑Yes d No \tif 44.-0...0. WATER VALVE ADJUSTMENT REQ'D ❑Yes El No PARKS DEPARTMENT ___ i m REVIEW REQUIRED — 6-s L1 Z — '' i� ❑Yes C 'No IA VI VI cl `, � .� LOCATION OF SIDEWALK pi Front Yard ❑ Side Yard ❑ Other —WIDTH OF SIDEWALK ❑ 4 Feet I .5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 78'° sq.ft. 4 in. sq.ft. 5 in. — sq.ft. 6 in. _ a CODE F - PATCHES tiNes ❑ No No.of Squares with Patches I CODE G - NOTEshall he repairer; by �asr sx a e�r�s iTi_Y�ifre"�with_,!tr�'ov ri:�lr'i'1P_;�iei�C-� by i'9.^;�_�'�'��.Al!�L�: �.�,...... .. .. . reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : M13 Date: IC) tb/ 1(7 -- PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM ` Z 2_ PROPERTY ADDRESS Zc x 3 l z � �S c. — c L 41,E ela3 - 1 74624 PARCEL CODE CONTROL NO. 3 a �'''�'317�—C:25 it Type of Defect (--, See reverse side for Defect Codes A F CLEAN SIDEWALK See below for Defect Code G I II Yes j:p No — a TRIM VEGETATION El Yes )111 No t WATER VALVE + ADJUSTMENT REQ'D El Yes ';r No PARKSREVIEW DEPARTMENTREQUIRED _ ❑Yes p No Iva 6`aeas y� LOCATION OF SIDEWALK R Front Yard El Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ,.II 5 Feet ❑ 5.3 Feet El Other DEPTH OF SIDEWALK D 4 inches El 5 inches El 6 inches AREA TO BE REPAIRED 2 5'S sq.ft. 4 in. - sq.ft. 5 in. -- sq.ft. 6 in. CODE F - PATCHES p Yes El No No.of Squares with Patches I CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: I zz:t� PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - vii PROPERTY ADDRESS ' , ;_ - 13 -2S- :y r, sv:. PARCEL CODE CONTROL NO. Type of Defect r i L° CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑Yes D No See below for Defect Code G I TRIM VEGETATION — ❑Yes El No A—©—* - WATER VALVE �'� I ADJUSTMENT REQ'D r '',. ❑Yes 0-No — ,_ PARKS DEPARTMENT R-- REVIEW REQUIRED r l CS C ❑Yes 0No �. -� � —Tca 0. _ ,3ti 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 El 4 inches ❑ 5 inches 0 6 inches if — AREA TO BE REPAIRED I g I• sq.ft. 4 in. sq.ft. 5 in. �° sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ;;r - ...... Date: ;;a c !- _ FIRST INSPECTION AND FORM MADE BY : - — PERMIT ISSUED ,.- FORMED POURED COMPLETED CITY' OF WATERLOO SIDEWALK REPAIR SURVEY FORM a PROPERTY f�ADDRESS ` f °•�1 7` -2 - `""-f - `r' - 49 PARCEL CODE CONTROL NO. ,A Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK _ See below for Defect Code G ❑ Yes (] No TRIM VEGETATION t -r ❑ Yes No .4-4211-1111,.. _ WATER VALVE 4-;.- ADJUSTMENT REQ'D ❑.Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED ;.�g. — — ❑ Yes 0 No Li �.. LOCATION OF SIDEWALK -I i Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C15.3 Feet ❑ Other DEPTH OF SIDEWALK E 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 'Eto& sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by — reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : "= Date: , ° PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS :',1 !?; - - 42 - 0,14 1 II PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect " ❑Yes D No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes 0NoNk — WATER VALVE At if ADJUSTMENT REQUIRED fQ.—► ❑Yes ❑`No 11(04 ► - PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 0 No — k1 - T 6 f{ LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 0'5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 1° sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes i 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. 7 ? FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 41q. i4tifl i2, _ - PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 0 Yes [1.'No See reverse side for Defect Codes A-F See below for Defect Code G • TRIM VEGETATION 0 Yes ErNo t WATER VALVE ADJUSTMENT REQUIRED 0 Yes 11'No 1(4, PARKS DEPARTMENT REVIEW REQUIRED 0 Yes 1=1'Jo • ti KO/ 7 LOCATION OF SIDEWALK El Front Yard 0 Side Yard 0 Other WIDTH OF SIDEWALK 0 4 Feet El 5 Feet C(5.3 Feet E] Other DEPTH OF SIDEWALK 0 4 inches El 5 inches 0 6 inches eV' AREA TO BE REPAIRED sq.ft. 4 in. 233 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES CI 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: -I Af PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM / / , f) .., ." PROPERTY ADDRESS /, „? , pi,pi.1 /..,,'4' ez;-- o-- • fit — SILetlf)1.- - )12, - -z: PARCEL CODE CONTROL NO. "11' — • n . CLEAN SIDEWALK Li , e[ - ..,— Type of Defect ,L-- 0 Yes J.0-No - — See reverse side for Defect Codes A-F See below for Defect Code G I • TRIM VEGETATION El Yes El No WATER VALVE ADJUSTMENT REQUIRED _ ....-0-0.. El Yes •-0"-No 1,04 PARKS DEPARTMENT _ REVIEW REQUIRED El Yes •D'No i — v.... — / / LOCATION OF SIDEWALK 0 Front Yard LI Side Yard 0 Other , — _,..., WIDTH OF SIDEWALK 0 4 Feet 0 5 Feet =Li 5.3 Feet II Other DEPTH OF SIDEWALK .0'4 inches 1=1 5 inches El 6 inches AREA TO BE REPAIRED .f) .-:; sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. _ CODE F - PATCHES 0 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. • t FIRST INSPECTION AND FORM MADE BY : 'tjtkl ' 47 l' Date:''- J fl ,.2 1.-7 ,--"' PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WrLTERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 11 I )Jf "f :f -2- 2 ' - %S' ..f,. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect "I C ❑ Yes ge No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yes [ No t WATER VALVE ADJUSTMENT REQUIRED ❑Yes D o PARKS DEPARTMENT REVIEW REQUIRED� ID Yes L-�-Kc LOCATION OF SIDEWALK i3'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet E7 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1071❑‘nches El inches ❑ 6 inches / AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 21No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : &si K;3-- Date: 12f-r7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I a �®! - !_� - Z'- z$/ - oZ7 7Z PARCEL CODE CONTROL NO. '- CLEAN SIDEWALK Type of Defect r ❑ Yes ❑°"No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETAT N I ❑ Yes ❑ No - * WATER VALVE JI ADJUSTMENT REQUIRED f—Q—► ❑Yes L`J NO PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Zr No4,6 — r Pity LOCATION OF SIDEWALK I'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet l5.3 Feet ❑ Other DEPTH OF SIDEWALK Z4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes Ca'No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � ' ix, Date: ` "1 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLO• SIDEWALK :EPAIR SURVEY FORM PROPERTY ADDRESS )2 Z reH C.4 ' /, -Z - lf, - o03 76/ z PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes Q No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes ❑4 WATER VALVE ADJUSTMENT REQUIRED 4-0 * � `, ❑Yes PARKS DEPARTMENT REVIEW REQUIRED LI Yes .0 No PHiY LOCATION OF SIDEWALK 12-Fro t Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet L 5 3 Feet ❑ Other DEPTH OF SIDEWALK (6-.4--inches LI 5 inches ❑ 6 inches AREA TO BE REPAIRED : sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 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 : (3�tit + -r Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,;/I1 V ,e/ g)(3 — z. — ZS/ - 02,f PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A Yes f 'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑Yeso WATER VALVE ADJUSTMENT REQUIRED ❑Yes ©1Io I i — PARKS DEPARTMENT REVIEW REQUIRED ElE 1v Yes - ofAor — 51 LOCATION OF SIDEWALK P`Front Yard ❑ Side Yard s� ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet C?15.3 Feet ❑ Other DEPTH OF SIDEWALK 7 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED °C sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes C -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: 3 2' -f PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I i7 n JL-`I - .19i3 -2% 2 r> - 0/i 7(,7 PARCEL CODE CONTROL NO. �11 CLEAN SIDEWALK Type of Defect ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION-.IO ❑ Yes CA'No WATER VALVE ADJUSTMENTTEQUIRED El Yes No — I PARKS DEPARTMENT REVIEW REQU E-D ❑Yes No 4. y, LOCATION OF SIDEWALK Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 211.3 Feet ❑ Other DEPTH OF SIDEWALK IZ 4 inches ICI S inches ❑ 6 inches 11 AREA TO BE REPAIRED 4-:1'‘` sq.ft. 4 in. � �' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES El Yes ❑`No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � !J KT' Date: .l'Z 1--17 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOG SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS NO AO - i3 _2 - 2 / - 02 ,/ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4` El Yes E'No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes El No * WATER VALVE 1 )I ADJUSTMENT RQUIRED 4-4D—* ❑ Yes ❑ No L� 1N. I - PARKS DEPARTMENT REVIEW REQUIRED IT' es El No — Pala 1 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 El 6 inches � ., AREA TO BE REPAIRED ` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES El Yes j2 No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : IP ' hf Date: 4'17 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS zoo 13 - - 01-1 7(, PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect e ❑Yes el No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes Alo t WATER VALVE ADJUSTMENT REQUIRED ~�-10.- ❑Yes ❑'( i PARKS DEPARTMENT 6.) REVIEW REQUIRED DYes ❑ No /4'7 .41 n am`/ LOCATION OF SIDEWALK .0'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet [ .3 Feet ❑ Other DEPTH OF SIDEWALK f214 inches p'5 inches ❑ 6 inches AREA TO BE REPAIRED 51°�� sq.ft. 4 in. 2 sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑Yes p'No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : i b 123— Date: 3--Z4�! PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 264 - ` / 3 -Z�- z r - � . 770 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect At, C- ❑Yes la-go See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes llo — WATER VALVE ADJUSTMENT REQUIRED ❑Yes ff'No I � - PARKS DEPARTMENT REVIEW REQUIRED - ❑-Yes ❑ No 1W/ _ LOCATION OF SIDEWALK Dont Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK El 4 Feet ❑ 5 Feet ° 5.3 Feet ❑ Other DEPTH OF SIDEWALK o 4 inches El 5 inches ❑ 6 inches AREA TO BE REPAIRED 90, t sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES Cl 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: 3 27-i 7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATEI LOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 2/O ,/" /4 6115 -z.5 -%8G - 03 -77 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ❑ i 1 See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION 1 ❑ Yes Cho ''1( WATER VALVE ADJUSTMENT REQUIRED ~ —110- ❑ Yes Eil o _ I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes (io LOCATION OF SIDEWALK lAiront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Erg-.3 Feet ❑ Other DEPTH OF SIDEWALK ❑'inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Lam,7 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes QIC 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 : � n , Date: 3 2417 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d?/X Pfc- ✓' — 713 - 5 -Z-30 - 0 773 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑Yes ❑i"No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ElC�'Yes No — * WATER VALVE 1 ADJUSTMENT REQUIRED� t—Q—► ❑Yes C�'No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes �No — r LOCATION OF SIDEWALK L 'Pront 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 LI sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes Li"No No. of Squares with Patches CODE G - NOTE :Areas marked with an '°F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ' Date: 3 z �17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FOR , PROPERTY ADDRESS f 61 Y f... gg2-5 -13 -Z 0 - cep ,_r` PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes a"lyO I See below for Defect Code G I I TRIM VEGETATION — I ❑Yes fo 1 ti1: WATER VALVE — � —► ADJUSTMENT REQUIRED a ❑Yes 0 No _ I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No ', — _ - LOCATION OF SIDEWALK ®front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet E 5.3 Feet ❑ Other DEPTH OF SIDEWALK finches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 'I sq.ft. 4 in. sq. ft. 5 in. — / sq. ft. 6 in. CODE F - PATCHES ❑ Yes 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 reconstruction of full sidewalk panels. by FIRST INSPECTION AND FORM MADE BY : / ' — �� Date: 3••2�17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS CONTR O. - PARCEL CODE CLEAN SIDEWALK 4—L--_ ❑Yes �'No _ Type of Defect See reverse side for Defect Codes A F I ION I See below for Defect Code G es TRIM VE STAT _ IVWq- 4tio I \ \t lf WATER VALVE ADJUSTMENT REQUIRED — ~ ©—+ G�``�fes ❑ No I ♦ PARKS DEPARTMENT REVIEW REQUIR 4.�'' ED ❑Yes o r - 4 E.�i LOCATION OF SIDEWALK thront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ]5.3 Feet ❑ Other ----- DEPTH OF SIDEWALK 4 inches 0 5 inches ❑ 6 inches / sq.ft. 6 in. — �,;�"i sq.ft. 4 in. sq.ft. 5 in. _------ AREA TO BE REPAIRED , CODE F - PATCHES 0 Yes 0/No No.of Squares with Patches — CODE G - _ _ marked ed! ,th an"F" '.1105 be repaired b:. LLlI I it other areas shall be re-paired by B..L;e[�s' Ali. y y = \V�L. •Areas IIIQI/��ilJ YYIL 1 411 IIIC1 be by f+0 III !"L reconstruction of full sidewalk panels. fill ICS Date: "Z 1 '— FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED FORMED POURED _ CITY OF WATER OO SIDEWALK 'EPAIR SU•yVEY FORM PROPERTY ADDRESS `a,11 Rine, I/S -2C-2,77 -col -171 PARCEL CODE CONTROL NO. G CLEAN SIDEWALK Type of Defect ❑Yes 'No See reverse side for Defect Codes A-F P See below for Defect Code G I TRIM VEGETATION I I ❑Yes A'/No WATER VALVE ADJUSTMENT REQUIRED ❑Yes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes I 'No 5,U 1,71 . a 64. LOCATION OF SIDEWALK %Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 145,3 Feet ❑ Other DEPTH OF SIDEWALK I 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 1-6 '‘ sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑YesIA/No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1.3N V7. Date: 3-Z '17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 31 4. . �( t/ - -`Z5' - �7 - 016, •,-/ 77 PARCEL CODE CONTROL NO. • CLEAN SIDEWALK Type of Defect ❑Yes 0-NC; See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes EYNo - WATER VALVE ADJUSTMENT REQUIRED — N ❑ Yes Q"No I I PARKS DEPARTMENT REVIEW REQUIRED Beres ❑ No wit L , LOCATION OF SIDEWALK 1..Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 2'5.3 Feet ❑ Other DEPTH OF SIDEWALK C'4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED M sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes L 'No No. of Squares with Patches CODE G - NOTE :Areas marked arked with on"F" may a y ba_ _re_pairad by pac e iai y.A®a u_iu ei_areas eas 7_I Ql1 b a_ _repaired L__ "vy reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : J Tr Date: 3. zz sf 7' — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS .220 &L-K 2 WEN S r 13 - -Lc 7--3 t - 016 76/ PARCEL CODE CONTROL NO. ff CLEAN SIDEWALK Type of Defect J" ❑ Yes /$No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION l ❑ Yes r'No t WATER VALVE ADJUSTMENT REQUIRED (t-CL L'� ❑ Yes lrlo O J I PARKS DEPARTMENT \,) C I �� REVIEW REQUIRED /`� r� Yes ❑ No rL , LOCATION OF SIDEWALK '& ront Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1 5.3 Feet ❑ Other — DEPTH OF SIDEWALK 44 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED °® sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes Rio No. of Squares with Patches CODE G - �. NOTE :Areas marked with an "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: 3/Z6/ /7 r PERMIT ISSUED — FORMED POURED COMPLETED RE,Vk&e. — CITY OF WATER_•• SIDEWALK REPAIR SURVEY FOi'M PROPERTY ADDRESS 51 3-11 ei — �5�c� -25 ot0 7S2. PARCEL CODE CONTROL NO. Type of Defect i% C- CLEAN SIDEWALK — See reverse side for Defect Codes A-F + ,� See below for Defect Code G I ❑Yes m�I TRIM VEGETATION Yes ❑ No .44 <= N -+ WATER VALVE i i \ ADJUSTMENT REQ'D — e ❑Yes X No PARKS DEPARTMENT - - — — — REVI W REQUIRED Yes ❑ No I J LOCATION OF SIDEWALK ❑ Front Yard .,Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .3 Feet ❑ Other — DEPTH OF SIDEWALK4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED SU sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes X.No No.of Squares with Patches CODE G _ 3. ipa,ned ,- ss; e,- clAe- 4o —4 w (make NOTE:Areas marked with an"F"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-Z S-V� -Zb- d' PERMIT ISSUED FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS //70: tv 4—f - f3 2z7 - )6 764 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ) v ❑Yes SEIND See reverse side for Defect Codes A-F a, I See below for Defect Code G I TRIM VEGETATION I l ❑Yes No WATER VALVE ADJUSTMENT REQUIRED ❑Yes ��lo 1,04 PARKS DEPARTMENT REVIEW REQUIRED ` ❑Yes ` No 3, 0 �,ryi r /1/7.) A LOCATION OF SIDEWALK pi Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK 64 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK p 4 inches ❑ 5 inches El6 inches AREA TO BE REPAIRED 12-- sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ` No No.of Squares with Patches CODE G - '\ NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. 071/- FIRST INSPECTION AND FORM MADE BY : 96 )$ Date: PERMIT ISSUED FORMED POURED COMPLETED— CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 667 $T3 - zs 7 - C161 7S'3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 6- ❑Yes W No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes CST No( — WATER VALVE ADJUSTMENT REQUIRED N �� ❑Yes [ -lo I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes o .5( o LOCATION OF SIDEWALK 71Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 0.5.3 Feet ❑ Other DEPTH OF SIDEWALK (1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED ° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes 'No No.of Squares with Patches � � 3 fl R << ��, � ° i4 CODE G - C-a� <e,,� 5 a,�a. " 1 �0.:� d4'V 900% ��1� r` SC hli ' �IPmaaY� _Areas marked �..z$with EIS®@ A,...6-.e�.,,� 1 vwi 1 E. .f I Gas 1'1 lal ked VYILI 1 all f may lay ua repaired by patching.ly.Ali other aI eab 6;Jail be I epd11 Gu by reconstruction of full sidewalk panels. /) FIRST INSPECTION AND FORM MADE BY : D�// 5 Date: 3,47/" — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM 1, I2 PROPERTY ADDRESS 1 I�',� I��_ -- Iiz - 30 - 3o/ -0//7_, 58 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect El Yes No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes rilc No WATER VALVE ADJUSTMENT REQUIRED .4"'112) ♦ ❑Yes ,G1-No 1� I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes © No if% LOCATION OF SIDEWALK ®Front Yard El Side Yard ❑ Other f WIDTH OF SIDEWALK El 4 Feet ;0_5 Feet ❑ 5.3 Feet El Other DEPTH OF SIDEWALK ❑ 4 inches i 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 2� L� sq.ft. 5 in. sq.ft. 6 in. F CODE F - PATCHES ❑ Yes kNo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : )31J i`vs Date: 3-2 '---f PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `` ' 51„C -30- ,= , - 7` O PARCEL CODE CONTROL NO. — CLEAN SIDEWALK Type of Defect ❑ Yes ❑'`No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes L`No - WATER VALVE ,01 ADJUSTMENT REQUIRED � ❑Yes ❑`No I ,► I I I PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes LI-No LOCATION OF SIDEWALK D'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 sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes ET No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 2') ;J Date: 2 La / PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS N ( ' >/ d 3 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ❑ No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes ❑'°No WATER VALVE ADJUSTMENT REQUIRED �� ❑Yes ©`No rt,04 PARKS DEPARTMENT REVIEW REQUIRED ❑Yes I]^No LOCATION OF SIDEWALK Li Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet d 5.3 Feet ❑ Other DEPTH OF SIDEWALK ;0::4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 04, sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes lir No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 's t -'fit0 Date: ) " 1 : PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - / I PROPERTY ADDRESS )4,ii, s"7 Al 5. = :Ii - _. PARCEL CODE '-=CONTROL NO. Type of Defect See reverse side for Defect Codes A-F R CLEAN SIDEWALK — See below for Defect Code G I ® Yes ❑ No 4I = TRIM yEGETATION — _ fl Yes ❑ No 41""0-10- °1 ‘.\ WATER VALVE I� I ® 'e ADJUSTMENT REQ'D L I] Yes ❑ No — (h ) PARKS DEPARTMENT ` -` \��^i REVIEW REQUIRED ti ❑ Yes ❑ No / LOCATION OF SIDEWALK EIFront Yard 0-Side Yard ❑ Other — WIDTH OF SIDEWALK la-4 Feet ❑ 5 Feet CI 5.3 Feet ❑ Other DEPTH OF SIDEWALK ID`4 inches ©5 inches ❑ 6 inches AREA TO BE REPAIRED 77, q 4 in. y ®1,7 sq. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - — — NOTE :Arens,rnnr!«d with nn "P'rnnv hn rrnnirM by pgtr:hirntg_All€ath sa r TAPS hS111 h re rppirpd h i reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : �'_�.. 13,1"r it) Date: 7,-:' 2/ I7 — PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -- � - - - 04) L. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ® No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑Yes ® No t WATER VALVE ADJUSTMENT REQUIRED ❑ Yes `© No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Q No r Ise 5-7 It LOCATION OF SIDEWALK Q Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet El Other 3 DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED " sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 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 : 2-5 1M Date: 3"- `t PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 6,i ) - I s .0 %?› -&S - Io -oo % 6Po PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ILI No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes ENo — �� N t WATER VALVE °� ADJUSTMENT REQUIRED ~©-0. ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes El No s c o LOCATION OF SIDEWALK !i Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet E Other DEPTH OF SIDEWALK El 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES J Yes ❑ No No.of Squares with Patches 4 `" CODE G NOTE :Areas marked with an°'F"may be repaired by patching.ran other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : R5 eA>a Date: 3®i - l PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS gZ0--8�4, 9Z ACM D2& i 3 n s 5 — — e3 — ooe ,--ilea 07, BeldLo PARCEL CODE CONTROL N�� • Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G 441 D Yes E>No I TRIM VEGETATION ❑Yes El No ♦" N '♦ WATER VALVE ADJUSTMENT REQ'D A. ❑Yes Iii No of, l PARKS DEPARTMENT REVIEW REQUIRED ❑Yes. El No s 5.0441 v d LOCATION OF SIDEWALK 1E1 Front Yard ® Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet g 5.3 Feet ❑ Other DEPTH OF SIDEWALK E,3 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 343.4 /sq.ft. 4 in. sq.it. 5 in. sq.ft. 6 in. 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 : R �� Date: 3 e B PERMIT ISSUED - FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ;2-.. 5 Icr � 13 -4; -‘,16,3 - 00, PARCEL CODE CONTROL NO. - CLEAN SIDEWALK Type of Defect ❑ Yes 1'No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes I l No - WATER VALVE ADJUSTMENT REQUIRED —' N L}.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 Il 5.3 Feet ❑ Other DEPTH OF SIDEWALK i 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 29.2 J sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes [ No No. of Squares with Patches CODE G - — NO1 E :Areas marked with an T."may be repaired by patching.Ali other areas shad be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .5 Date: 7 PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Via& - 9 2-1 ` � - %3 -45 -a -ow ✓ eiC PARCEL CODE CONTROL NO_ Type of Defect GLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I El Yes RI'No 0 I TRIM VEGE I ATION CI Yes CI No \it it 44— N t WATER VALVE 1 I ADJUSTMENT REQD ❑Yes IN 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 M Other -7°1- - DEPTH OF SIDEWALK LI 4 inches El 5 inches El 6 inches AREA TO BE REPAIRED 3 ,0 /sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ® No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Date: s -L PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F See below for Defect Code G I ❑Yes CI No TRIM VEGETATION "- t El Yes (] No : ~®,. WATER VALVE c,011 I rr ADJUSTMENT REQ'D ❑ Yes (] No PARKS DEPARTMENT REVIEW REQUIRED .- - — — — ❑ Yes iI No LOCATION OF SIDEWALK El Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches 0•5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - — NOTE .Areas marked with "F"fria: repaired by:iehi :,: Ail other.r...-.. .hEiii b 1\V�I.- iZIGRA�IIg1I�GU with A�� � �i�ay LG by Nc�w��i��y.nu other areas ai�a�i be repaired by reconstruction of full sidewalk panels. • FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I l 1 6A-016 7 1 -G? - i%•7 - 014 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A 5 ❑ Yes D`No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑Yes ❑No WATER VALVE 1 iv ADJUSTMENT REQUIRED �� ❑Yes 0'No I PARKS DEPARTMENT -- REVIEW REQUIRED ❑ Yes D`No 7(IC KI N . LOCATION OF SIDEWALK 0-Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 1311.3 Feet ❑ Other DEPTH OF SIDEWALK (]4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED m°`' sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. 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: 3'`1-t 7 PERMIT ISSUED FORMED POURED COMPLETED — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I ° f�� .40 oa - /77- I ` / 61 PARCEL CODE CONTROL NO. _. CLEAN SIDEWALK Type of Defect ❑ Yes ❑No — See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I I ❑ Yes 0 No — WATER VALVE ADJUSTMENT REQUIRED — ~®� ❑Yes ❑ No PARKS DEPARTMENT REVIEW REQUIRED 4i ❑Yes ❑ No rd 1/} 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 CA-inches ❑ 6 inches B AREA TO BE REPAIRED sq.ft. 4 in. n" ? /sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes I'No No. of Squares with Patches CODE G - — NOTE :Areas marked with an"F"may be repaired by patching.Ail other areas shah be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : °L Date: 3" 1` '1 PERMIT ISSUED — FORMED POURED COMPLETED -- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS 1 2- �� �3 � ,'./ PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes p No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION ❑ Yes Ill No WATER VALVE ADJUSTMENT REQUIRED N ❑ Yes ® No I I 1 PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes ® No 4-1 St ( LOCATION OF SIDEWALK 0 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet fl 5.3 Feet ❑ Other DEPTH OF SIDEWALK ❑ 4 inches p 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. 210 sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes p No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : t=9 Date: 3 - 0'i PERMIT ISSUED FORMED POURED COMPLETED Si-` : 1_ to 4- CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS L S L S s'Tc-A - v, Dk -ZS -z-S5 -102_ ,e PARCEL CODE ,A, 4 CONTROL NO. s Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes ® No See below for Defect Code G �4. TRIM VEGETATION e ❑ Yes NoNt4 o _ — ~©`— r" WATER VALVE d a —I ADJUSTMENT REQ'D �4 I i ❑ Yes No — 4 e" 6, 4 '� PARKS DEPARTMENT REVIEW REQUIRED - - � — ❑ Yes [Ft No tA. ,b4I p. I - 4 SHEET TOTAL <,°' a.�` r2_T O _— Div t siL'7'e.� _ 127,0 1 g4. 2 "7c+c,c, a' LOCATION OF SIDEWALK ® Front Yard [l Side Yard ❑ Other P 3 `ti` WIDTH OF SIDEWALK ❑4 Feet N7 5 Feet ®,5.3 Feet ❑ Other ` fig•q ' 6''- DEPTH OF SIDEWALK Et 4 inches ❑ 5 inches F 6 inches T , AREA TO BE REPAIRED IV.Z sq.ft. 4 in. sq.ft. 5 in. 1 27.0 sq.ft. 6 in. CODE F - PATCHES ❑ Yes 1 i No No.of Squares with Patches CODE G - — — NOTE :Areas marked with an "F"may be repaired by petchlne,_All other,areas shall ,be.repaired bys reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : g b'',5 Date: 3'"at 1-1 _ PERMIT ISSUED FORMED POURED COMPLETED F 4- 4-CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS I V L S 'C ilks--.- 57 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes C No See below for Defect Code G as j TRIM VEGETATION ❑ Yes ff No WATER VALVE ADJUSTMENT REQ'D ❑ Yes [yi'No 5,1 PARKS DEPARTMENT g REVIEW REQUIRED LI Yes Sir No L A rY a LOCATION OF SIDEWALK y Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK ® 4 inches ❑ 5 inches IR 6 inches AREA TO BE REPAIRED ZZg.14 q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes p No No. of Squares with Patches CODE G - NOTE:Areas marked with an "F°'may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 5 Sp 5 Date: 3-Z1 m" PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS &/< r4ty /2 T . _ 13 —Z 20 — oZ5 eZ7 PARCEL CODE CONTROL NO. _ Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes ❑ No TRIM VEGETATION ❑ Yes ❑ No 0-10. WATER VALVE j, a I ADJUSTMENT REQ°D .4„1 ❑Yes ❑ No I � PARKS DEPARTMENT REVIEW REQUIRED — El Yes ❑ No j � ,r ie �n xL4_ 0a ��,�Ls1 f . c � l� _ set LOCATION OF SIDEWALK p 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 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. -- CODE F - PATCHES ❑ Yes ❑ No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: PERMIT ISSUED _ FORMED POURED COMPLETED CITY OF WATE LO( SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 677 5 , 104 0It 3 -15 - ZO3 - 017,7- e z PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect k C— ❑Yes Q� No See reverse side for Defect Codes A-F See below for Defect Code G I TRIM VEGETATION I ❑ Yes C/No )0' WATER VALVE ADJUSTMENT REQUIRED ~ � ❑ Yes No PARKS DEPARTMENT REVIEW REQUIRED f/ ❑Yes Rio i-P4 • • 1, /k o v P S:.c.45 s A S)i�G 4-'Ati4 S�A��i���� o LOCATION OF SIDEWALK © Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet 13 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 53/D sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. —' CODE F - PATCHES ❑ Yes K10 No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : II Date: oV7/7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS s(-1 sY o 5-1.4 255 a -Z. -ZZ3-0i3 (S3 PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK -- See reverse side for Defect Codes A-F See below for Defect Code G I ; ❑ Yes 1 I No TRIM VEGETATION ❑ Yes No N WATER VALVE ADJUSTMENT REQ'D 3 ❑ Yes ® No PARKS DEPARTMENT REVIEW REQUIRED — 4.4 ❑ Yes No LOCATION OF SIDEWALK ® Front Yard NI Side Yard ❑ Other --- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet In Other 5°4 DEPTH OF SIDEWALK ❑ 4 inches ❑ 5 inches re 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. 2_5_ a sq.ft. 6 in. — CODE F - PATCHES ❑ Yes ® No No.of Squares with Patches CODE G - NinTP . runt°mnnvvr with Inn e rCr�.rC o mil ra . M ,lea tog=re",air d b.,� er�¢� n.P f 64a. ,o„�i?:�, �.I:�r�r� �i�.-.:c � ..r. reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 3-2' PERMIT ISSUED FORMED POURED COMPLETED - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS P;s 'Sr ,:. 4. -PARCEL CODE CONTROL NO. Type of Defect I/'a s 6., See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G I ❑ Yes CI No I -" TRIM VEGETATION �, .q=' ❑ Yes C7 No Ie,► '� WATER VALVE i ADJUSTMENT REQ'D — y ❑ Yes C7 No PARKS DEPARTMENT -- - - _ REVIEW REQUIRED : ;, ❑ Yes [Q No - 11, LOCATION OF SIDEWALK Er Front Yard ❑ Side Yard ❑ Other _ — WIDTH OF SIDEWALK ❑4 Feet 0~5-Feet O 5.3 Feet ❑ Other DEPTH OF SIDEWALK []~4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED <; V sq.ft. 4 in. _ sq.ft. 5 in. -- CODE F - PATCHES --sq. 6 in. ❑ Yes CINo No. of Squares with Patches CODE G - --- NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : '" . ru y,� e, Date: .,._�';1 PERMIT ISSUED -.. FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0,0 (46,' f i} 1' '° C, / N_i - '� 303 - CONTROL NO. PARCEL CODE CLEAN SIDEWALK , r.<� ❑Yes 0/NoType of Defect See reverse side for Defect Codes A F TRIM VEGETATION I See below for Defect Code G ❑Yes C `No I\ * WATER VALVE ADJUSTMENT REQUIRED ❑Yes 0/No 4'\1 5, 0 \ , , I PARKS DEPARTMENT REVIEW REQUIRED _i_ I \ t ❑Yes L No iS — LOCATION OF SIDEWALK C]'Front Yard ❑ Side Yard ❑ Other __--- / WIDTH OF SIDEWALK ❑ 4 Feet 125 Feet ❑ 5.3 Feet ❑ Other — — 4 inches ❑ 5 inches ❑ 6 inches DEPTH OF SIDEWALK I sq. sq.ft. gin. — 0` T ft. 4 in. --sq.ft. 5 in. ------ AREA TO BE REPAIRED i `° : CODE F - PATCHES ❑Yes ❑"No — No.of Squares with Patches CODE G - "�� paired U patching.il~�..Ali other areas shall be I GEJ"dll GU by : Areas---_k_d _._ s:. NOTE .Areas I I ldl K�U W I It 1 dl I r lilay be i0�' Y reconstruction of full sidewalk panels. 1 �� ''; Date: ° ` FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED FORMED POURED _ CITY OF WATE LoO SIDEWALK REPAIR SU \VEY FORM PROPERTY ADDRESS °Z 3 V .4 ; 9. c 9f3 -25 o VH7 PARCEL CODE CONTROL NO. i CLEAN SIDEWALK Type of Defect ❑Yes `�No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION • ❑Yes A, No WATER VALVE lt ADJUSTMENT REQUIRED -- I ❑ Yes ;( 'No a I PARKS DEPARTMENT REVIEW REQUIRED I� ❑Yes Ig\lo - fix x x - - \ 33' 6-f.61 t-SAW VinjtOlk- LOCATION OF SIDEWALK igFront Yard ❑ Side Yard ❑Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet X5.3 Feet ❑ Other DEPTH OF SIDEWALK $4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED in°' sq.ft. 4 in. sq. ft. 5 in. sq.ft. 6 in. CODE F - PATCHES p❑ Yes ❑ No No. of Squares with Patches CODE G - � elf o C�4e ;o k e k IDR,n - rtpkteA, NOTE:Areas marked with an"F"may be repaired by patching.All other-areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : . � D Date: 3' 77 7 73 1/ . `7D-17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SI itEWALK REPAIR SURVEY F•RM PROPERTY ADDRESS 1 2- STt v PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F ID Yes ® No See below for Defect Code G TRIM VEGh I ATION ❑Yes C+ No _ 41-- —� m�� a WATER VALVE • ADJUSTMENT REM °�• ❑Yes ID No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes El No _/ d L c a k e s s SDEv O `®' WASP- LOCATION OF SIDEWALK 2I Front Yard ❑ Side Yard LI Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet LI 5.3 Feet I I Other '7° 6 — DEPTH OF SIDEWALK ,l 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ® No No.of Squares with Patches �. CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. -- FIRST INSPECTION AND FORM MADE BY : l° 305 Date: 3-la-(1 PERMIT ISSUED FORMED POURED COMPLETED _, CITY OF WATERLOO ( 7-f SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 41 \3 - - 02,1 - 0 (NN PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION I ❑ Yes No 1`1` VL ADJUSTMENTWATERAVE REQUIRED \ ElYes No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes JNo 4-0 4°t 1/31 41, LOCATION OF SIDEWALK VI Front Yard ❑ Side Yard Li Other . WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet iI 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1i4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED .2 sq,ft. 4 in. sq.ft. 5 in, sq.ft. 6 in. CODE F - PATCHES ❑ Yes II No No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � �> Date: 3—D— !—I PERMIT ISSUED " FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM - PROPERTY ADDRESS WO guy e,,5 -i5- /57 -��7 51 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes IK No See reverse side for Defect Codes A F See below for Defect Code G I TRIM VEGETATION I ❑Yes JNo 7 WATER VALVE ADJUSTMENT REQUIRED ♦...( --► ❑ Yes [ }No /1,0k PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No LOCATION OF SIDEWALK N,Front Yard ❑ Side Yard ❑ Other ..._ WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ®.Other 6,7 DEPTH OF SIDEWALK . ❑ 4 inches 1S4 5 inches ❑ 6 inches — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ❑ No No.of Squares with Patches CODE G - iNT' a1 — NOTE :Areas marked with an"F"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-. 17 PERMIT ISSUED — FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /00 ad< ;" F i0 .. 8 3 - '- i 8 c2o7 PARCEL CODE CONTROL NO. s Type of Defect A. CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑Yes q'No t JI WATER VALVE 411-0`,- ADJUSTMENT REQUIRED a ❑ Yes 'No PARKS DEPARTMENT �oG1.7e.„k c),r� REVIEW REQUIRED d'Yes ❑ No i'A; !. 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 12-1' LI sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 0 No No. of Squares with Patches CODE G NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : .i Date: VO{7= PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS -s-c:,, 13 1 k ro io,Utz PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect [ \Yes El No See reverse side for Defect Codes A-F TRIM VEGETATION I See below for Defect Code G — 14 ElYes q No g ' WATER VALVE �'' ADJUSTMENT REQUIRED t---W ❑Yes M:No \ — I PARKS DEPARTMENT REVIEW REQUIRED _I_ ❑Yes li No — cRlu�_ 30 LOCATION OF SIDEWALK Q'Front Yard ❑ Side Yard ❑ Other ( WIDTH OF SIDEWALK El Feet ❑ `' 5.3 Feet ❑ Other — 5 Feet DEPTH OF SIDEWALK j1 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq. l'l ✓ ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. No No.of Squares with Patches CODE F - PATCHES ❑Yes --- CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. — �/�i�L�� FIRST INSPECTION AND FORM MADE BY N'1 Date: PERMIT ISSUED FORMED POURED COMPLETED -"' CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM -- PROPERTY ADDRESS 52 ta<< io;, PARCEL CODE CONTROL.NO. Type of Defect r CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes No See below for Defect Code G TRIM VEGETATION ❑Yes ® No 1 WATER VALVE �--Q ADJUSTMENT REQUIRED I /� "' ❑Yes No I l� I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes No — — --- -__ I I� — — LOCATION OF SIDEWALK L. 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 ' '5-s .ft. 4 in.q sq. ft. 5 in. _ sq.ft. 6 in. CODE F - PATCHES ❑Yes 13 No No. of Squares with Patches CODE G NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : !P I ��5 i Date: �:j Z�GC+P�7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Zoo 5/6 l`C1 (110,0416A. r113 -25 -2cr2. - C tO 855 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect 4 f (r7 ❑Yes ' 0 No — See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes . g No IP•= WATER VALVE _ ADJUSTMENT REQUIRED A—CI_„ ❑Yes la No i Ot - — PARKS DEPARTMENT REVIEW REQUIRED ❑Yes la No 2G' 1 � — — MOT/YA — LOCATION OF SIDEWALK J `Front Yard ❑ Side Yard ❑ Other — WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ® Other oo 2 ! DEPTH OF SIDEWALK C .4 inches ❑ 5 inches LI 6 inches AREA TO BE REPAIRED 1 C'Li' sq.ft. 4 in. sq. ft. 5 in. � sq.ft. 6 in. CODE F - PATCHES ❑Yes Q No No.of Squares with Patches CODED - < r , te-A 00i I ago \p c I 4 U !>> � \no%) -0, 17) �' \ote, ( vit r ,L„ NOTE :Areas marked with an_.- may De repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. g _ FIRST INSPECTION AND FORM MADE BY �'�.I'� Date: - i � �1 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /Co L , .k 0 89 a -36 - 36.E - to a PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F El Yes 'No " j See below for Defect Code G TRIM VEGETATION ❑Yes ( 'No ti At if WATER VALVE --42)•-0. ADJUSTMENT REQUIRED I( ❑Yes J 'No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes `No 57i" -Pearbm C LOCATION OF SIDEWALK ,q Front Yard ❑Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5.3 Feet ❑ Other DEPTH OF SIDEWALK 1.4 inches ❑5 inches ❑ 6 inches AREA TO BE REPAIRED 2 c) sq.ft. 4 in. _ sq.�- 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes 01 No No.of Squares with Patches- CODE G - NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be e reconstruction of full sidewalk panels, repaired by FIRST INSPECTION AND FORM MADE BY : '. Date: /O//7I /4, PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d 26 (baba 0 9.j 0-30 oot CO,ROLP10. ._ PARCEL CODE • CLEAN SIDEWALK Type of Defect Yes ❑ No -- See reverse side for Defect Codes A-F TRIM VEGETATION See below for Defect Code G ❑Yes 1 No WATER VALVE \'tif ADJUSTMENT REQUIRED 41-4111-- ❑Yes 4 No /1,0k — I PARKS DEPARTMENT REVIEW REQUIRED ❑Yes k No — _A LOCATION OF SIDEWALK l Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet (,5.3 Feet ❑ Other s DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑ Yes 4 No No.of Squares with Patches — CODE G - NOTE:Areas marked with an:.Fc,may be repaired by patching.Aii other areas snail be repaired by reconstruction of full sidewalk panels. /4Z- 4� _ FIRST INSPECTION AND FORM MADE BY Date: PERMIT ISSUED FORMED POURED COMPLETED . -- - CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS d 2.6 e el PARCEL CODE { CONTROL NO. Type of Defect �"� CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No I See below for Defect Code G I TRIM VEGETATION ❑Yes alNo TALE 4"'Q—► ADWAJUSTERMV ENTV REQUIRED I 11\ ❑ Yes f No I I — I PARKS DEPARTMENT REVIEW REQUIRED ________L ❑ Yes N No 57o a l Sri iHa LOCATION OF SIDEWALK 'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ,& 5.3 Feet ❑ Other DEPTH OF SIDEWALK 111 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED i �sq.ft. 4 in. _ sq,ft. 5 in. _ sq,ft. 6 in. CODE F - PATCHES ❑ Yes ❑ No 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 Date: 17 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS B 41 oar, `re% 89 P Z 0 C)0 J CONTROL NO. PARCEL CODE CLEAN SIDEWALK Type of Defect ,Yes ❑ No -- See reverse side for Defect Codes A-F TRIM VEGETATION J See below for Defect Code G ❑Yes No 1 WATER VALVE — ADJUSTMENT REQUIRED '° ❑Yes No 1 ♦ 1 PARKS DEPARTMENT J REVIEW REQUIRED ❑Yes X No -- _i_ dip 1 OW ___ ___ — - LOCATION OF SIDEWALK '`Front Yard ❑ Side Yard 0 Other ----- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet c5 5.3 Feet 0 Other DEPTH OF SIDEWALK N 4 inches 0 5 inches 0 6 inches + s ft. 5 in. sq.ft. 6 in. — AREA TO BE REPAIRED G 5�.G �'�_ sqq sq.ft. 4 in. 0 Yes No No. of Squares with Patches CODE F - PATCHES — CODE G - Areas marked. itf be--_-:_^ patching.Ali other areas shall be repaired by NOTE . i11'QI RGI,I VYILII an��f�� 111-Q�% IGF1d11CU by reconstruction of full sidewalk panels. ®a — FIRST INSPECTION AND FORM MADE BY : " a Date: PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 15, r&d-ti - - 3 1. PARCEL CODE CONTROL NO. Type of DefectA CLEAN SIDEWALK ❑Yes No See reverse side for Defect Codes A-F J See below for Defect Code G J TRIM VEGETATION ❑Yes .ri No WATER VALVE FQ--► ADJUSTMENT REQUIRED 0 Yes No J I PARKS DEPARTMENT REVIEW REQUIRED 110, 41 Yes ❑ No DadlOd VD LOCATION OF SIDEWALK IR Front Yard 0 Side Yard ❑ Other WIDTH OF SIDEWALK 0 4 Feet 0 5 Feet J 5.3 Feet ❑ Other DEPTH OF SIDEWALK 4 inches 0 5 inches ❑ 6 inches AREA TO BE REPAIRED 53. sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes • No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : !i'15 Date: //Z/Z7 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WA ERWOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 9101 Der born 3c - 36 - 305 - u i 1 0(gl PARCEL CODE CONTROL NO. Type of Defect A f Fu CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes No See below for Defect Code G 1 � 1 TRIM VEGETATION I1 ❑Yes [ ] No L f4 WATER VALVE ADJUSTMENT REQ'D 'co I(p^I�(`► ❑Yes 523 No Jci4 I� V . _. PARKS DEPARTMENT (1 o o REVIEW REQUIRED 1\q _ _& �;B 11 4'61_ d Yes ❑ No fa./Poot) c) 0 (..„1„,c„.A0 LOCATION OF SIDEWALK IN Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet Yk5.3 Feet ❑ Other .r DEPTH OF SIDEWALK 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED VP 5- sq.ft. 4 in. 24' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES A Yes ❑ No No.of Squares with Patches CODE G - Pivw s Gp2 cutvve, aleat,fc+ Awe 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 : P16 Date: 8/Z�/ZOd7 PERMIT ISSUED FORMED POURED COMPLETED • CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 5.'co gicLic 8 113 - 25-z1a - oil, g PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect • C See reverse side for Defect Codes A F ❑Yes Na See below for Defect Code G • TRIM VEGETATION I ❑Yes ®No \At if WATER VALVE ADJUSTMENT REQUIRED \ ❑Yes IV No PARKS DEPARTMENT REVIEW REQUIRED _.. ❑Yes IN No LOCATION OF SIDEWALK ®'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet 5 ° ❑5.3 Feet ��Other DEPTH OF SIDEWALK ®4 inches ❑ 5 inches ❑6 inches AREA TO BE REPAIRED '0'Z sq.t. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes El No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � Date: 'Ohl 170/fz r PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS `I3 - 25- 2oi - oo 3 - PARCEL CODE CONTROL NO. Type of Defect ACLEAN SIDEWALK See reverse side for Defect Codes A-F ❑Yes E' Na See below for Defect Code G l S. TRIM VEGETATION T k El Yes ❑ No •1t, ' ~ 0-4, _� -4-- WATER VALVE R - ADJUSTMENT REQ'D �,r ° ❑Yes tY1 No Cj PARKS DEPARTMENT REVIEW REQUIRED • ❑Yes C ;No t ; J E)vo • LOCATION OF SIDEWALK L] Front Yard It Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet :NI 5.3 Feet ❑ Other _ DEPTH OF SIDEWALK rfl 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 23,'S sq.ft. 4 in. sq.ft. 5 in. "` sq.ft. 6 in. — CODE F - PATCHES ❑ Yes lrNo No.of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. _ FIRST INSPECTION AND FORM MADE BY : 11,13 Date: PERMIT ISSUED FORMED POURED COMPLETED _ CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS # L ;m scii3 - 25- 21Z - Cv Li ea:4 PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑Yes ' I$ No See reverse side for Defect Codes A F — I See below for Defect Code G TRIM VEGETATION ( 0 Yes l `No • \At JI WATER VALVE F —► ADJUSTMENT REQUIRED ❑Yes ®No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes Q No ._. led r LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑5.3 Feet Xi Other !bb DEPTH OF SIDEWALK I '4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED LI'S sq.it 4 in. sq.ft. 5 in. — sq.ft. 6 in. CODE F - PATCHES ❑Yes p No No. of Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : tvi0 Date: B°/9 Zc71 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Uq - '_5 - z.12_ - co3 &. PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect C ❑Yes • SI No — See reverse side for Defect Codes A F See below for Defect Code G TRIM VEGETATION ❑Yes rA No \ WATER VALVE t JI ADJUSTMENT REQUIRED �—Q—► ❑Yes M No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes 1 No 4,3' - - • Foo LOCATION OF SIDEWALK ®'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ®Other DEPTH OF SIDEWALK NI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED Z 3 sq.ft. 4 in. — sq. ft. 5 in. — sq.ft. 6 in. CODE F - PATCHES ❑Yes 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 : 1‘16 Date: COiicliZ°3 - PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY.ADDRESS0C t` Ian - 25- 23L3 - cos PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect A El Yes No • See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes ! No �t WATL �I'R♦ ADJUSTERMVA ENTVE REQUIRED �/� ❑Yes 13i No PARKS DEPARTMENT REVIEW REQUIRED ❑Yes I No a d tEsld LOCATION OF SIDEWALK ® Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet ❑5.3 Feet ,ji Other 5' ' DEPTH OF SIDEWALKL:4 inches ❑5 inches ❑ 6 inches AREA TO BE REPAIRED Liu'3 sq.ft. 4 in. sq.ft. 5 in. — sq.ft. 6 in. CODE F - PATCHES ❑ Yes gi No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 'a Date: lab vz PERMIT ISSUED FORMED POURED COIVIPLE I ED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ;' . i3 ` - 6'6•F - 4 - 1 0C cy s t ! PARCEL CODE CONTROL NO. '- �, CLEAN SIDEWALK Type of Defect o ti ❑Yes 'EX No See reverse side for Defect Codes A F ( See below for Defect Code G ( TRIM VEGETATION ( Yes ❑ No WATER VALVE t JI ADJUSTMENT REQUIRED 411—•0-110- ❑Yes l No ( ( PARKS DEPARTMENT REVIEW REQUIRED ❑Yes J No — /• LOCATION OF SIDEWALK &'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet 40 Other 7 DEPTH OF SIDEWALK Ti 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED �•° sq.ft. 4 in. — sq.ft. 5 in. — sq.ft. 6 in. —' CODE F - PATCHES ❑Yes F "No No.of Squares with Patches- CODE G - NOTE :Areas marked with an`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°4 Date: iehr,�l� _. PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,: ; i.Vccek c j:icAe0,2161C-el- a - ' q;Z -5 -2-U 1 - 003 A/o/A' PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑ Yes No See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION ❑Yes No 't WATER VALVE ` ADJUSTMENT REQUIRED /( \ ❑ Yes I No PARKS DEPARTMENT REVIEW REQUIRED ❑ Yes No ? c u,c I v1 Je 0-er%CI evi ce- 9 LOCATION OF SIDEWALK 0'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet C7 Other DEPTH OF SIDEWALK Q 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED /537 5 sq. ft. 4 in. sq.ft. 5 in. ® sq.ft. 6 in. CODE F - PATCHES ❑ Yes I No No. of Squares with Patches CODE G - NOTE :Areas marked with an "F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : f Date: ic�/ �2"Pl PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS �� `�ill '�6v `k3 - 5- 2o7 - \ °, - PARCEL CODE CONTROL NO. A Type of Defect $ ) (C?..\ =' CLEAN SIDEWALKSee reverse side for Defect Codes A-F - ; ❑Yes No See below for Defect Code G TRIM VEGETATION ®Yes El No (4 rvl /1 WATER VALVE ` ADJUSTMENT REQ'D — v �j� ❑Yes ® No E 6 PARKS DEPARTMENT — REVIEW REQUIRED cr. '"" �,`ikb'''- — — — t��,; ❑Yes N No ___..) ..... 'Irv;t' U LOCATION OF SIDEWALK IRI Front Yard ❑ Side Yard ❑ Other 5:2 4 WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet ® Other DEPTH OF SIDEWALK R 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 79)'(' sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. — CODE F - PATCHES ❑Yes ® No No.of Squares with Patches _ CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : +g Date: ! I i iz(3) T PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 0 l' L,, �fi a ate >= 13 - 25- i 5 i - CO3 g z) PARCEL CODE CONTROL NO. CLEAN SIDEWALK Type of Defect ❑ Yes ®°No • See reverse side for Defect Codes A-F ` See below for Defect Code G TRIM VEGETATION ❑ Yes ® No WATER VALVE ADJUSTMENT REQUIRED ❑ Yes ® No — I PARKS DEPARTMENT REVIEW REQUIRED • ❑ Yes JD No — 62/ lc,/ \ LOCATION OF SIDEWALK x'Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet g5.3 Feet ❑ Other DEPTH OF SIDEWALK .4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 7c1'5- sq.ft. 4 in. sq.ft. 5 in. sq. ft. 6 in. CODE F - PATCHES ❑ Yes . ,_ No No. of Squares with Patches CODE G - )c55;We a,x 13ti et t d,v ; (Ztric'nca :) _) I NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : � .._. Date: Iv/7_`'7i e 9'c PERMIT ISSUED -� FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM _ PROPERTY ADDRESS 26,0 01.Z - SO- co& g 71 PARCEL CODE CONTROL NO. - CLEAN SIDEWALK ,-, Type of Defect in 0 Yes ,a No --__. --- — See reverse side for Defect Codes A-F See below for Defect Code G TRIM VEGETATION N I: o oy ,-it/I 1,7 ,1 i- 3 WATER VALVE \ ADJUSTMENT REQUIRED — -) 41--0-0- Ie 1\k PALIRKYSesDEP:RTNM°ENT REVIEW REQUIRED 0 Yes ) (No - -- - - - - - tx , .... ..._ LOCATION OF SIDEWALK 71 Front Yard 0 Side Yard 0 Other — — WIDTH OF SIDEWALK 0 4 Feet El 5 Feet $5.3 Feet El Other DEPTH OF SIDEWALK 171 4 inches X 5 inches 0 6 inches AREA TO BE REPAIRED Z—sq.ft. 4 in. 2_7_69. sq.ft. 5 in. —sq.ft. 6 in. — CODE F - PATCHES 0 Yes g No No. of Squares with Patches _ CODE G - — NOTE :Areas marked with an'F' may be repaired by patching.Aii other areas shall be iepaii ea by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : 1:1Y9 31\___-- Date: ------ PERMIT ISSUED ----_ , FORMED _—_______ POURED -- COMPLETED ---_ CITY OF WATERLOO P3' IA SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 7WC JSkx< 4v I -30 - -oil 7�. PARCEL CODE CONTROL NO. Type of Defect See reverse side for Defect Codes A-F CLEAN SIDEWALK i See below for Defect Code G I Yes 1 No TRIM VEGETATION y� ❑Yes I No Old � � 4e, \ ,5ctvco v WATER VALVE I of. ADJUSTMENT REQ'D ❑Yes g No PARKS DEPARTMENT REVIEW REQUIRED 7 ❑Yes Q No Lot_ LOCATION OF SIDEWALK 18 Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK Cl 4 Feet ❑5 Feet 1I 5.3 Feet ❑ Other DEPTH OF SIDEWALK j 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 318.v sq.ft. 4 in. sq.ft. 5 in. — sq.ft. 6 in. CODE F - PATCHES ❑ Yes C No No.of Squares with Patches CODE G - NOTE :Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 1?1/i7/ at• PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO -7 j SIDEWALK REPAIR SURVEY FORM p, PROPERTY ADDRESS .Pac lm 0 , a gcc IL -3(: -,2. - L v 1 g7Z- PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK See reverse side for Defect Codes A F , j Y No See below for Defect Code G N f TRIM VEGETATION 1 , ❑Yes 0 No 94—� WATER VALVE I(1 1 I'at 1 . ADJUSTMENT REQ"D ` ❑Yes 11 No co is b� PARKS DEPARTMENT REVIEW REQUIRED 0 ` cf 0.9` ❑Yes tir No • . v I &9d � y! 5:i .fr // LOCATION OF SIDEWALK Q Front Yard Er,Side Yard El Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet .Q 5.3 Feet El Other DEPTH OF SIDEWALK LYI 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 676 ac'r sq.ft. 4 in. — sq.ft. 5 in. a©' z sq.ft 6 in. CODE F - PATCHES ❑ Yes Ix No No.of-Squares with Patches CODE G - NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : ) Date: i I71 ZLf , PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z 8 H,,,0[€rr`I PARCEL CODE CONTROL NO. Type of Defect Y See reverse side for Defect Codes A-F CLEAN SIDEWALK See below for Defect Code G ❑Yes > No TRIM VEGETATION /21 ❑Yes l `No t ; VL ADJUSTWATERMA ENT VE REQ'D ❑Yes ps No PARKS DEPARTMENT REVIEW REQUIRED — — ❑Yes ,fiq No E-, �+ LOCATION OF SIDEWALK , . Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑ 4 Feet ❑5 Feet IN/5.3 Feet ❑ Other DEPTH OF SIDEWALK X 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 2"'5 sq.ft. 4 in. ' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑Yes ®•No No.of Squares with Patches CODE G NOTE :Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. }} 1 FIRST INSPECTION AND FORM MADE BY : I''i b Date: IOI Z I /Cam,l(0 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS /201 fr1M I - ��Il� - z - 2 1 - Ui1 1- PARCEL CODE CONTROL NO. -- Type of Defect r); / CLEAN SIDEWALK — See reverse side for Defect Codes A-F ❑Yes Li,No See below for Defect Code G 1 �- TRIM VEGETATION jt r3 ❑.Yes [ No + Q-0. ?- WATER VALVE ADJUSTMENT REQ'D I� El Yes No \,,, PARKS DEPARTMENT REVIEW REQUIRED — — ❑Yes El No ill LOCATION OF SIDEWALK C].Front Yard C Side Yard LI Other WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ❑ 5.3 Feet A Other 5-,q DEPTH OF SIDEWALK Mt 4 inches ❑ 5 inches ❑ 6 inches AREA TO BE REPAIRED 14 I'5 sq.ft. 4 in. sq.ft. 5 in. — sq.ft. 6 in. — CODE F - PATCHES tgl,Yes ❑ No No.of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : `iAV-) Date: i )Z"!zo (4 PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS ,�cx k L ? PARCEL CODE CONTROL NO. Type of Defect CLEAN SIDEWALK ❑Yes 9 No See reverse side for Defect Codes A-F A� See below for Defect Code G TRIM VEGETATION -- ❑Yes . No WATER VALVE 1� Q—.► ADJUSTMENT REQUIRED Nr J I ❑Yes N.No — I PARKS DEPARTMENT REVIEW REQUIRED t_s± ❑Yes 1 No eas Mt��1r LOCATION OF SIDEWALK 5t Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK f '4 Feet ❑ 5 Feet ❑ 5.3 Feet ❑ Other DEPTH OF SIDEWALK I 4 inches ❑5 inches ❑ 6 inches AREA TO BE REPAIRED LIZ sq,ft. 4 in. _ — _ sq. ft. 5 in. .__sq. ft. 6 in. CODE F - PATCHES ❑Yes 0,No No. of Squares with Patches CODE G - NOTE:Areas marked with an"F"may be repaired by patching.All other areas shall be repaired reconstruction of full sidewalk panels. P ed by FIRST INSPECTION AND FORM MADE BY : I Date: /13/M 7- /1-•• PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORut PROPERTY ADDRESS 112, - so- i`c 9 - °c:•5 0 i C(p - CONTROL NO. PARCEL CODE CLEAN SIDEWALK Type of Defect 0 Yes •KNo See reverse side for Defect Codes A F • I See below for Defect Code G I TRIM VEGETATION ❑Yes • P;No WATER VALVE ADJUSTMENT REQUIRED *-0- 0 Yes No PARKS DEPARTMENT I REVIEW REQUIRED ❑Yes ®No / ' \-15' LOCATION OF SIDEWALK i.Front Yard 0 Side Yard 0 Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 FeetQ,5.3 Feet 0 Other 4 inches C�.5 inches ID inches DEPTH OF SIDEWALK �' — s ft. 4 in. �`I sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED q• CODE F - PATCHES 0 Yes Q No No.of Squares with Patches s CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. ' G ( FIRST INSPECTION AND FORM MADE BY �"��� Date: I � PERMIT ISSUED FORMED POURED COMPLETED c q i J CITY OF WATERLOO J SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS iccx, Bk,„ __I / s`tcs -25 - i7(p - CO4 P 1 7 PARCEL CODE 00,} CONTROL NO. - �/ -L h� J f�i •�� V/ Type of Defect AA c i n r; �� See reverse side for Defect Codes A-F3 k CLEAN SIDEWALK — See below for Defect Code G �'� El Yes Er No i TRIM VEGETATION' ❑ Yes .U,'No ��� t 4.,,.. i bra �.61i 4 WATER VALVE i k I . w ADJUSTMENT REQ'D ❑Yes Ti 1 \. No 4 6, 1 T.: PARKS DEPARTMENT 7 .5 lh, M REVIEW REQUIRED VI r/ - : Yes ❑ No hi; cm I _,) - LOCATION OF SIDEWALK O Front Yard Ill Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet Lfl 5.3 Feet ❑ Other — DEPTH OF SIDEWALK lell 4 inches ❑ 5 inches e L7 6 inches u r AREA TO BE REPAIRED t sq.ft. 4 in. -' sq.ft. 5 in. 0 /'S sq.ft. 6 in. — CODE F - PATCHES ❑ Yes f:il No No. of Squares with Patches CODE G - _ NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Il g‘k/ Date: fit; IZLi PERMIT ISSUED FORMED POURED COMPLETED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS r SW W j - 2 5 - I.79 t CONTROL NO. PARCEL CODE \N 6 CLEAN SIDEWALK — Type of Defect _._� a See reverse side for Defect Codes A F ❑Yes 'b No See below for Defect Code G s \ `"-1 "---:� TRIM VEGETATION — ❑ Yes Q No -_ �d= 0-- WATER VALVE ,i ADJUSTMENT REQ'D i l- ❑Yes p No . �k�, PARKS DEPARTMENT ( : a' REVIEW REQUIRED ❑Yes p No 114,74 I; ';2 A/WX \ % �2 - (L„r (V) IN (ut") 8S �,�CC1\vl_, OA., LOCATION OF SIDEWALK Q-Front Yard D`Side Yard ❑ Other .._--- WIDTH OF SIDEWALK ❑ 4 Feet ❑ 5 Feet ,5.3 Feet R Other -- DEPTH OF SIDEWALK C7 4 inches ❑ 5 inches Ca inches ®" sq.ft. 5 in. sq•ft. 6 in. AREA TO BE REPAIRED 5_'S sq.ft. 4 in. _---- CODE F - PATCH ES 0 Yes ❑ No No. of Squares with Patches l— CODE G - NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. Loa, —Date: fdf�`'. FIRST INSPECTION AND FORM MADE BY ��2-) PERMIT ISSUED COMPLETED FORMED POURED CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Z f- C C „c PARCEL CODE L e CONTROL NO. — Type of Defect 7 . L -,n See reverse side for Defect Codes A-F t,,, n — CLEAN SIDEWALK See below for Defect Code G -'1 \ ' ❑ Yes iiil No 41 At TRIM VEGETATION "`— ~a >� ❑ Yes 0No .4•12) 1110' . i J s WATER VALVE >- ADJUSTMENT REQ'D ❑ Yes N No iSi ri ' PARKS DEPARTMENT _ _ _ ' - ` REVIEW REQUIRED ❑ Yes IQ No p LOCATION OF SIDEWALK I Front Yard 0 Side Yard 0 Other _ WIDTH OF SIDEWALK ❑4 Feet 0 5 Feet ,p 5.3 Feet 0 Other DEPTH OF SIDEWALK I:14 inches ❑ 5 inches 02(,6 inches AREA TO BE REPAIRED 16 i ' 1 sq.ft 4 in s 3y — q ft. 5 in. r sq.ft. 6 in. CODE F - PATCHES ❑ Yes [A,No No. of Squares with Patches CODE G - — NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : S Date: ,j G j Z( ' )Zvl PERMIT ISSUED FORMED POURED COMPLETED . — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM I 27 51tei itiol-e, PROPERTY ADDRESS eci)3 - 25- 177 - 010 PARCEL CODE 0‘ k CONTROL NO. Type of Defect_ ,___A, 6__,___L--_ V CLEAN SIDEWALK — See reverse side for Defect Codes A-F D Yes 111.No See below for Defect Code G 41 TRIM VEGETATION i 4 o Yes E3 No — &% 1 / • ‘70,- .,41--(Z)--s.- 1 V 5{06' - -- ,1 t 10, WATER VALVE i 04 i ::'2- ADJUSTMENT REQ'D k 0-1 0 Yes ,11 No I — VIIA toxiki' __ PARKS DEPARTMENT --- REVIEW REQUIRED 0 Yes 0 No _ I 'ILOCATION OF SIDEWALK 0 Front Yard, Eg,Side Yard 0 Other —__ — WIDTH OF SIDEWALK 0 4 Feet 0 5 Feet vs,5.3 Feet 0 Other —_ DEPTH OF SIDEWALK S,4 inches 0 5 inches 11.6 inches — ., i ,/ AREA TO BE REPAIRED 1.11 sq.ft. 4 in. __=:__- __sq.ft. 5 in. :1-a-C'—' sq.ft. 6 in. — CODE F - PATCHES 0 Yes 12 No No.of Squares with Patches —_ CODE G - gc5X0LA--', la 5.--A4, _ - I NOTE:Areas marked with an"F" may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : frl 1---3--- Date: 10/Z0 /7016., — --------_ _--. PERMIT ISSUED ____----- — FORMED -------- POURED ------- COMPLETED __.----_ — CITY OF WATERLOO SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS 170 t. s yc — / 6 PARCEL CODE " CONTROL NO. Type of Defect A : t CLEAN SIDEWALK See reverse side for Defect Codes A-F ❑ Yes '® No See below for Defect Code G TRIM VEGETATION ❑ Yes fl`No i WATER VALVE �— � ADJUSTMENT REQUIRED 0/0 ❑ Yes I No — I I PARKS DEPARTMENT r i! .- -- �� REVIEW REQUIRED �� Yes �'q+ LtO F ®No 4/71 LOCATION OF SIDEWALK .O Front Yard ❑ Side Yard ❑ Other WIDTH OF SIDEWALK ❑4 Feet ❑5 Feet ®5.3 Feet ❑ Other DEPTH OF SIDEWALK /IR 4 inches ❑ 5 inches L4 7, ❑ 6 inches AREA TO BE REPAIRED 61 .8 sq.ft. 4 in. q sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES ❑ Yes I2 No No. of Squares with Patches CODE G NOTE:Areas marked with an "F"may be repaired by patching.All other areas shall be repaired by reconstruction of full sidewalk panels. FIRST INSPECTION AND FORM MADE BY : Date: 9L/20ia t PERMIT ISSUED FORMED POURED COMPLETED LS CITY OF WATERLOO _ SIDEWALK REPAIR SURVEY FORM PROPERTY ADDRESS Iwo o Fie,/' '5. C..;va.c:ft, i s I -,7 5 - Igo - c.-)i LA CONTROL NO. PARCEL CODE / /' Type of Defect -_ CLEAN SIDEWALK — See reverse side for Defect Codes A F ❑Yes .g1 No See below for Defect Code G I TRIM VEGETATION \ -6`.'2 7) ❑Yes K No i E WATER VALVE N ADJUSTMENT REQ'D I J4 ElYes ® No _ PARKS DEPARTMENT 3 REVIEW REQUIRED ro 9 D Yes ® No :i° IP _ ... , E. 10__________:________ _ di- LOCA TION OF SIDEWALK 1Z Front Yard V Side Yard ❑ Other __---- WIDTH OF SIDEWALK ❑4 Feet ❑ 5 Feet ❑ 5.3 Feet XI Other 5• 0 5 inches 0 6 inches DEPTH OF SIDEWALK N 4 inches _ ` , B sq.ft. 5 in. '=sq ft. 6 in. AREA TO BE REPAIRED ----- sq.ft. 4 in. — CODE F - PATCHES 0 Yes ® No No. of Squares with Patches — _ CODE G - th an„ repaired bypatching.All other areas shall be repaired by m NOTE:re onstruct on ofeas marked t ��full sidewalk panels. Date: i� Z`: �;IG- FIRST INSPECTION AND FORM MADE BY PERMIT ISSUED COMPLETED FORMED POURED 1 111 1 ! - I I 1 1 111 1- - I I III I , 11 I 1 I I 1 . I I