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HomeMy WebLinkAboutREPAIR LOCATIONS BOOKLET ',.;,..., :i. 1,; ......' _ '--- ..";. ' , . , '.•!• — :, ..: ,.,.. „. .,,,,,,=,..',,,,,.- REPAIR LOCATIONS BOOKLET _. FOR .-.v,..... ;r1 , — „ F.Y. 2011 ',--1 1 k- k SIDEWALK REPAIR , r 5.3; .. ASSESSMENT PROGRAM _ ...11, _ . ::; !„.., ZONE 10 x... . 11, ' '' 4 Itt ti i':::!;:i;,, .:q. — 73 i.c• .,.,.. liv, L -,- . . , — .,.._ .,. ..... , . ,.‘. - P; 4. ertoo .„, ,,, -,,,,, ,,,, .... __ .„,, ,,1 , CONTRACT NO. 781 ,. ,....,.. - _ r„ :" „... ,. ,„, z., - ,,, .„. k.'" .. P.; '' ... .4"- ,r. ''..;”..‘ fIIIIILIfaIIIJII1LIIJIIIfJIIILITIIIIY3IIIIIIIL1IZt1IIEIIIrII1LLILIIIIWfIILfIILIIIIIIIIPIIIILIALILIJjII1IIRIwILIJP.1 _ _ _ ZONE 10 F.Y. 2011 SIDEWALK REPAIR ASSESSMENT PROGRAM CONTRACT NO. 781 _ PROPOSED PLATS r _ _ I- J Z Q Q _L F- ai m Q >1 o O 0 0 0 w < r r r r J w O 0 U) 0 W w r w > 0 Q 0 O�- r 0 J00 0111 - W w 2 Z C4 X 0 ~ NZWQ UNWC -� N Q W WQ. W �_ Q U °N° 111111 v W (n w a _� a Y O O r CO O O O co). 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IOWA PROPERTY ADDRESS. . 300 b/K E, 6 55 13-23-336,— 06 v 4- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR VZ f/Yl'WA L so length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) --)K1 ADDRESS. I t21 N WATER SHUTOFF aCan ' VISIBLE 0 zo+ rise BROKEN ❑ MISSING 0 /5,5 ? Property tine E . I st st, LOCATION OF SIDEWALK M.FRONT YARD 0 SIDE YARD 0 OTHER 1101 OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET ❑ OTHER DIEM OF SIDEWALK ❑ 4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ■q.ft. 4 in. (81'`1q.ft. 5 In. ■q.ft. 6 in. CODE F — PATCHES YES ❑ NO Fd NO. Of SQUARES WITH PATCHES NOTE. Arens marked with on -r may be repaired by patching. Ali other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: K.5 Date: 5 2 4 `,f? Park Department Review Required ❑ YES lit NO PERMIT ISSUED NO, DATE:, INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other. -- 1 } CYz SIDEWALK REPAIR SURVEY FORM �,e � CITY OF WATERLOO. IOWA PROPERTY ADDRESS 3z 0 E; I s+ t o PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E. AREA NEEDING REPAIR W/ZZI/ 'A L - length of repair needed Type of defect L See reverse side for Defect Codes A—F) 3 (See below for Defect Cods C) ADDRESS. 32.-0 I ( WATER SHUTOFF VISIBLE ❑ \ • sib BROKEN 0 MISSING 0 601 Property Line • S�- • LOCATION OF SIDEWALK IX FRONT YARD 0 SIDE YARD 0 OTHER yium OF SIDEWALK ❑ 4 FEET 0 5 FEET 121 5.3 FEET 0 OTHER DEPTH OF SIDEWALK yy 4 INCHES ❑ 5 INCHES 0 6 INCHES JAREA TO BE REPAIRED -'1 tr)qft. 4 in. —•q.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES ❑ NO 0 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other urea* shall be repoirsd by reconstruction of full squares. First Inspection and Form Made By;,. Ks Date; 2 3 I 0 Pork Department Review Required V7 YES ❑NO Jj PERMIT ISSUED NO. DATE:, INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: 4 CODE C — Other _JI . I1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS . 21 £ ) Sty ` ift I3-1]-3-- 36 — ✓ . 7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND Cam' L' AREA NEEDING REPAIR tliilllillWt t length of repair needed Type of defect ji (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 3 21 I ' WATER SHUTOFF V1518LE ❑ BROKEN ❑ MISSING 0 .3. Pr.. rty Unit 0 5t‘iif' _ OF SIDEWALK f FRONT YARD 0 SIDE YARD 0 OTHER maw OF SIDEWALK 0 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 10//,/ 4 INCHES 0 5 INCHES 0 6 INCHES J� AREA TO BE REPAIRED 7 sq.tt. 4 in. ■q.lt. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES [] NO i NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an -r may bn repaired by patching. All other areas • shall be repaired by reconstruction of full squ s. first Inspection and Form Made By: i�s V 6i Dale: 7-2 jJ ! /O Pork Department Review Required YES ❑NO PERMIT ISSUED NO. DATE:, INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. —. CONTRACT COMPLETION DATE: CODE G — Other° • r SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA 3Z7 C I ' f� PROPERTY ADDRESS 3C7t_l 23 - y3 0Q. . ✓ 8 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR W/7/7777/A L = length of repair needed Type of defect A, G (See reverse side for Defect Codes A—F) (See below for Defect Code G) 3�7 . ` ADDRESS: I b Ira c-- Property Line WATER SHUTOFF VISIBLE ❑ CAP a } BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK FRONT YARD s: SIDE YARD ❑ OTHER — WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET El OTHER , DEPTH OF SIDEWALK g 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED /67' f q.ft. 4- in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES Cl NO rA, NO. OF SQUARES WITH PATCHES ~- NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: ! _` Date: 3—2- "ID Park Department Review Required g YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other f eir rl��a«Mend a.' S:&e i K 1 + e r et�s ct.re SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 3Z .. z n a S r 22 )3-23-iig-0 1 V /4 PARCEL CODE CONTROL NUMBER CERT. NUMBER - LEGEND L' AREA NEEDING REPAIR WZ/ZIAilla L - length of repair needed /i j G Type of defect f (See reverse side for Defect Codes A-F) (See below for Defect Code C)--)Kr ADDRESS. 22I WATER SHUTOFF _. VISIBLE sib BROKEN ❑ • MISSING ❑ Property Line 51, ,sir taipC� OF SIDEWALK 12,1f. FRONT YARD 0 SIDE YARD ❑ OTHER yams OF SIDEWALK 0 4 FEET 0 5 FEET [2(5.3 FEET 0 OTHER _. DEPTH OF SIDEWALK f2J 4 INCHES 51 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED / + sq.ft. 4 in. �r`1+7sq.1t. 5 in. sq.fl. 6 in. CODE F - PATCHES YES [] NO 54 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may bn repaired by patching. All other areas -, • shalt be repaired by reconstruction of full squares. First Inspection and Form Made By: �LS Dale; 3-23 JO Pork Deportment Review Required ck YES ❑NO _. PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE:• CODE C - Other. Token4;a� CP��4cg.nnc�e.t err 5;�2wr`K i�r +rte rams axe. r rL g ervk eke-{-e r nt-n¢41 b 4 C i t y ,e rt3;Ar eer- j 1 - SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS /j g € . - ._ Sa_13_— —3 —� ✓ _ 15 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --+-� AREA NEEDING REPAIR vi////lf/jt L — length of repair needed Type of defect Ai (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. WATER SHUTOFF VISIBLE ❑ SE BROKEN ❑ MISSING ❑ /G.o Property line LOCATION OF SIDEWALK ® FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 0 OTHER —.. . DEPTH OF SIDEWALK f4 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 53,©_ sq.ft. 4 in. _ _.___sq.ft. 5 in. isq.ft. 6 in. CODE F — PATCHES YES [,] NO ' j NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repoired by potchinq. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By:_ - R-S Date: Park Department Review Required ❑ YES ( NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE G — Other SIDEWALK REPAIR SURVEY FORM CM( OF WATERLOO, IOWA PROPERTY ADDRESS 40, bJ/< C Q 45 5-- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —� AREA.NEEDING REPAIR W//Tull/A L = length of repair needed Type of defect ,C (See reverse side for Defect Codes A—F) (See below for Defect Code G) .1051‹ ADDRESS: ,+A \ v I - QI \ 1111 P�L�'I\it7 LZ P ` n 4.1 Property Line11111 _ V WATER SHUTOFF VISIBLE ❑ CAP BROKEN 0 c j MISSING 0 i i h2 v- �J 5+, LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET RI OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. g51°sq.ft. 6 in. CODE F — PATCHES YES ❑ NO ® NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: fRS S)(s Date: 3 -Z3 =r /b Park Department Review Required ❑ YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CV OF WATERLOO, IOWA PROPERTY' ADDRESS 460 bie za I 3 21 / 7 PARCEL CODE CONTROL NUMBER • CERT. NUMBER LEGEND L' • AREA NEEDING REPAIR V/77777777A L = length of repair needed ,.- Type of defect t (See reverse side for Defect Codes A-F) \;:t (See below for Defect Code G) *C$4, ADDRESS: I 1.1.- Property Line to'f' 14,1 f:t?f WATER SHUTOFF' VISIBLE 0 • p0*Vex' poiZ BROKEN El MISSING LOCATION OF SIDEWALK 0 FRONT YARD 'a SIDE YARD El OTHER WIDTH OF SIDEWALK D 4 FEET El 5 FEET la 5.3 FEET Ell OTHER DEPTH OF SIDEWALK Ej 4 INCHES El 5 INCHES I 6 INCHES AREA TO BE REPAIRED q.ft. 4 in. sq.ft. 5 in. Z_ZZLLs:/ q.ft. 6 in. CODE F - PATCHES YES U NO 1,X, NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. • First Inspection and Form Made By: 'ZS ,LG• Date: 3 3 Park Department Review Required Ej YES El NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: • CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 4a9 bif E 3 • 313-2 -_ .54- CO ! ✓ /7 - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' — AREA NEEDING REPAIR v<Iliislzlf L = length of repair needed t Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. WATER SHUTOFF \ VISIBLE ❑ Lase BROKEN 0 — MISSING 0 Property i�e — F' t P rr. Ave. LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 s FEET 0 5.3 FEET 0 OTHER____— '— DEPTH OF SIDEWALK 0 4 INCHES 0 5 INCHES CI 6 INCHES AREA TO BE REPAIRED --sq.ft. 4 in. ■q:ft. 5 in. Z( sq.ft. 6 in. CODE F — PATCHES YES [] No ❑ NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an 'F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Mode By: `- _.. . Date: 23 /0 Pork Department Review Required 0 YES 0 NO PERMIT ISSUED NO. — DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE C — Other — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA _ PROPERTY ADDRESS `00 JJk �. 4 6-&/ 2c_I 3 -a - 1s5 _ 2e5 J rV PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t-N— L' - AREA NEEDING. REPAIR f/I7IIZ/777f s ,q L = length of repair needed \` ` l Z + Type of defect A d a 1a eO �` (See reverse side for Defect Codes A—F) (See below for Defect Code G) >l<19. ADDRESS: I ,i) 0 c -1L- r-T . Property Line WATER SHUTOFF VISIBLE 0 CAP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK El FRONT YARD ❑ SIDE YARD ❑ OTHER _ WIDTH OF SIDEWALK ❑ 4 FEET 0 5 Fttl El 5.3 FEET RI OTHER _ DEPTH OF SIDEWALK Cg 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED '90'0 sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES El NO 1l NO. OF SQUARES WITH PATCHES_ - NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: KS 1)Cr- Date: 3_2 m_/0 Park Department Review Required 0 YES 0 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS Zzs- 2Z9 1213 ✓ _. PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -� AREA.NEEDING REPAIR tV///777/7/A L = length of repair needed , Type of defect �! (See reverse side for Defect Codes A-F) W- (See below for Defect Code G) AA- >1(11 ADDRESS: .2 Z9 \O Property Line WATER SHUTOFF VISIBLE IN et\71 Aeed adj✓s+e r---1CAP BROKEN ❑ MISSING ❑ y +k S+ LOCATION OF SIDEWALK 2 FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET OTHER DEPTH OF SIDEWALK 143 4 INCHES 0 5 INCHES ❑ 6 INCHES _ AREA TO BE REPAIRED • 6h sq.ft. 4 in. 5 in. qq.ft. 6 in. CODE F — PATCHES YES ❑ NO g NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. • First Inspection and Form Made By: fy.s. Date: 3`z 3 ` Park Department Review Required ❑ YES '`�] NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3o ) 303 L , PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND -- L' —� AREA.NEEDING REPAIR t//77777777A L = length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: Q I • Property Line WATER SHUTOFF VISIBLE ❑ CAP } BROKEN ❑ L 1 t�,� rt i MISSING ❑ • LOCATION OF SIDEWALK ❑ FRONT YARD Nt.SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET IX!. OTHER _ DEPTH OF SIDEWALK M., 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 2C:)1 O 'q.ft. 4 In. cq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO RI NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 1 ' 1 Date: 3 L 3 /0 Park Department Review Required ❑ YES NI NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA — PROPERTY ADDRESS 715 r' • PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND k L' - • AREA.NEEDING REPAIR f//I//////l�l L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) ADDRESS: c l\lv + a Property Line rs \/� WATER SHUTOFF t VISIBLE ❑ ,IS 1Di �e BROKEN 0 • MISSING ❑ L..-1 inn L, LOCATION OF SIDEWALK fell FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET ❑ 5 FEET 5.3 FEET 0 OTHER — DEPTH OF.SIDEWALK 4 INCHES El 5 INCHES ❑ 6 INCHES r ' AREA TO BE REPAIRED • I J` . q•ft. 4 in, 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO ( NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F' .be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 1 C- . LC/ Date: •J -Js �J C i • Park Department Review Required ❑ YES ® NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: . SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS ( PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' — • AREA.NEEDING REPAIR V///7Z////A L = length of repair needed /1 Type of defect i I (See reverse side for Defect Codes A—F) (See below for Defect Code G) • >< ADDRESS: F I Prro,erty Une WATER SHUTOFF VISIBLE ❑ fr5,c CAP pj BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 5 FEET El 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK IA 4 INCHES 0 5 INCHES El INCHES _ 4.c.0 , AREA TO BE REPAIRED sq.ft. 4- in. sq.ft. 5 in. sq.ft. 6 in. • CODE F — PATCHES YES ❑ NO l NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full uares. First Inspection and Form Made By: IJ Date: Park Department Review Required ❑ YES [ ] NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: . CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . j t ,. i ) S+, - _ .► 3 —a1-307_007 Z4 PARCEL CODE CONTROL NUMBER CERT. NUMBER — • LEGEND L' AREA NEEDING REPAIR W,'777li7A L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) — ADDRESS. I I I ( —WATER SHUTOFF VISIBLE ❑\ . _ Sim BROKEN 0 MISSING 0 _ C.%._6 AN 01-I<) 5 �'` _ Properly line --i i - ---- - -T7,--ix19,1 i 0,, , , c),'N.,) \ lea L� 1�...-- f. Off -ATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET OTHER - f DEPTH OF SIDEWALK a4 INCHES 0 5 INCHES # 6 INCHES AREA TO BE REPAIRED �,g1F -q.ft. 4 in. q.ft. 5 in. ■q.ft. 6 in. — CODE F — PATCHES YES 0 NO 96 NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an - may bn repaired by patching. All other urea* shall be repaired by reconstruction of full squares. j / first Inspection and Form Mode Ely: �- '' Dale: ��" J/a Pork Department Review Required 0 YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: . IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. — CONTRACT COMPLETION DATE: , CODE G — Other. --- I 1 1 — 1 j " SIDEWALK REPAIR SURVEY FORM CITY QF WATERLOO, IOWA PROPERTY ADDRESS . Sal F I t t PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' '"1 AREA NEEDING REPAIR r7///Jf wMA L s length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C)ADDRESS. Cf a!i I WATER SHUTOFF max ❑ SAE BROKEN ❑ MISSING 0 .50,it Properj/.ine ff i LA/MOB OF SIDEWALK IX FRONT YARD 0 SIDE YARD 0 OTHER 5 it .1lslab OF SIDEWALK 0 4 FEET 0• 5 FEET 0 5.3 FEET OTHER_.._- - DEPTH OF SIDEWALK I4 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED `26.s q.tt. 4 in. eq.it. 5 in. 64.11 6 in. CODE F — PATCHES YES [] NO 04 NO. Of SQUARES WITH PATCHES NOTE. Arras marked with an - may bn repaired by patching. All other areas shall be reooired by reconstruction of full squares.First Inspection and Form Mode By:_ t_ � Date: 3-g(to l/ 0 Park Department Review Required 0 YES ANO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. _ CONTRACT COMPLETION DATE: CODE G — Other. _i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS /c' b/k ¢�} � - PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' • AREA.NEEDING REPAIR VW/7//77Tit L = length of repair needed Type of defect !� (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: f f Pig;AN I -7 l j Property Line Ki WATER SHUTOFF 1 VISIBLE ❑ �.G CAP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK N FRONT YARD ❑ SIDE YARD CJ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 5 FEET ❑ 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK k 4 INCHES ❑ 5 INCHES E] 6 INCHES AREA TO BE REPAIRED a 5 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO g NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an 'F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 4 v 1,/4 Date: Park Department Review Required ❑ YES ,-(1NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL'ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS /4.Z/ - 4/11 57- 52 / 3 z4 - Qpg PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - . AREA.NEEDING REPAIR G77/777777A L = length of repair needed Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: /(OZl" /ls Z5 _ `l kk) 61-14-116/4 Property Line 4,5 '741 WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ E 4 ST MISSING ❑ LOCATION OF SIDEWALK Elk FRONT YARD El SIDE YARD ❑ OTHER WIDTH OF.SIDEWALK ❑ 4 FEET El 5 FEET ❑ 5.3 FEET ® OTHER 5'Z. DEPTH OF SIDEWALK fig 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 'Z3I q.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: -re- L . Date: 3_Z 3 -/& Park Department Review Required ❑ YES 04 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 1O rLAJ ti ,� 17L -61-6= ©Q_ .3‘v, • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR r/// /A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >1(iADDRESS: Property Line WATER SHUTOFF VISIBLE ❑ HCAP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD E" IDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK D 4 INCHES ❑ 5 INCHES 12"-€: INCHES AREA TO BE REPAIRED .sq.ft. 4 in. Gq.ft. 5 ln �0 sq.ft. 6 in. CODE F — PATCHES YES ❑ NO []� NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: L �. Date: 3/&Ka-c)/° Park Department Review Required ❑ YES []-N0 PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . Ll C L Al t CN 5+� 3-9.1-' C?tQ—(D°4 3`7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom' E' AREA NEEDING REPAIR IIW/llll/'!A L — length of repair needed Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 1 C ' I I WATER SHUTOFF VISIBLE ❑ SSE BROKEN ❑ MISSING 0 Property Line C.,. 51{ Ivil)}JD LOCATION OF SIDEWALK V. FRONT YARD ❑ SIDE YARD ❑ OTHER jd OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET ❑ OTHER ItEenj OF SIDEWALK LJ` 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BC REPAIRED ` ` ■ytt. 4 in. ■q.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES [] NO ' NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an 'F" may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares,• _ 'First Inspection and Form Made By: -rE Li✓ .,._ Cafe; ^Y1O Pork Department Review Required 0 YES 1 NO PERMIT ISSUED NO, DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other• SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • PROPERTY ADDJESS 434 4Gi140AAo •Sr 13-a , _3° d°Y 4 / PARCEL CODE CONTROL N UMBER CERT, NUMBER LEGEND L' AREA.NEEDING REPAIR r/TIITI///lei L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) • • ADDRESS: Lo I MI '00 Property Line WATER SHUTOFF VISIBLE ❑ S9E BROKEN ❑ MISSINGtjtt ❑ LOCATION OF SIDEWALK jid FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH Or SIDEWALK ❑ 4 FEET .-14' 5 FEET ❑ 5.3 FEET ❑ OTHER _ DEPTH OF.SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED" d` aq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE •F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may .be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: Date: Park Department Review Required 0 YES g NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS i, 56 a-. iq L in 016i D S r / 1 3 ; _ _3.01 -OcOL ✓ 4-i, — PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1--i- L' --0-1 • AREA NEEDING REPAIR t/I////////�1 —k--`— "r L = length of repair needed . Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: (13` -T _\, f) \_,4 Property Line — WATER SHUTOFF VISIBLE 0 CAP , g BROKEN ❑ E MISSING ❑ LOCATION OF SIDEWALK `t'1 FRONT YARD ❑ SIDE YARD ❑ OTHER _ WIDTH OF.SIDEWALK El4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK 4 INCHES K 5 INCHES 0 6 INCHES — AREA TO BE REPAIRED 3 `�q.ft. 4 in. 0 sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO 0 NO. OF SQUARES WITH PATCHES — NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares.First Inspection and Form Made By: L--(' Date: .-3 ',T '-(O •Park Department Review Required 0 YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: . SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: . CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS .549 bile /etAik y S7: • ' • it3 - _ BLit ,/ 43 PARCEL CODE CONTROL.;NUMBER CERT. NUMBER LEGEND L' — AREA.NEEDING REPAIR V///777/W/A L . length of repair needed Type of defect _ (See reverse side for Defect Codes A—F) • (See below for Defect Code G) • ....›Kop ADDRESS: I Property Line j/ /r` WATER SHUTOFF VISIBLE ❑ tG . C } BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 1?:1(5` FEET •❑ 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK IA/ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 51 aq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NI NO. OF SQUARES WITH PATCHES -- NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full,squares. First Inspection and Form Made By: 1 Li" Date: 3 ` V -10 '— Park Department Review Required YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: — IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: - CODE G — Other • — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA - • — PROPERTY ADDRESS . C� j � 111� ti� al.i .- Ley- oc�s '� 4 ' PARCEL CODE ' CONTROL NUMBER CERT. NUMBER LEGEND 1.-. L` _04 — AREA.NEEDING REPAIR V wU,,/I/A • L = length of•repair needed (� Type of defect t`t — • (See reverse side for Defect Codes A—F) See below for Defect Code G) s ADDRESS: C�. ,, O� N c Property Line WATER SHUTOFF _ole VISIBLE ❑ — • — BROKEN ❑ , *1 D e .5�J MISSING ❑ — LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD • 0 OTHER _, WIDTH OF SIDEWALK El4 FEET 5 I-Le. FEET 1 0 5.3 • 0 OTHERDIM ._ OF SIDEWALK of 4 INCHES 0 5 INCHES //La ❑ 6 INCHES TO BE REPAIRED `I�'S sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES 0 NO pil N0. OF SQUARES WITH PATCHES • — NOTE: Areas marked with an "F' may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. • First Inspection and Form Made By: v 3 -:) —1° Date: •Park Department Review Required YES 0 NO -PERMIT ISSUED — NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G — Other SIDEWALK REPAIR SURVEY FORM _ CITY OF WATERLOO. IOWA • PROPERTY ADDRESS . 1 I 1 G f ke-vi �� Sc 1-3 -ail_i0 -©la 4- 0/9 PARCEL CODE CONTROL NUMBER CERT. NUMBER -- • LEGEND l' AREA NEEDING REPAIR rrz/zzz. .m — L � length of repair needed Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code C) — .4* ADDRESS. L H n _ WATER SHUTOFF VISIBLE ❑ — \ . BROKEN 0 MISSING 0 Property Line i tY6 ____ ow / -\--- • _ fk"\ce 1 — OF SIDEWALK I1 FRONT YARD ❑ SIDE YARD 0 OTHER cit latiti OF SIDEWALK CI4 FEET 0 5 FEET 0 5.3 FEET )0OTHER—--- izelli OF SIDEWALK V 4 INCHES 0 5 INCHES 0 6 INCHES If AREA TO BE REPAIRED t ■q.f1. 4 in. •q.11. 5 in. aq.f1. 6 in. CODE F - PATCHES YES 0 NO siti- NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. An other areas _ shall be repaired by reconstruction of full squares. _ 3 _ First impaction and Form Made By:_� lV 1 ' — Data: Pork Deportment Review Required 0 YES 0 NO i • i PERMIT ISSUED NO.__ DATE; INSPECTION DATE: L ESSMENT A IF UNCOMPLETED. CONTRA AS COMPLETIOCONTR CT NO• j _ CODE G - Other l i i _ • i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS ji ( ie , y PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -0-1 AREA NEEDING REPAIR V!!IZZAWA — I = length of repair needed 4 Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) )1(10,1 ADDRESS. Li( ( I I WATER SHUTOFF VISIBLE\ • SAE 0 BROKEN ❑ . MISSING ❑ tO-a A._ Property Line /7) S,t LOCATION OF SIDEWALK 1014.41, FRONT YARD ❑ SIDE YARD 0 OTHER _ OF SIDEWALK ❑ 4 FEET Cal 5 FEET 0 5.3 FEET 0 OTHER DEM OF SIDEWALK TO 4 INCHES ❑ 5 INCHES ❑ 6 INCHES 15 AREA TO BE REPAIRED `51—sq.tt. 4 in. ■q.ft. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES [] NO NCI. OF SQUARES WITH PATCHES— • NOTE. Areas marked with an -r may be repotted by patching. All other areas • shall be repaired by reconstruction of f II squares. First Inspection and Form Mods By: t Date: r Park Deportment Review Required YES ' ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. _ CONTRACT COMPLETION DATE: CODE G - Other t • . SIDEWALK REPAIR SURVEY FORM . . _ CITY OF WgTERLOO. IOWA PROPERTY ADDRESS . I I-1 A-A 1.\ 5_i-cill i3 -44__ 10a -O0k / .5Z PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND L' AREA NEEDING REPAIR vilililil/A — L - length of repair needed /�_ Type of defect /� (See reverie side for Defect Codes A—F) (Sea below for Defect Code C) — • ---)1(411*' ADDRESS. Li I t WATER SHUTOFF 1 VISIBLE ❑ — \` .CASE ❑ • MISSING ❑ �ee al — ri ropsrty line . . . ._..,. �tl4,l1j — arjalial OF SIDEWALK ta.FRONT YARD 0 SIDE YARD ❑ OTHER yam OF SIDEWALK ❑ 4 FEET p. 5 FEET 0 5.3 FEET 0 OTHER — MEDI OF SIDEWALK la 4 INCHES 0 5 INCHES 0 6 INCHES Of — AREA TO BE REPAIRED . -sq.1t. 4 in. ■q.ft. 5 In. 2q.tt. 6 in. . CODE F - PATCHES YES 0 NC) 151 NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an 'F" may bR repaired by patching. All other areas _ shall be repaired by reconstruction of -fullll squares. j G- �''` • Date: 3_-- ` "-It 0 First Inspection and Form Made Ely:_._ Park Department Review Required 0 YES 1 NO — PERMIT ISSUED NO. ,_,• DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL CONTRACT GOMPLETION CONTRACT NO ' -- CODE G - Other 1 I _ 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS . /co �,p yee, - ,577 ✓. 2)a -Z3 - 2Z8-03 ✓ 54 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-40— L' AREA NEEDING REPAIR VIZZ/Z,/ZIA L - length of repair needed Type of defect (Sea reverse side for Defect Codes A—F) See below for Defect Cods C) ADDRESS. I t k e ( WATER SHUTOFF Lg 1— max ❑ gee BROKEN 0 MISSING 0 Property Line /2G yL & -s 1QCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER WiQUI OF SIDEWALK CX 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER mEtu OF SIDEWALK Ok. 4 INCHES lip INCHES 0 6 INCHES AREA TO BE REPAIRED O f. 4 in. sq.ft. 5 in. •q.fl. 6 in. CODE F — PATCHES YES 0 NO CK NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. AN other areas shall be repaired by reconstruetio f full s uarss, First Inspection and Form Made 8y: J Date: _54 S"/ J o Park Department Review Required ❑ YES 010 PERMIT ISSUED NO, DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other. • SIDEWALK REPAIR SURVEY. FORM • CITY OF WATERLOO, IOWA PROPERTY ADDRESS. , toe ea< �6y L E �7' e/ a9...L3-z3-�813 -0,1 '/ 55 PARCEL CODE CONTROL NUMBER CERT. NUMBER _ LEGEND L. AREA NEEDING REPAIR LII//All//A _ L mg length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I I V A-C ' I WATER SHUTOFF \ • L } / VISIBLE ❑ , U`� gee BROKEN 0 MISSING 0 Property Line —. c2,e)q 0 AUC--- 12x LI ' x5 IAW Y LE S 11 OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER Mad OF SIDEWALK ! 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER — imem OF SIDEWALK g 4 mcmes 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 7z �1, 4 i ■q•ft. n. 4 'Q ` •q.it. 5 in. ■q.ft. 6 in. — CODE F — PATCHES YES ❑ NO X NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction full squo�r. z/Z���U First Inspection and Form Made By:,_ {t{J5 Date: J Pork Deportment Review Required ID YES [j�NO PERMR ISSUED NO. DATE: _ INSPECTION DATE: . IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. — CONTRACT COMPLETION DATE: CODE G — Other. -- I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 20 11-26Y' Jr, • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I.- L. --.I AREA NEEDING REPAIR Vt/i'fw7A L s length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) — ! ADDRESS. U 6' WATER SHUTOFF VISIBLE 0 BROKEN ❑ MISSING ❑ 76 Property Line Al2,6yeh LOCATION OF SIDEWALK c4 FRONT YARD 0 SIDE YARD ❑ OTHER Amu OF SIDEWALK 0 4 FEET T( 5 FEET 0 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ` 1q.ft. 4yin. sq.ft. 5 in. Mq.ft. 6 in. CODE F — PATCHES YES [] NO ,�J NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an r may bn repaired by patching. All other once shall be repaired by reconstruction of full squares. /Z / First Inspection and Form Made By:..; 5 Date: Pork Department Review Required ❑ YES [ O PERMIT ISSUED NO. DATE: INSPECTION DATE: — IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: • CODE G — Other ��— SIDEWALK REPAIR SURVEY FORM CITY QF WATERLOO. IOWA PROPERTY ADDRESS . 4Gb b/k ilie6ye. --- Sr. - _. $g13 _. H_ 03_003 .5, PARCEL CODE CONTROL NUMBER CERT. NUMBER _ ' LEGEND 1.*-- L' - AREA NEEDING REPAIR vii'itliiifA _ I. on length of repair needed Type of defect rT (See reverse side for Defect Codes A—F) (See below for Defect Cods C) - -+\ ADDRESS. I I AL l WATER SHUTOFF — V `f\Y / VISIBLE ❑ � v1 See BROKEN ❑ MISSING 0 PropF Line 5i°' _ jaczto OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER Tl OF SIDEWALK 0 4 FEET q'5 FEET 0 5.3 FEET 0 OTHER DEEM OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES 42,5,01 AREA TO BE REPAIRED •q.fl. 4 in. ■q.tt. 5 in. ■q.ft. 6 in. — CODE F — PATCHES YES 0 NO Q/ NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. All other areas shall be repaired by reconstruction of J1 squares. first Inspection and Form Made 9y:.._ 1" Date; a � �`� Pork Department Review Required ] YES ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: ' • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- — CONTRACT COMPLETION DATE: CODE G — Other i i { i _ i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 403 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA NEEDING REPAIR 1r71,17/t/ZIA L - length of repair needed A- Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Cods C) ADDRESS. II c* WATER SHUTOFF VISIBLE ❑ \ • BROKEN ❑ MISSING D • • w- ` Property Line A- -- LOCATION OF SIDEWALK §z FRONT YARD 0 SIDE YARD ❑ OTHER Of SIDEWALK ❑ 4 FEET 5 FEET 0 5.3 FEET 0 OTHER am OF SIDEWALK '4 INCHES llS',1 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ..t`5 q.tt. 4 in. _ y.it. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES [] NO 14 NO. OF SQUARES WITH PATCHES— • NOTE. Areas marked with an - may be repaired by patching. All other areas shall be repaired by reconstruction of-;f' squares. First Inspection and Form Mode By: �U �� Dais: 2 -c 5 I C Pork Department Review Required IK YES ❑NO PERMIT ISSUED NO, DATE:, INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: , CODE C - Other. 11; i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS `R , \ 3 _4E_.3 03 _0 et, az PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V7/7ZZ/ZZZA L s length of repair needed P- (SeeType of defect reverse side for Defect Codes A—F) (See below for Defect.Code G) ADDRESS. �<iS WATER SHUTOFF \ VISIBLE ❑ BROKEN ❑ MISSING 0 Property Line 111/11/1 JICATION OF SIDEWALK V.FRONT YARD 0 SIDE YARD 0 OTHER mQjd OF SIDEWALK ❑ 4 FEET [ 5 FEET ❑ 5.3 FEET 0 OTHER OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED J' 5' q-ft. 4 in. ■q.lt. 5 in. •q.ft. 6 in. CODE F — PATCHES YES [] NO NO. Of SOUARE5 WITH PATCHES NOTE. Areas marked with an ..F.. may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. -, First Inspection and Form Made By:,._,._L`2 — Date: Park Deportment Review Required ❑ YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0. — CONTRACT COMPLETION DATE: CODE G — Other i — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS / 3 ,612 A-fA o 3 7 57 89 /3 _ z3_ L5Z_ sot 1 `P4 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -� AREA.NEEDING REPAIR rl///TTIZ7ZA L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) >1<ae. ADDRESS: 916 I �J Property Line WATER SHUTOFF VISIBLE [] Pr CAP / BROKEN ❑ P,LUI'N f�Z S MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD *SIDE YARD ❑ OTHER WIDTH OF.SIDEWALK ❑ 4 FEET ❑ 5 FEET ,.`-t' 5.3 FEET ❑ 0Y HER _ DEPTH OF SIDEWALK IX 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO [Z NO. OF SQUARES WITH PATCHES_ NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction o f fttII squares. First inspection and Form Made By: l �- Date: J V/i 0 Park Department Review Required t; NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 4/39 V -T j\I D i3C iZ . . 8611.-z2_252 - 003f (,9 PARCEL CODE CONTROL NUMBER CERT. NUMBER _ LEGEND L' AREA NEEDING REPAIR v//I11/l//A L ow length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) — • ADDRESS. T / ' WATER SHUTOFF . VISIBLE \ • smte BROKEN 0 . _ MISSING 0 1q, 6. 14-c - _ Property Line i (/)4// / / \ (f.. ij L' , . BRA-v.7\(4'13E(Z 51— LOCAjiON OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER 2II OF SIDEWALK 0 4 FEET 0 5 FEET q 5.3 FEET ❑ OTHER DIMILI OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED �` sq►. 4 in. sq.it. 5 in. sq.fl. 6 in. • CODE F - PATCHES YES 0 NO NO. Of SQUARES WITH PATCHES NOTE. Areas marked with on -f- may be repaired by patching. All other areas • shall be repaired by reconstruction f full squares. / //�� first Inspection and Form Made By:_ z5 Date: .C/ Pork Department Review Required 0 YES p NO _ PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. - CONTRACT COMPLETION DATE: , CODE G - Other I I 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS JO O g I o cK B rd a.c4 w aY S 89 13—Z3-255— oo3 (aL PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR WlllllllA L - length of repair needed /� Type of defect A (See reverse side for Defect Codes A-F) (See below for Defect Code. C) ' ADDRESS. I ` WATER SHUTOFF Y OL.00.. L VISIBLE Q t .CAP BROKEN ❑ _. MISSING ❑ 12.02 E, O.I Property Line `t•I rao.. r1a., S , LOCATION OF SIDEWALK 54 FRONT YARD ❑ SIDE YARD ❑ OTHER -_� mu OF SIDEWALK fa 4 FEET ❑ 5 FEET ❑ 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 10 4 INCHES [.J 5 INCHES 0 6 INCHES AREA TO BE REPAIRED PM.$_sq.ft. 4 in. •q.ft, 5 in. sq.ft. 6 in. CODE F - PATCHES YES [] NO bL NO. OF SOUARE5 WITH PATCHES NOTE. Areas marked with an '"r may bet repaired by patching. All other areas shall be repaired by reconstruction of full squares. Li-21_f6 ,Q.s First Inspection and Form Made By:_ f3 P.1.43 Date: 3 Z g-10 Pork Department Review Required 0 YES tg NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4aq 62opkg vi q'c1 86113. - ?3 - Z0a- Q 01 70 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-0— L' --04 - AREA NEEDING REPAIR V///l/7777A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4:- ADDRESS: -r Z Li r IVOLW l ¢ 4 a 4" � 1 N _. Q /0'— -Property Line ,j,d �.'J I;I'11'%--1 I ( -t1 WATER SHUTOFF � VISIBLE ❑ / Ci 1 Ci \ / \ a Di CRP ____\, BROKEN ❑ MISSING ❑ F D vJr-�rZ0 S T LOCATION OF SIDEWALK ❑ FRONT YARD . SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET 0 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES [11 6 INCHES AREA TO BE REPAIRED .8 2 ' I q.ft. 4 in. sq,ft. 5 in. 1(' `5 sq,ft. 6 in. CODE F — PATCHES YES ❑ NO Y NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction f full squares.• l First Inspection and Form Made By: Date: 3/ L //0 Park Department Review Required ❑ YES XNO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: - C©DE G — Other SIDEWALK REPAIR SURVEY FORM Oily OF WATERLOO, IOWA PROPERTY ADDRESS 506 8 ra a d w a S f, _ 2.ai -23 _Z.6- oJ© 71 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t"— L' --� AREA.NEEDING REPAIR r///I////l/A L = length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4 ADDRESS: -S68 c Property Line WATER SHUTOFF VISIBLE El CAP BROKEN ❑ MISSING El road way/ SF. • LOCATION OF SIDEWALK ❑ FRONT YARD 14,SIDE YARD El OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET Ig 5.3 FEET ❑ CTHER— DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES ri 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in.2 ® sq,ft. 6 in. CODE F — PATCHES YES ❑ NO ® NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. I..30_/a , Sc First Inspection and Form Made By: ma AS. Date: -3-2L1 Park Department Review Required ❑ YES .2 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL'ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 60z ;S2,04,60,4}/ sr.- BT 13 Z 3= Jef- Pa/ 71- • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —"� ' • AREA.NEEDING REPAIR el1///7//7. 112 L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) M • (See below for Defect Code G) ui N ..,47>l< ADDRESS: (vUZ I * J sx5.4 Property Line . h WATER SHUTOFF i VISIBLE ❑ rij CAP BROKEN ❑ &ltky MISSING ❑ LOCATION OF SIDEWALK M FRONT YARD 14 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET IXL 5.3 FEET I4 OTHER _ DEPTH OF SIDEWALK Z.- 4 INCHES ❑ 5 INCHES k] 6 INCHES AREA TO BE REPAIRED 49 3 sq,ft. 4 in. sq.ft. 5 in. ZZ'O sq.ft. 6 in. CODE F — PATCHES YES ❑ NO E NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "E' may be repaired by patching. All other areas shall be repaired by reconstruction of fullAll squares. I�i First Inspection and Form Made By: E5. Date: 3/14110 Park Department Review Required ❑ YES IN NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS . (100 QIa cK) -N/E I _7 89/3 -23_z3/ -c°Z / " -7 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I Li AREA NEEDING REPAIR VIllllllll. L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) --StE ADDRESS. I f I I WATER SH • • \ VISIBLE ■ i�_E=-Ai-I �. 44.--kc- -- BROKEN H Z01. L OF LI " Property Line J 33 " 33 " / \ 1 • t 6//i ST-. jacAlal OF SIDEWALK fi4 FRONT YARD 0 SIDE YARD 0 OTHER wbTlj OF SIDEWALK L 1 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK (( 4 INCHES 0 5 INCHES 1,0 6 INCHES gyp^ cc4.g ✓ 4_ ✓ AREA TO BE REPAIRED `'"!' •q.tt. 4 in. ■q.it. 5 in. 2 •q.ft. 5 in. CODE F - PATCHES YES ❑ NO 0 NO. Of SQUARES WITH PATCHES • NOTE. Areas marked with an -F' may bn repaired by patching. All other urea* shaft be repaired by reconstruction of ui sew First Inspection and Form Made By: "� 5 Date, /z- // • Pork Department Review Required 0 YES ttl E4NO -""j PERMIT ISSUED NO. _ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. ..j CONTRACT COMPLETION DATE: i • i; CODE C - Other' ji 1 i� . 1 1 i- i I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS Z 5 - 89J3_ _23_ z3o_ vo8 77 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' — • AREA.NEEDING REPAIR ►/I//777777A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) l� (See below for Defect Code G) 4 3 _. ADDRESS:. v/AC , o J Property Line _ v WATER SHUTOFF DVISIBLE ElCAP BROKEN ❑ CCN1 �T MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ( SIDE YARD ❑ OTHER WIDTH{ OF SIDEWALK ❑ 4 FEET El 5 FEET ❑ 5.3 FEET VI OTHER 3'J DEPTH OF SIDEWALK 9( 4 INCHES ❑ 5 INCHES ❑ 6 INCHES i AREA TO BE REPAIRED -41C 2 sq.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO d' NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be rep fired by patching. All other areas shall be repaired by reconstruction o full square First Inspection and Form Made By: Date: 3/&'/iO — Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • _ CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS Zo7 C it .e 57. 6,1.5 _?3- z33- vot3 / 73 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' - . AREA.NEEDING REPAIR V77 77777- L = length of repair needed Type of defect A (See reverse side for Defect Codes A-F) (See below for Defect Code G) Xamp ADDRESS: Za 7 N Property Line Z 3 43 f4 11. WATER 'SHUTOFF f VISIBLE ❑ A'5 CRP LL /34c4.0 aF&JR BROKEN 0 One-4 � 5T MISSIN,S ❑ LOCATION OF SIDEWALK ❑ FRONT YARD rea SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 ,,FE��ET ❑ 5 FEET El 5.3 FEET (� OTHER 30 {{ DEPTH OF SIDEWALK I� 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 67 _.,sq,ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F - PATCHES YES ❑ NO ® NO. OF SQUARES WITH PATCHES NOTE: Areas marked with on "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: Mt? F5s Date: Z d Park Department Review Required ❑ YES rk NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPER-TY ADDRESS 215 C Arr6g $ e9 (3 -Z-3 -z33 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR P/Il/Ifl!/a L s length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 2 /5 1 WATER SHUTOFF VISIBLEroe C7 BROKEN 0 MISSING 0 /d Property Line LOCATION OF SIDEWALK L<FRONT YARD ❑ SIDE YARD ❑ OTHER Num OF SIDEWALK ❑ 4 FEET 0 5 FEET y(5.3 FEET 0 OTHER — DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 53 _sq.ft. 4 in. •q.ft. 5 in. nq.ft. 6 in. CODE F — PATCHES YES NO 0 NO. OF SOUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other areas shalt be repaired by reconstruction o f II squ / First Inspection and Form Made By: . Gate: I_l4//0 Park Deportment Review Required y. YES ❑NO PERMIT ISSUED NO. _.,_ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE G — Other. —__ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS , 1 J 9 C 7 ' Yr 89 / 3 _ z3 —cs2Z 6 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-0— E' AREA NEEDING REPAIR vritiiimA L - length of repair needed Type of defect (See reverie side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. ,5 1 R I I WATER SHUTOFF v,SIeLErgse ❑ BROKEN ❑ MISSING 0 Property Line / a L'eN7"7 j LOCATION OF SIDEWALK JRONT YARD ❑ SIDE YARD 0 OTHER jd OF SIDEWALK 0 4 FEET 0 5 FEET ❑ 5.3 FEET .+S OTHER DEPTH OF SIDEWALK 0 4 INCHES cX 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED sq.tl. 4 ; - sq.ft. 5 In. ■q.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES.._. NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares;6 1/0 first Inspection and Form Made By:___ Dale; // Pork Department Review Required [I YES 111��J _96O PERMIT ISSUED NO, DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. 4777 , 09 13_z-3_Zc,4-_c:Df PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND tom' L' AREA NEEDING REPAIR vW7.1IU7ZIA L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. ! /6 I 1 WATER SHUTOFF VISIBLE ❑ BROKEN 0 MISSING 0 Properly Line 3 A _ LOCATION OF SIDEWALK It FRONT YARD 0 SIDE YARD 0 OTHER (� mail OF SIDEWALK 0 4 FEET 0 5 FEET ❑ 5.3 FEET cif OTHER 5 ' DEPTH OF SIDEWALK EX 4 INCHES ❑ 5 INCHES 0 6 INCHES 6. AREA TO BE REPAIRED q•It. 4 in. •q.it. 5 In. •q.ft. 6 in. CODE F — PATCHES YES C] NO NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. All other areas shall be repaired by reconstruction I full aqua First Inspection and Form Made ay: th47// 6 Date: • Pork Deportment Review Required ❑ YES NO -. PERMIT ISSUED NO. DATE:, INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other• SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS / /O ('/-/557 / /r 57 • 8913 -Z _ Z37 - 02-7 erAer PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —01 AREA NEEDING REPAIR v/Z/ZIM/A L ,6 length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) I ADDRESS. / !1 I I I WATER SHUTOFF VISIBLE ❑ Lae BROKEN 0 . MISSING ❑ 6° Get (,) 1.4.5/15' T oS/?' e- Property line 4./ LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER itatb OF SIDEWALK 4 FEET ❑ 5 FEET ❑ 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 16' ,q-fl. 4 in. ,q.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES ❑ NO [ NO. OF SQUARES WITH PATCHES— NOTE. Arens marked with an - may be repaired by patching. Ali other urea+ shall be repaired by reconstruction of f it quores. //� first inspection and Form Mode Ely: 5 .-- Dole; 3/ // • Park Department Review Required ❑ YES VINO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other. • ( SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. �3 eh fn t- c1 - PARCEL CODE CONTROL NUMBER CERT. NUMBER - ' LEGEND LI AREA NEEDING REPAIR Ill!/IiiZZfA _. L - length of repair needed Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code C) - ADDRESS. -/ {..y't�tv�.� i, WATER SHUTOFF - VISIBLE 0 \ • L'U:It- ' LSE U��. ���L�" BROKEN ❑ MISSING 0 A_ A Property tin I ''1/1 1 r i, L7/I I tcii .55f�� v. ct V .i ,,,.., i 1 tt-) CAS OF SIDEWALK Yl. FRONT YARD 0 SIDE YARD ❑ OTHER OF SIDEWALK 0 4 FEET F45 5 FEET 0 5.3 FEET ❑ OTHER OF SIDEWALK 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED `]' eq.ft. 4 in. ■q.fl. 5 In- ■q.ft. 6 in. CODE F - PATCHES YES ❑ NO ILI NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F. may be repaired by patching, All other areas shall be repaired by reconstruction of full squares, �1 ( first Inspection and Form Made By: L .. Date: 3 - S-jf G Pork Department Review Required ,K YES 0 NO __ ` PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. - CONTRACT COMPLETION DATE: i CODE G - Other° i , I 1 I 'I- t SIDEWALK REPAIR SURVEY FORM CaY QF WAT'ERLOO, IOWA PROPERTY ADDRESS /09 l/k COY ,57- PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' —40-1 AREA.NEEDING REPAIR rl//77//777ll L = length of repair needed -� Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: Lo-r" — Property Line v WATER SHUTOFF p/ VISIBLE [] CAP BROKEN r_J MISSING ❑ LOCATION OF SIDEWALK t34FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET El 5 FEET K1, 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED y�•�q ft. 4, in.q• eq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES 0 NO PS., NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. MI other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: : u/ Date: _3 Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: _ CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS ZOO b//zl G'L y ST. • 5113 ail - oi-aa3, 62® PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR Wlllllll/A L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) e-1 --)1(4*. ADDRESS. I spc`•AA/r WATER SHUTOFF VISIBLE Leie BROKEN ❑ MISSING ❑ 2 Property Line • 1,1 J4CATIQB OF SIDEWALK 'FRONT YARD ❑ SIDE YARD 0 OTHER itiglij OF SIDEWALK 0 4 FEET 0 5 FEET tg, 5.3 FEET 0 OTHER DEPTH OF SIDEWALK •4 INCHES (] 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ,0 7' 4 in. eq.ft. 5 in. ■q.it. 6 in. CODE F — PATCHES YES C] NO tsi NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. All other areas shall be revoked by reconstruction of full squares. First Inspection and Form Made By: -rE _tom . _ Dale: Pork Department Review Required [] YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other' i • { i — SIDEWALK REPAIR SURVEY FORM CITY OF WVTERLOO. 1 OWA PROPERTY ADDRESS . :_D(p '-� �`' +, • �71.3 2. _3 03 _O d0 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1' AREA NEEDING REPAIR TrflffZIMA L — length of repair needed (A Type of defect `i (See reverse side for Defect Codes A—F) (See below for Defect Code C) 4)1Eocci/20,9 �1 WATER SHUTOFF \ VISIBLE al OK Lee BROKEN ❑ 1: MISSING ❑ P Property Line A C1N LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER Id OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 0 OTHER nem OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED _ q.tt. 4 ,a. •q.tt. 5 in. •q.ft. 6 in. CODE F — PATCHES YES ❑ NO y. NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. AU other areas shalt be repaired by reconstruction of tuft squares. First Inspection and Form Made By: Date; Pork Department Review Required 91 YES ❑NO PERMIT ISSUED NO., DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE C — Other i SIDEWALK REPAIR SURVEY FORM _ CITY QF WATERLOO, IOWA PROPERTY ADDRESS , .9,1 7 C-k 5f', - - ti PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND L' - AREA NEEDING REPAIR Illfwm.flA _ L - length of repair needed / Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) — ADDRESS. 3) 1 - WATER SHUTOFF VISIBLE 0 \ . SIC BROKEN 0 MISSING ❑ f t- 1 C/44C Prdp 4 Vnei —, 1 5,C' l I ' _ j ragN OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Aim OF SIDEWALK 0 4 FEET 0 5 FEET t-5.3 FEET 0 OTHER ,_ / DEPTH OF SIDEWALK 0 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED _ q.ft. 4 ;n. •q.ft. 5 in. ■q.ft. 6 in. — CODE F — PATCHES YES 0 NO of NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. All other urea* _ • shall be repaired by reconstruction of full uores. First Inspection and Form Made By:WL_L S Dale: • Pork Department Review Required 0 YES [ NO -- ! PERMIT ISSUED NO. ,— DATE: INSPECTION DATE: . i IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO ' CONTRACT COMPLETION DATE: i • • CODE G — Other° 1 I i i 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS � ,�L 3+ • _I 1__: i� �� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR I/ll/ill///A L — length of repair needed Type of defect ' 1 (See reverse side for Defect Codes A—F) (See below for Defect Code C) 441* ADDRESS. 1 V ! I I WATER SHUTOFF VISIBLE ❑ BROKEN ❑ MISSING 0 Properly'Line LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD ❑ OTHER Igo OF SIDEWALK 0 4 FEET 0 5 FEET . 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK IS 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ` I •q.ft. 4 in. •q.ft. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES [] NO NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with on "r may be repoirsd by patching. All other areas • shall be repaired by reconstruction of full squares. - First Inspection and Form Made By: v t�(� Dale: • Pork Deportment Review Required ❑ YES (Z NO PERMIT ISSUED NO. DATE:, INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C - Other. — 1 f • SIDEWALK REPAIR SURVEY FORM CiTY QF WATERLOO, IOWA - PROPERTY ADDRESS 9: C �/L. Sr /4- • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --•-1 • AREA.NEEDING REPAIR YII%17lZ 4 L = length of repair needed - Type of defect I S � (See reverse side for Defect Codes A-F) (See below for Defect Code G) f> ADDRESS: c a` q 1<fr, I _ \ N---,-„, J �- ' i 1:::::15 Property Line _ .� 1, ! 1 WATER SHUTOFF i (0 ic.C)(S.3 VISIBLE El/ \ / BROKEN 0 i w / MISSING ❑ - j rx LOCATION OF SIDEWALK .4; FRONT YARD 'SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET NI 5 FEET 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK ] 4 INCHES 5 INCHES ❑ 6 INCHES / T Sf r 0✓ AREA TO BE REPAIRED . Ib '' ,q.ft. 4 in. - '• sq.ft. 5 in. sq.ft. 6 in. • CODE F - PATCHES YES ❑ NO yi NO. OF SQUARES WITH PATCHES • NOTE: Areas marked with an "r may be repaired by patching. All other areas shall be repaired by reconstruction of fullpuorea. . First Inspection and Form Made By: i .-. (,-- Date: - --0 Park Deportment Review Required 0 YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3I� ( ✓ ci�.j 5+- - PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND k- L. AREA NEEDING REPAIR Uf/J7I2W A L - length of repair needed A Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code C) 41--* ADDRESS. 3 I Li WATER St-UTOFF \ VlS18LE ❑ BROKEN ❑ MISSING ❑ Prbpsrty Line (//// 5.5 0 • C* j LOCATION OF SIDEWALK P. FRONT YARD 0 SIDE YARD 0 OTHER _ d OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 0 OTHER DEEM OF SIDEWALK 0, 4 INCHES ❑ 5 INCHES 0 6 INCHES J AREA TO BE REPAIRED ■q•tl. 4 in. —■NA. 5 in. ■q.fl, 6 in. CODE F — PATCHES YES [] NO NO, OF SQUARES WITH PATCHES— NOTE. Areas marked with an "F" may bn repaired by patching. All tither ones shall be repaired by reconstruction of lull squares. First Inspection and Form Made By: 'It— L / Dale; -4'i -to Park Deportment Review Required (`tg YES ElNO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE G — Other' _ i j • I i SIDEWALK REPAIR SURVEY FORM CITY OF WATRLOO, IOWA PROPERTY ADDRESS , c91 7/3Q 5 C'fF ` c5Ts PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-w-- L' • AREA.NEEDING REPAIR P77/77/II7A L = length of repair needed — Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 3 Z! 2-5 Y�V • Property Line WATER SHUTOFF VISIBLE ❑ • BROKEN ❑ MISSING ❑ • LOCATION OF SIDEWALK $ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF-SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER _ DEPTH OF.SIDEWALK 3n. 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 Lig NO. OF SQUARES WITH PATCHES NOTE: Areas marked with art "F' may.be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Mode By: C� ' Date: �y , Park Department Review Required ❑ YES V NO ' I PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • • CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS �,'��� �� PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' —0"1 AREA.NEEDING REPAIR r/J/l//II//A L length of repair needed Type defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: i A _ Property Line // /, WATER SHUTOFF VISIBLE ❑ .0i 1 0i) ��W SAe r), BROKEN ❑ eY t MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD "C SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 5 FEET ❑ 5.3 FEET ❑ OTHER — DEPTH OF.SIDEWALK `T` 4 INCHES ❑ 5 INCHES ❑ 6 INCHES Q✓ • AREA TO BE 'REPAIRED JCp, sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO `-tti NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F' may.be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection'and Form Made By: lw Date: 3-± t -/O Park Deportment Review Required 1 YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: _ CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS ziero ,g(dam ci ,s et 9 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' _. AREA NEEDING REPAIR rriziww,A L - length of repair needed Type of defect A G (See reverse side for Defect Codes A—F) (See below for Defect Code G) 44*1 ADDRESS. Va.C.tLe! ' WATER SHUTOFF VISIBLE 0 Lee BROKEN ❑ elt .r MISSING 0 14'6' 05.I‘ t D.O' Property Line A,,,*cAt\ s7,N4 LOCATION OF SIDEWALK 121 FRONT YARD 0 SIDE YARD ❑ OTHER lam OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK Da 4 INCHES 0 5 INCHES ❑ 6 INCHES • AREA TO BE REPAIRED i°4•L q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in.CODE F — PATCHES YES [] NO ►4 NC). OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. q-z2_/Q kg First Inspection and Form Made By:_ T F L C. Date: 3- -tO Park Department Review Required 04 YES ❑ NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other- _ _�_ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . eico bJk vm55- S7- 8, /3__Z3__ Z68 -v12, ✓ 43z PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR VZliMILIA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) \)✓ (See below for Defect Code C) w tJFYG ' ADDRESS. LC T WATER SHUTOFF VISIBLE ❑ BROKEN 0 MISSING 0 L_ I _ / Property Line / / ( 411 1A1A-LL (xi w �� Sfi OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER .1Q1k OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET i OTHER " DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 'r' g.t. 4 in. ■q.it. 5 In. ■q.1t. 6 in. • CODE F — PATCHES YES [,] NO 0 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By:1 \� .__ Date; 1/�9/�0 Pork Department Review Required ic, YES ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0' CONTRACT COMPLETION DATE: CODE G — Other' • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS z9 taw) 31L :. -Z3, - Z - (Lei /er:23 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —4x-1 • AREA.NEEDING REPAIR VI/%T//T//il L = length of repair needed Type of defect (`1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) >< ADDRESS: O \\, - Property Line WATER SHUTOFF VISIBLE ❑ -)! CAP BROKEN ❑ ��0 S MISSING ❑ LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET5.3 FEET ❑ OTHER DEPTH OF SIDEWALK C 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 153 5 sq.ft. 4 in. sq.ft. 5 in. Sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with on "F" may be repaired by patching. All other areas shall be repaired by reconstruction of ful squares. �/) First Inspection and Form Made By: Date: 5/Z5//v Park Department Review Required YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS `7 q 7 COL.' Uhl,.8..T-P&< 5.17 'f 8 ? -23_Zo8_G i ✓ d�� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR vl rtwi ei L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (Sea below for Defect Code C) I ADDRESS. I7` I I WATER SHUTOFF VISIBLE ❑ BROKEN ❑ { {HISSING ❑ 1 — Pitipe.t, tint l 44f).o` C'O LvivlF3Tq- j j°CATION OF SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER OF SIDEWALK ® 4 FEET ❑ 5 FEET 0 5.3 FEET I OTHER S" DEPTH OF SIDEWALK Lx' 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Z_ `�.ft. 4 in. eq.ft. 5 In. ■q.ft. 6 in. CODE F — PATCHES YES [] NO NO. Of SQUARES WITH PATCHES NOTE. Areas marked with on 'f.. may be repaired by patching. All other areas • shall be repaired by reconstruction of till squares. r4 First Inspection and Form Made By: Dale; 3/Z'3 /2 J` Pork Department Review Required YES ❑NO PERMIT ISSUED NO._ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other. ji 1 SIDEWALK REPAIR SURVEY FORM C[TY OF WATERLOO, IOWA PROPERTY ADDRESS 603 eowM e 13 z3_ 07 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —� AREA.NEEDING REPAIR V/Il/7777/A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4‹ ADDRESS: 503 N 3 WATER SHUTOFF VISIBLE ❑ A G � CAP BROKEN ❑ W pt�c 5T• MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET OTHER _ 5, 5 DEPTH OF SIDEWALK " 'l 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED - SG sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of f I squares. ' First Inspection and Form Made By: ' Date: 3 )z4 /D Park Department Review Required YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other CO IV C1 r Ots./ • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS (neV h/.I<71r1L CJ/Y7 PT4 .:ST 13._z 3_ 22.?-003 /Oel PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND L' AREA NEEDING REPAIR . . 1/711/Z fi7A L = length of repair needed Type of defect Z (See reverse side for Defect Codes A—F) 6 2 (See below for Defect Code C) 46--)1E ADDRESS. I WATER SHUTOFF VISIBLE ❑ . BROKEN 0 MISSING 0 Property tine 7.5 A Q • C a G t.)n4 _51, ISIGEKIII OF SIDEWALK 94 FRONT YARD ❑ SIDE YARD __ RI 0 OTHER . jd OF SIDEWALK 0 4 FEET 0 5 FEET i� 5.3 FEET 0 OTHER DEEM OF SIDEWALK 4 INCHES ❑ 5 INCHES ` ❑ 6 INCHES AREA TO BE REPAIRED •l_.sq.tl. 4 in. ■q.ft. 5 in. sq.tt. 6 in. CODE F — PATCHES YES ❑ NO [ NO. OF SQUARES WITH PATCHES,r NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction f full ■ u s. First Inspection and Form Made By:_ j q ._ Dale: 3/2 5—j Jd Park Department Review Required YES ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- - CONTRACT COMPLETION DATE: CODE G — Other: I _ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS Co 5 Cod 6cI- 2 jr PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - �i AREA.NEEDING REPAIR V/'277//7/A —\\NN = length of�repair needed \ Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) l< U1 . ADDRESS: h S T3LpG. i 0 Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ C,cn/6 2 S� F-1 MISSING El 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 (k6 INCHES a AREA TO BE REPAIRED . sq.ft. 4 in. sq.ft. 5 in. 7i-7" sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F' may be repaired by patching. All other areas shall be repaired by reconstruction of f II squares. First Inspection and Form Made By: • Date: 3) 51 1 0 — Park Department Review Required ❑ YES PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: ' CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS lac, brk [— 0A 6-i 5( PARCEL CODE CONTROL CERT. NUMBER LEGEND L' AREA NEEDING REPAIR I1!l1771Mt1 L. iv length of repair needed Type of defect (See reverie side for Defect Codes A—F) l Z 5 (See below for Defect Code C) //9 ADDRESS. WATER SHUTOFF VISIBLE ❑ . \ • 20 Pb rise BROKEN ❑ MISSING ❑ I .`1 Property line // i C i \----- ' (v L4 ' 5f ON OF SIDEWALK (FRONT YARD ElSIDE YARD ❑ OTHER MO OF SIDEWALK LYJ 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER TH DEP OF SIDEWALK //,� 0 1 INCHES 67 5 INCHES 0 6 INCHES AREA TO BE REPAIREDq.tt. 4, n. 1`�•q.lt. 5 in. •q.ft. 6 in. CODE F — PATCHES YES 0 NO L4 NO, Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other urea* shall be repaired by reconstruction II squ first Inspection and Form Made By: Date: �l zU/1/0 Pork Department Review Required 0 YES [ 'NO --j! INSPECTION DATE: • i PERMIT ISSUED NO. ._ DATE: JIF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0* , CONTRACT COMPLETION DATE: CODE G — Other Ii -� it I i l SIDEWALK REPAIR SURVEY FORM CITY QF WATERLOO. IOWA PROPERTY ADDRESS . Z, 2 8[ _ _Cod6g \ STI 4��3.-2-j- U-Dv} ✓ //` PARCEL CODE CONTROL NUMBER CERT. NUMBER — ' LEGEND I-m— L' AREA NEEDING REPAIR vi717i11:1iA L length of repair needed Type of defect (� (See reverse side for Defect Codes A—F) 62(See below for Defect Cods C) f /5 1.— //.2 �j� ADDRESS. I t / I (J t c . WATER SHUTOFF \ • (...-437— VISIBLE 0 BROKEN 0 . MISSING 0 • y U S h *warty Unn { 5 o ' C11.0 ,1 (A)4 L.- • j,QLA/1O,N OF SIDEWALK fl FRONT YARD 0 SIDE YARD 0 OTHER 202111 OF SIDEWALK ❑ 4 FEET 0 5 FEET / ` 5.3 FEET 0 OTHER — DIEM OF SIDEWALK L 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED '2.5 �q.ft. 4 in. •q.It. 5 in. ■q.fl. 6 in. CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with on -r may bn repoi d by patching. All other areas • shall be repaired by reconstruction f uli sou s.First Inspection and Form Mode By: ?S Dote; -J /L' PO Park Department Review Required % YES 0 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: , CODE G — Other. i I I j : i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 2 . .0 4l G /' S%/ 8. 13- z3= Z29- oc)S Z PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' -04 vt AREA.NEEDING REPAIR V//Z/7//7/A L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) N - (See below for Defect Code G) l< ADDRESS: 3 2- :a:-' I o � 0 Q" T _ Property Line _ ^ " WATER SHUTOFF VISIBLE ❑ Di CAP BROKEN ❑ CcN 6 E MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD [( SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET [ , 5.3 FEET ❑ 0-HER_ DEPTH OF SIDEWALK P. 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED q.ft. 4 in. 'q.ft. 5 in. sq,ft. 6 in. CODE F - PATCHES YES ❑ NOtY\i/ NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may .be repaired by patching. All other areas shall be repaired by reconstruction of ful squares. 2 First Inspection and Form Made By: Date: 3/zc1 w - Park Department Review Required ` 4 YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM . CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 7/3 (9 A/ &-i2 .ST - — aD 13 -Z -004 - c�� /13 PARCEL CODE CONTROL NUMBER CERT. NUMBER — ' LEGEND 1-0— L' '"1 AREA NEEDING REPAIR uzwzzif A — L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) — ADDRESS. - ` 3 I I WATER SHUTOFF — VISIBLE O \ ' ME BROKEN ❑ MISSING 0 7•/ .__. Property tine i /A--( _ _____.. . TION OF SIDEWALK I 'FRONT YARD 0 SIDE YARD 0 OTHER fQI OF SIDEWALK ���,\\\\ 4 FEET Cl 5 FEET 0 5.3 FEET CIOTHER _ DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED a` ■q.fl. 4 in. q.ft. 5 in. ■q.tl. 5 in. CODE F — PATCHES YES 0 NO ti NO. Of SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. Ali other areas shall be repaired by reconstruction t ail squares. /�z //1/ First Inspection and Form Made By: , Date:/��j! 6 Pork Deportment Review Required 0 YES ( NO — PERMIT ISSUED NO, DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: , CODE G — Other. I 1 i i _. I I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • PROPERTY ADDRESS . 1/7 eaA(G / • eD 13 -z3-ac4_ace //4 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR mUtiflflf t L length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. 'e/2 WATER SHUTOFF \ vISIBLE ❑ \\ SAE BROKEN 0 MISSING 0 8 Property Line • roA16E2 �'T• UM OF SIDEWALK d FRONT YARD ❑ SIDE YARD 0 OTHER lagld OF SIDEWALK PC 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER Dom OF SIDEWALK tQ 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 3 Z' ■qfl 4 in. ■q.ft. 5 in. ■q.f1. 6 in. CODE F — PATCHES YES D NO NO. OF SQUARES WITH PATCHES NOTE. Argos marked with an -r may be repo lid by patching. All other areas shall be repaired by reconstruction f ull ■ ■. 3 !!ll First Inspection and Form Made By:� 5 ._ Date: ri/ 72X lV Pork Department Review Required 0 YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other' .._ i 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA - PROPERTY ADDRESS 309 •C RE 5 CEA(7- PC. PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I.-- L' —•"I AREA.NEEDING REPAIR V7//77///7Ai L = length of repair needed Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code G) _ 1<ip ADDRESS: (3(9 / I _ I v �• Property Line WATER SHUTOFF 1 VISIBLE ❑ CRP L " BROKEN 0 , L fC�LA/ , ,, ` MISSING El I LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD ❑ OTHER i WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET ElOTHER _ \' I DEPTH OF SIDEWALK yl 4 INCHES 0 5 INCHES ❑ 6 INCHES /, i AREA TO BE REPAIRED '7�, 1 gq.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO X NO. OF SQUARES WITH PATCHES 6. NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of f II squares. First Inspection and Form Made By: I ,5 Date: V.ZS7/(/ Park Department Review Required (X YES 0 NO PERMIT ISSUED NO: DATE:T INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: - CODE G — Other _.. i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. JOWA PROPERTY ADDRESS 32.7 ��p{—.)C&A/7— p . 8 3 i 3 -23—z Z— o /40, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR vmzzAwA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. ✓2'7 WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING 0 Property Line $ CRC5( /T LOCATION OF SIDEWALK g FRONT YARD ❑ SIDE YARD 0 OTHER Nlimi OF SIDEWALK 0 4 FEET 0 5 FEETc:45.3 FEET 0 OTHER — DFPTH OF SIDEWALK I1`I 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED /sq.ft. 4 ;n. •q.ft, 5 in. eq.ft. 6 in. CODE F — PATCHES YES 0 NO [)4NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on "F" may be repaired by patching. All other arson shall be repaired by reconstruction f full squ s. First Inspection and Form Mode By: Dale: 3/0 5'Y/0 Pork Department Review Required ❑ YES X1 NO PERMIT ISSUED NO._ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other: —__ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 2c) j VAtI Sl /3 - - t52- cx__) /17 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —04 • AREA.NEEDING REPAIR t7///T/I///i L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 2 a3 ( — A Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ I-060/ E , MISSING ❑ LOCATION OF SIDEWALK ( FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET El5 FEET El5.3 FEET 7g� OTHER - -S• Z DEPTH OF SIDEWALK 4 INCHES El 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ZE'' S q,ft. 4 in. sq,ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO clf NO. OF SQUARES WITH PATCHES . NOTE: Areas marked with an "F may be repaired by patching. All other areas shall be repaired by reconstruction o f II squares.First Inspection and Form Made By: Date: J 7 Z,/0 Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: 0 CODE G — Other • SIDEWALK REPAIR SURVEY FORM . CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 64C.Z, L:7/, 1�i4-,iJ i/. • ql 1 1 _1. --.ass_O c� / /7-0 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR BriZZ/ZIZI/.t L - length of repair needed j� Type of defect f' pc-6 ` See reverse side for Defect Codes A—F) Y �c s (See below for Defect Code C) ( ECIGP *-- ADDRESS. VA-f.AN jr WATER S►tUTOFF \ . ,i,ct. i. Lae /J 4� C1 BROKEN MISSING ❑ Property tine _ A kl JjaCEMI OF SIDEWALK al FRONT YARD 0 SIDE YARD 0 OTHER imi OF SIDEWALK 0 4 FEET `A 5 FEET 0 Si FEET 0 OTHER OF SIDEWALK 1217 4 INCHES 0 5 INCHES ❑ 6 INCHES J ✓ AREA TO BE REPAIRED 6`o •q.ft. 4 in. —sail 5 in. sq.fl. 6 in. • CODE F — PATCHES YES 0 NO N NO. Of SQUARES WITH PATCHES ._ J NOTE. Areas marked with an -r may bn repaired by patching. All other areas shalt be repaired by reconstruction of full squares. . k-6 3 a-> — to first Inspection and Form Made By: f Date: _J Pork Deportment Review Required 0 YES j*NO i PERMIT ISSUED NO. DATE: INSPECTION DATE: • J. IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: ii i CODE C — Other ! . ..: . II I_ t-I. I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS S Z / 1:),4/u r. s 7` • '1 13- -1-ls -0° ✓ /zj PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I-0- L' AREA NEEDING REPAIR VW7f. WA L S length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) _ -4(--- ADDRESS. G Z / 1P` WATER SHUTOFF � S VISIBLE 0 0 5a/ p BROKEN 0 A U MISSING ❑ Li" I _ ! I Property Line A . /jt J`i V/ 1/4/ / t5.5. 'LL , \ ' D�.Ilz LOCATION OF SIDEWALK tzl FRONT YARD 0 SIDE YARD 0 OTHER NUM OF SIDEWALK 0 4 FEET `I 5 FEET 0 5.3 FEET 0 OTHER REEM OF SIDEWALK 12 4 INCHES 0 5 INCHES gl, 6 INCHES °✓ t2f . AREA TO BE REPAIRED __�' •q.ft. 4 in. •q.ft. 5 In. __a q.f I 6 in. — CODE F - PATCHES YES 0 NO El NO. Of SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. All other areas • shall be repaired by reconstruction of full squares. First Inspection and Form Mode By:_— IT- L.,c Dale: S to • Park Deportment Review Required 0 YES 0 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO CONTRACT COMPLETION DATE: CODE G - Other. i I 1 i i i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS j i g £D W /2 D aq -?3 `Z.3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND F'*' EI AREA NEEDING REPAIR ViiWii1WA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. WATER SHUTOFF \ v1SI8l£ ❑ SAE BROKEN ❑ MISSING 0 5.5 Property Line Ef.)07Ari,125 LOCATION OF SIDEWALK L FRONT YARD 0 SIDE YARD 0 OTHER g OF SIDEWALK ❑ 4 FEET 0 5 FEET g 5.3 FEET 0 OTHER — DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES r4 6 INCHES ( AREA TO BE REPAIRED fI _sq.ft. 4 in. ■q.ft. 5 in. . ' Lsq.it. 6 in. CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES— NOTE. Areas marked with an -r may be repaired by patching. AR other areas shall be repaired by reconstruction I full ■qu ��Gl?� O First Inspection and Form Made By: Dais: o Park Department Review Required ❑ YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: • • CODE G — Other • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS Zc.),C, E.1) ,4,ip5 6'5' _23 . 233 oaj Iz- PARCEL CODE CONTROL NUMBER PERT. NUMBER LEGEND 1-•1-- L' -*4 - AREA.NEEDING REPAIR tl/////////A L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) Lf; \�' l< , ADDRESS: i \,. � v �c0(-�Jq- Cu-5—u" '+ - Property Line h �\Q . r WATER SHUTOFF VISIBLE ❑ Di CAP BROKEN ❑ ED tVirt 12DS �� MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD (c4 SIDE YARD ❑ OTHER rC7 WIDTH OF SIDEWALK ❑ 4 FEET 5 FEET • 5.3 FEET L�1 OTHER � - El DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES ' AREA TO BE REPAIRED r!' v sq.ft. 4 in, sq.ft. 5 in. sq,ft. 6 in. CODE F - PATCHES YES 0 NO q NO. OF SQUARES WITH PATCHES --NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction �ful( squares. ���/ First Inspection and Form Made By: .. S Date: /O - Park Department Review Required ❑ YES y NO PERMIT ISSUED NO: DATE: INSPECTION DATE: --- IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: . CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO; IOWA PROPERTY ADDRESS 316 6D v A $ j = 89 13_23_Z3Z -© /2e7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I' -.4 AREA NEEDING REPAIR wiz _fl��A L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods G) 41E- ADDRESS. WATER SHUTOFF ras VISIBLE BROKEN ❑ 8 MISSING ❑ — _ Property Line EDw�Q.Ps LOCATION OF SIDEWALK (1 FRONT YARD ❑ SIDE YARD ❑ OTHER . jQf OF SIDEWALK ❑ 4 FEET 0 5 FEET di 5.3 FEET 0 OTHER DEEM OF SIDEWALK 0 4 INCHES gi 5 INCHES 0 6 INCHES AREA TO BE REPAIRED LS ` q.ft. 4 ;n. •q.tt. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES ❑ N'AO No. Of SQUARES WITH PATCHES NOTE. Areas marked with on 'f may be repaired by patching. All other areas shall be repaired by reconstruction of NI squares, first Inspection and Form Mode By: Data: /Z3-/ Park Department Review Required ❑ YES [ONO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G - Other. .._, I'I j SIDEWALK REPAIR SURVEY FORM _ CITY OF WATERLOO. IOWA PROPERTY ADDRESS V/6 ED I/JA f -57" 89 L _z3_20b—Ei 3 /3/ PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I-0-- L' AREA NEEDING REPAIR erWIlUli,,'t- — L No length of repair needed Type al defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) —)tE" ADDRESS. "1/6 WATER SHUTOFF VIS` IBLE D \ ' BROKEN 0 MISSING 0 Property line _ C9 . — E.0 VO 0S jarahaf OF SIDEWALK lZ FRONT YARD 0 SIDE YARD 0 OTHER mans OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET Id! OTHER 5-2 DEPTH OF SIDEWALK ( 4 INCHES 0 5 INCHES 0 6 INCHES _ AREA TO BE REPAIRED 2- sq.tt. 4 i •q.1t. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other areas .— shalt be repaired by reconstruction o II squ /Z� /! First Inspection and Form Made By; - Date; Pork Department Review Required [ YES 0 NO PERMIT ISSUED NO. DATE:. INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' — CONTRACT COMPLETION DATE: CODE G — Other' 1 I 1 I I i i • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • PROPERTY ADDRESS , (C o 81 K,). Fro r,K I n c f. _ 13 _23--lino,_Q06.. !3 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I-+-- L' -*-1 AREA NEEDING REPAIR UW/IIzZ'/A L. m length of repair needed Type of defect I) (See reverse side for Defect Codes A-F') (See below for Defect Cod. C) --)K. ADDRESS. 60"Gil I �L�� V 1- I WATER SHUTOFF Frtaealg' iOe VISteLE ❑ \ . L-o+ Sae BROKEN 0 MISSING ❑ f Property tine it(Qr.K1l rD St. =Mai OF SIDEWALK Gd FRONT YARD 0 SIDE YARD 0 OTHER majli OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET fa OTHER 5-11 � OF' SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2c1•� •q.fi. 4 in. •q.fi. 5 In. ■q.ft. 6 in. _ CODE F - PATCHES YES 0 NO 0 NO. Of SQUARES WITH PATCHES • NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. S-7_10 ks first Inspection and Form Made By: Rs D& Dale; 3-0q-10 Pork Department Review Required 0 YES EZNO PERMIT ISSUED NO. DATE: INSPECTION DATE: If UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: , CODE G - Other. I I' • i >I; f I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA _ PROPERTY ADDRESS 6.0 ( y rra,„ I j a _st , ✓ la l L - yzi Q®2 135 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' 1f, k _. AREA.NEEDING REPAIR VI/7-7///7A tft- L = length of repair needed Type of defect — (See reverse side for Defect Codes A—F) (See below for Defect Code G) N -I- >l<4% ADDRESS: ...,0 -ed-I ®I T N i C 'c s I`. i 120 6 rip Property Line WATER SHUTOFF i VISIBLE ❑ 11 0 CAP BROKEN El MISSING fih p ve. LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET 15.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK ,! 4 INCHES cgt 5 INCHES ❑ 6 INCHES AREA TO BE 'REPAIRED �07 6 sq.ft. 4 in. JOO.7 sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO 0 NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. • First Inspection and Form Made By: R. 4 . S Date: ? - 7'4 -/ Park Department Review Required YES - 'PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL'ASSESSMENT CONTRACT NO: . CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 67 890 _z3_423 _oz� /3� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I- L' AREA NEEDING REPAIR v1WI11iwzA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. 7 WATER SHUTOFF nstcL.E ❑ Vie BROKEN ❑ . MISSING 0 �1. l 12 Property Line i r lgaq I /L <I-;'I C 5 �} ,�2�1n11Lt�f T- t OCATION OF SIDEWALK .FRONT YARD ❑ SIDE YARD 0 OTHER OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET ❑ift-PT8 OF SIDEWALK INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 550 eq.ft. 4 in. ■q.ft. 5 in. •q.ft. B in. CODE F — PATCHES YES [] NO [ NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. All other urea* shall be repaired by reconstruction of full squares. First Inspection and Form Made By:. _! "Lj __ Date; /25//D Pork Department Review Required ❑ YES ONO POUR ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other r r ., SIDEWALK REPAIR SURVEY FORM __ CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 307 - ,1,14 r v\ 3 -r - ` !_3-_�-3i1-QI0v /45 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND 1-e— (. AREA NEEDING REPAIR I!Z/IZZArIZA - L - length of repair needed Type of defect t� (See reverse side for Defect Codes A-F) (See below for Defect Code G) - -4E- /7 0 / ADDRESS. `1 WATER SHUTOFF VISIBLE ❑ • \ — S� BROKEN 0 MISSING 0 C, A Property Line _ — / ‘,0 \ .(. c , , TION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Nam OF SIDEWALK 0 4 FEET 0 5 FEET 17(5.3 FEET 0 OTHER _. DEPTH OF SIDEWALK El 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED _-:_■q.ft. 4 ;n. ��. •q.ft. 5 in. •q.fi. 6 in. CODE F - PATCHES YES ❑ NO 04 NO. OF SQUARES WITH PATCHES 1 NOTE. Areas marked with an - may bn repaired by patching. All other areas r shall be reooirsd by reconstruction of fulls ores. First Inspection and Form Mode By.___ t`� �� .._ Date; �� _ f Park Department Review Required 0 YES I NO i PERMIT ISSUED NO.i DATE:, INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0• _ CONTRACT COMPLETION DATE: • CODE G - Other• l i I _ • SIDEWALK REPAIR SURVEY FORM CITY OF WATRLOO, IOWA PROPERTY ADDRESS T-:-/-3 I 3315 s--1 11 - c)03 /4147 PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' • AREA NEEDING REPAIR T/777//77i1 L = length of repair needed C/ Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) • ADDRESS: 313/3 '15-3 ZN °T. -r 1,1) Property Line /42 WATER SHL TOFF VISIBLE ID F-3 BROKEN CD MISSING 0 LOCATION OF SIDEWALK Ei FRONT YARD tA SIDE YARD D OTHER WIDTH OF SIDEWALK D 4 FEET 0 5 FEET 5.3 FEET OTHE Qteni OF SIDEWALK 4 INCHES El 5 INCHES 0 6 INCHES .5(c.k I AREA TO BE REPAIRED sq.ft. 4 In. q.ft. 5 in. cqft. 6 in. CODE F — PATCHES YES El NO 12A NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F.' may be repaired by patching. All other areas shall be repaired by reconstruction of full sgu.pres. First Inspection and Form Made By: Date: Park Department Review RequIred 0 YES 10 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: • SPECIAL ASSESSMENT CONTRACT NO: • CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS VO Pi< i_T-SQ I5 i /3 23- 2je_ 001 ./ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L° • AREA.NEEDING REPAIR r////777/77if L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) l< ADDRESS: O t lt t/A G o '� 1-01 1I V Property Line ie JA WATER SHUTOFF VISIBLE ❑ �S CAP p BROKEN ❑ /iAapx..5cil 57 MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD EX SIDE YARD ❑ OTHER WIDTH OF.SIDEWALK t�Ct 4 FEET ❑ 5 FEET ❑ 5.3 FEET 0 OTHER DEPTH OF SIDEWALK \ (� 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED .Sq sq.ft. 4 in. cq.ft. 5 in. gq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. l /, First Inspection and Form Made By: 3 5 Date: 3 2.5 f � C) Park Department Review Required ❑ YES [ NO PERMIT ISSUED NO: DATE: INSPECTION DATE:IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS /5 l 42 i50N ST PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR WW1:If/17A L mg length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. /5V WATER SHUTOFF . VISIBLEEl LAE BROKEN 0 MISSING 0 4 ' Property I o — p y Line A it--/a�Rs OAt sz= .00ATION OF SIDEWALK jI FRONT YARD n SIDE YARD 0 OTHER IctQl8 OF SIDEWALK 0 4 FEET ❑ 5 FEET . \ 5.3 FEET 0 OTHER TH DEP OF SIDEWALK L!f 4 INCHES 0 5 INCHES///���\ 0 6 INCHES AREA TO 8E REPAIRED Z1` _s q.ft. 4 in. ■q.it. 5 in. ■q,ft. 6 in. CODE F — PATCHES YES ❑ NO NU. OF SQUARES WITH PATCHES NOTE. Arens marked with an "F" moy be repaired by patching. All other areas •— shall be repaired by reconstruction of full aq s, J First Inspection and Form Made By:_ �,— Daie:3/Z.L.• Pork Department Review Required { YES 0 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other. . SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA ZiS PROPERTY ADDRESS gAte 5e7A1 51 • — e2D _Z4-- /ST- —.a c 1 154f PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND U AREA NEEDING REPAIR P/l/ZZI A L .s length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect. Code C) 205 -4(-- ADDRESS. 2 1_5- ( WATER SHUTOFF\ - t J VISIBI E ❑ .CASE -1 - BROKEN 0 MISSING 0 9,2 ' Property Line - ( i ; / c; \ - LOCATION OF SIDEWALK Y" FRONT YARD ❑ SIDE YARD 0 OTHER MIMI OF SIDEWALK 0 4 FEET 0 5 FEET 05•3 FEET 0 OTHER -.,-...r.. DEPTH OF SIDEWALK 0 4 INCHES [ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED __scot. 4 in. sq.ft, 5 in. *q.ft. 6 in. CODE F - PATCHES YES 0 NO [ NO. OF SQUARES WITH PATCHES— NOTE. Areas marked with an -F,. may be repaired by patching. All other areas shall be repaired by reconstruction f full squares. ��� /� First Inspection and Form Made By:....__ _ Date: - Pork Department Review Required ❑ YES PERMIT ISSUED NO. ., DATE: INSPECTION DATE: -,-- IF UNCOMPLETED. SPECtAL CONTRACT COMPLETION DATE: NO , CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS • y7 ( 3 .9-'1_ 163_ ,,i a /57 PARCEL CODE CONTROL NUMBER CERT, NUMBER - LEGEND 1-0-- L' "�'1 AREA.NEEDING REPAIR V7777777.//i1 L = length of repair needed Type of defect B (See reverse side for Defect Codes A-F) (See below for Defect Code G) >i<R, ADDRESS: 7 I I N )<, S 11 Property Line r//1/1/! I. WATER SHUTOFF VISIBLE [l ji $ see BROKEN ❑ -nu:cti MISSING El LOCATION OF SIDEWALK 0 FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET tAl 5 FEET 0 5.3 FEET ❑ OTHER _, DEPTH OF.SIDEWALK 4 4 INCHES ❑ 5 INCHES 0 6 INCHES 5610i AREA TO BE REPAIRED sq,ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO F NO. OF SQUARES WITH PATCHES • — NOTE: Areas marked with an "E" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: I C� L- J tf —jC; --It Date: Park Department Review Required 0 YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE C - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA _ PROPERTY ADDRESS ij47 - /f.e}e f/gpLIW D1� ee I3-oZ- 15_z - 0.14 — 157-A" PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -•-1 AREA NEEDING REPAIR WIWziziVX L — length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. 8141 -/149 I I I WATER SHUTOFF VISIBLE ❑ \ . BROKEN MISSING 0 Property Line r —. ---7W 5 LOCATION OF SIDEWALK 154FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK Ez. 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER —.r. — DEPTH OF SIDEWALK 1a 4 INCHES [} 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED W•0—sq.ft. 4 in. _.____sq.ft. 5 in. eq.ft. 6 in. CODE F — PATCHES YES 0 NO I-J NO. OF SOUARES WITH PATCHES NOTE. Areas marked with an "F' may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. A2—. First Inspection and Form Made By:_r .,_ _._R re Date: ...,_, .. V2 Pork Department Review Required 0 YES Rt NO PERMIT ISSUED NO. _ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL CONTRACT CONTRACT COMP ETIONDATE NO / — CODE G — Other -- _. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS /2p/ — 1Z03 //AptAyj Pll gE —oZ— /5Z —o/7 157-8 PARCEL CODE CONTROL NUMBER CER". NUMBER LEGEND I- L' -'-I AREA NEEDING REPAIR Vi//U2///.1 L — length of repair needed A Type of defect rl (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. l Z4/ ' I Z03 I ' WATER SHUTOFF VISIBLE ❑ rAe BROKEN ❑ • MISSING 0 Property Line v,, LOCATION OF SIDEWALK [t FRONT YARD [_.:I SIDE YARD 0 OTHER WIDTH OF SIDEWALK D4 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER _— DEPTH OF SIDEWALK Cf2r, 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ZO'° sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO IL NU. OF SQUARES WITH PATCHES NOTE. Areas marked with on "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 1` Dale: _31�.eJ/Zd/6 Pork Department Review Required [] YES alNO PERMIT ISSUED NO. — DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NC/- CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, TWA PROPERTY ADDRESS 00 h/k L.c a� 54 , • gq 13 — 23— 60 ✓ !400 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L` AREA NEEDING REPAIR v1/sifslrrt L length of repair needed Type of defect rl (See reverse side for Defect Codes A—F) (See below for Defect Code G) F—DDRESS. I sWeAeTE R SHUTOFF VISIBLE BROKEN ❑ _ MISSING 0 Property Line .5-a,I jQCTION OF SIDEWALK 1'FRONT YARD [_I SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET g 5.3 FEET 0 OTHER -- nEEni OF SIDEWALK 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 2 D sq.tt. 4 in. sq.ft. 5 in. sq.ft. 6 in. - CODE F — PATCHES YES 0 NO [ .. NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F may bet repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 1`,S .b Date: 3 "2/4 -.I b . Pork Department Review Required ❑ YES (.NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4- CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 5( 1-,1 c.1e}A-e 54- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V//7i/I77 A L - length of repair needed Type of defect /� (See reverse side for Defect Codes A-F) (See below for Defect Code G) ADDRESS. 562 WATER SHUTOFF VISIBLE ❑ _CM BROKEN ❑ MISSING 0 IZ,b Property Una 5" LOCATION OF SIDEWALK (FRONT YARD ❑ SIDE YARD ❑ OTHER mu OF SIDEWALK ❑ 4 FEET 0 5 FEET a 5.3 FEET 0 OTHER _— DEEM OF SIDEWALK ❑ 4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED _sq.tt. 4 i 61 � n. o' •q.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES [] NO Q1 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on "r may br+ repaired by patching. All other areas shall be repaired by reconstruction of full squarer. First Inspection and Form Mode By:, _KS_ D r-s Date: 3-214' 4 0 Pork Deportment Review Required 0 YES aNO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE C - Other —� SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3z S+, 31 3— —43.E— 01-1 3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND U AREA NEEDING REPAIR ffviffa L — length of repair needed Type of defect (See reverse side for Defect Codes A—r) (See below for Defect Code G) i ADDRESS. -5 Z i I WATER SHUTOFF VISIBLE 0 -CAE BROKEN ❑ MISSING ❑ 8 ° Property Line • L �� ie , LOCATION OF SIDEWALK Ijg FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET 12) 5.3 FEET ❑ OTHER -- Dow OF SIDEWALK 5ft 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Z .._sq.ft. 4 in. •q.ft. 5 in. •q.ft. 6 in. CODE F — PATCHES YES [.' NO ( NO. OF SOUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. All other areas _. shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 1.S .) _ Date; 3 "GPI ' f O Park Department Review Required 0 YES f4 NO PERMIT ISSUED NO. — DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 6 Lej 6, 1. +4-e Si-, 4icI of 3 ✓ /4q PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR I/!/l//lll/A L length of repair needed Type of defect +� (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 6.3 I WATER SHUTOFF \ vl518LE ❑ BROKEN ❑ MISSING ❑ q i 5-.6 Property Linn WXI G Ye,- 1v14/tQ. LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER . IQ ZJ OF SIDEWALK 0 4 FEET C} 5 FEET MI 5.3 FEET 0 OTHER' DEPTH OF SIDEWALK l-- 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ' •q.ft. 4 .n. ■q.It. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES 0 NO ' NO. OF SQUARES WITH PATCHES— NOTE. Areas marked with an -r may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: IS 1) ' Date; 3 ~2 4 -t 0 Pork Department Review Required YES ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0• CONTRACT COMPLETION DATE: CODE C - Other V'Ok repktCQ QA4 nc s{{'I'cae�relK iTr }rep rae4-s �e_, r °es T �S ct e S e4-N 1 h Q 4 C�t4-7 �✓YQ i I��iQ�f' i j { SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS ,SOD La.c-vy+ *-4-.. 39 3 _23 - yg _ o0 1140'� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —4P'1 AREA.NEEDING REPAIR I'/l//lI///ZA L = length of•repair needed Type of defect 1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) >Kik ADDRESS: 2 G o I — tv Et- Emiao+ ►1oaSE 11.1 L� 1 Property Line WATER SHUTOFF fn VISIBLE ❑ CAP BROKEN ❑ MISSING El LOCATION OF SIDEWALK g FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 54,5.3 FEET Cl OTHER DEPTH OF SIDEWALK ( 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED - 0 sq.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F' may .be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: Date: 3 "2 -r® Park Department Review Required ❑ YES R.NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IQWA PROPERTY ADDRESS 4-e bl gi►_ -00(.0 ✓ /& PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA NEEDING REPAIR U//////f/eil L — length of repair needed Ap Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) i ADDRESS. WATER SHUTOFF VISIBLE 0 1.0Ck BROKEN ❑ MISSING 0 Property Linn /7/ y LOCATION OF SIDEWALK 54 FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET OK. OTHER — DEPTH OF SIDEWALK ❑ 4 INCHES 0 5 INCHES Z. 6 INCHES AREA TO BE REPAIRED .sq.ft. 4 in. — sq.ft. 5 in. + Q q.t1. 6 in. CODE F — PATCHES YES ❑ NO _14, NO. OF SQUARES WITH PATCHES .. NOTE. Areas marked with an MF' may Ian repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: Date: 3r2.3" )a _a Pork Department Review Required ❑ YES Qz NO PERMIT ISSUED NO. +. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 400 b/k Z }Vo77-- ,jam, bal. Z L3 ' d.Q T ,/` 0E.99 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND ke--- L' • AREA.NEEDING REPAIR r///I/77W/A L = length of repair needed Type of defect /�k (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 4>l< '3 O Z°Property Line KO1WATER SHUTOFF ��f® VISIBLE ❑ eaJi \ rj LAE " BROKEN ❑ L . 3 :-GQ j MISSING ❑ LOCATION OF SIDEWALK 4a FRONT YARD 5it SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET IA 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK jg 4 INCHES ❑ 5 INCHES 54 6 INCHES AREA TO BE REPAIRED P34 7 sq.ft. 4 in. cq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO 12 NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. Ail other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: ,b Date: i 3 ItO Park Department Review Required jL YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other ?.• ts.4 0,t ( c&c.e.•Ae....* a Sic �wallL',�r -1-r-ep r-oc43 are_, pct,.s@.,4sr qS &Q.1e4-M1he-d[ y Cl4ry C^37nQe-r SIDEWALK REPAIR SURVEY FORM -- d rY OF WATERLOO, IOWA PROPERTY ADDRESS L4 2_ L et>rcti e_ 5- s'9 I3 - Z� - 35 c�8LZ /70 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km— L' —•-{ -/- AREA.NEEDING REPAIR I77- lllTll� L = length of repair needed , Type of defect Ai G i (,,�5 1 �„0 (See reverse side for Defect Codes A—F) 4.` (See below for Defect Code G) .......) >1c. ADDRESS: I v1 i ?de ivy Ci� L if., \S,°\,\\,„\\‘ : q.. , i Jrj y V Property Line V fi`/ WATER SHUTOFF ti ; �� / VISIBLE ❑ C am'7,,4• o t, CAP Iv` 1;7 e." l ! -, 2 BROKEN ❑ MISSINS ElLCAc'cl-e.+ e Si- t LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD LI OTHER _ WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET ' OTHER _ DEPTH OF SIDEWALK ilil 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 6,23' 1 sq.ft. 4 in. nq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES_ — NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: J` S C Date: 5 Z-g IC Park Department Review Required IN YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other ?6-e-✓141-c.\ r eptga.e.., .t o f 5.e e...-.••,.1 K ,C 4-ref .'o134s" 2-e i re,S CAA GLs $.-41'e.f-re i"..e_ct lay C i 4.7 e rt,4 it e e.r i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS £a2s Z-ck cle $€ S , .S9 1 - -_J :.5 Q5 / /7/ _ PARCEL CODE CONTROL NUMBER CERT. NUMBER i . LEGEND L' —04 � I©Yi5�i AREA.NEEDING REPAIR V7.1TT7Tll�i i L = length of repair needed p X Type of defect !r1 (See reverse side for Defect Codes A—F) T'" O (See below for Defect Code G) L ADDRESS: 1 2.5" ' ,I., \ YMCA dr ...... " '� i AV Property Line _ `t: — bPi WATER SHUTOFF f VISIBLE ❑ i .3 I ..5 ' w CAP 1.0 x 1„�..' BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK 0 FRONT YARD ER, SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET OTHER _ DEPTH OF SIDEWALK I2( 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 22.7;0 sq.ft. 4 in. sq,ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO t NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: RS G Date: 3 "2 3 _/d Park Department Review Required ❑ YES 1Z1, NO PERMIT ISSUED NO: DATE: INSPECTION DATE: • IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 5 3-2 ) _ Lc c-aj th}e , PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR CwlmizzA L a length of repair needed /�, Type of defect /1 (See reverse side for Defect Codes A—F) (See below for Defect Code C) 'SINE ADDRESS. 52 I I I WATER SHUTOFF \ VISIBLE ❑ • BROKEN ❑ MISSING 0 -5,Lii)(6 a g':. x5.y _._ Property Line L,cc,t1 e++e 5+. _LOCATION OF SIDEWALK 'a FRONT YARD C] SIDE YARD 0 OTHER ASO OF SIDEWALK ❑ 4 FEET C] 5 FEET 0 5.3 FEET t4 OTHER DEPTH OF SIDEWALK IR 4 INCHES ❑ 5 INCHES 0 G INCHES AREA TO BE REPAIRED 78'.•q.tt. 4 3n. ■q.it. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES ❑ NO NO. Of SQUARES WITH PATCHES— • NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of full sguaras �y First Inspection and Farm Mode By: Date: ? G 3-)0 • Park Department Review Required ❑ YES aNO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO CONTRACT COMPLETION DATE: CODE G - Other i I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . TOO )o cK L i rt Co t rt S+, - g9 f —2.3-29 —®®.3 )76 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR II1'7Z7J7 7AA L length of repair needed Type of defect �� (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. I G Q r aam e WATER SHUTOFF VISIBLE FF VISIBLEcar\ • q BROKEN 0 MISSING 0 3aq/ Property tine '— LirtCoin ST, LOCATIONOF SIDEWALK b' FRONT YARD 0 SIDE YARD 0 OTHER Inca OF SIDEWALK F4 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK ►' 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ' ■q•tt. 4 in. ■q.tt. 5 in. •q.1t. 6 in. • Coot F — PATCHES YES 0 NO Es NO. Of SQUARES WITH PATCHES • NOTE. Areas marked with an "F" bn repaired by patching. All other areas 'PS • shall be repaired by reconstruction of full squarer. ij-ZZ-io First Inspection and Form Mode By;_ �• Date: 3'26'i d • Park Department Review Required ❑ YES 0 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: ' • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: • • CODE G — Other. I _ ,• ii SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO, IOWA PROPERTY ADDRESS I 0S L �tG -�I , '/ 13D t3 - Z-3 _ .�- azoj ✓ — 7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1..■- . L' --41 . AREA.NEEDING REPAIR VI L = length of repair needed Type of defect J (See reverse side for Defect Codes A-F) (See below for Defect Code G) i ?, d>1<r„ I ADDRESS: 1 05. 3 ` I _ �E ,,.( `".'A(_CL o t\ J Property Line S ' �A�r' ^-.,`Y I 2.5 t 4.D' as ' I WATER SHUTOFF VISIBLE_, i------) _ p� O - ❑ OF 5„ 4`1 5" CAP BROKEN ❑ MISSING ❑ L_OGA-4 - LOCATION OF SIDEWALK FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK I 4 FEET ❑ 5 FEET (2' 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES Imo' 5 INCHES ❑ 6 INCHES ! ,� ✓ ,( Q �/ C AREA TO BE REPAIRED ' �' . q.ft. 4 in. 3' sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO fl NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 1"C5 t)JDS Date: 3 -a4- /0 "" Park Department Review Required ❑ YES 1:53 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS , //s L ;,,,, Din ..s+. - S 9 13 _23 _2& —DO > l78 PARCEL CODE CONTROL NUMBER CERT. NUMBER ° LEGEND I-0- L' AREA NEEDING REPAIR vz*z f A L - length of repair needed A G Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Cods C) -i(--- ADDRESS. //S WATER SHUTOFF , r, - ws OLE ! .2 ;3 i\ , sa - e BROKEN 0 • MISSING ❑ 1 y,.D Property line •-- - 1 1®I . �>/. O / . 1 Q 1 LOCATION OF SIDEWALK 174 FRONT YARD ❑ SIDE YARD 0 OTHER yam OF SIDEWALK ja.g 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEMMH OF SIDEWALK It 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Zd`p_sq•ft. 4 in. ■q.ft. 5 In. •q.ft. 6 in. -°- CODE F - PATCHES YES 0 NO is NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -F" may be repaired by patching. All other areas .5_13-it) QS F • shall be repaired by reconstruction of full squares. First inspection and Form Mods By: j'l8 ftIS Date; - /26,/®a • Park Department Review Required 0 YES VI NO i PERMIT ISSUED NO, DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: , CODE G - Other. 5;d ew 0.1K /D&vie.l ;Ts f ne. . Li)q1 r Va,1Ve. rteed- cackduS4ed down . . SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 1 L a m Ca I S • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND -+- L' -� AREA NEEDING REPAIR milli/,WA L s length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) i ADDRESS. 1 :3 9 WATER SHUTOFF VISIBLE [] BROKEN ❑ MISSING ❑ � .0` e i S. e 5 lI Property Liss �`� 5 Li d! L-_A n e a I rr s+s LOCATION OF SIDEWALK R FRONT YARD ❑ SIDE YARD 0 OTHER tagib OF SIDEWALK Cgl 4 FEET 0 S FEET 0 5.3 FEET ❑ OTHER - DEPTH OF SIDEWALK co.2 4 INCHES rs5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Li _sq.tt. 4 in. ' sq.ft, 5 in. rq.ft. 6 >n. CODE F - PATCHES YES ❑ NO El NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may bra repaired by patching. All other areas shall be repaired by reconstruction of full squares. 'i-02- f�S First Inspection and Form Made 8y: -e 3s Date: Park Department Review Required 0 YES (aNO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- __ CONTRACT COMPLETION DATE: 4 CODE G - Other SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO, IOWA PROPERTY ADDRESS 50 3 L.-A/ccz// 5-77 f 65' l3_ - 2 - 232- 6 2 ✓ lgZ - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —' ' AREA.NEEDING REPAIR VIIITTITI/A L = length of repair needed Type of defect J (See reverse side for Defect Codes A—F) (See below for Defect Code G) k >i< ADDRESS: (5o .1 .-- .\ N �` N - Property Line I 5:1 I WATER SHUTOFF VISIBLE ❑ 0 A ty r----1CAP `/ BROKEN ❑ MISSING ❑ 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 9` sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NIV NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an 'F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares.First Inspection and Form Mode By: X23 13., Date: 3 Jz. S !l io Park Department Review Required YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 60 f / \76-6 Lit! __ST 69 13 - Z3- cciD / 6 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR W//7//7I%i1 L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >< ADDRESS: 60 / • J V < Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ C6//7 /�' MISSIh'u ❑ LOCATION OF SIDEWALK [ FRONT YARD ❑ SIDE YARD ❑ OTHER _ WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET IEA 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 ❑ NO [ NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired/ by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: -3 S Date: Park Department Review Required ❑ YES [A/NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other C'C E c rran/ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS (-02,6 t,TA/C oL f E35 t3 Z3: E3c,_ oc, ✓ /0�, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND C"— L' AREA NEEDING REPAIR tl///TTllllrl L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: ( _ ' Property Line l< cie . q(-/e'l T WATER SHUTOFF1 1<1i I ---) VISIBLE ❑ CAP BROKEN ❑ t MISSING ❑ /V6�2 5r . LOCATION OF SIDEWALK ❑ FRONT YARD LQcSIDE YARD D OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET L\5.3 FEET [-_-_I OTHER _ DEPTH OF SIDEWALK INCHES ❑ 5 INCHES/ ❑ 6 INCHES AREA TO BE REPAIRED 7y, 2 q.ft. 4 in. q.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO [4: NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "P' may be repaired by patching. All other areas shall be repaired by reconstruction of squares, First Inspection and Form Made By: �� Date: 3/ fh Park Department Review Required 9( YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 00 Lail' Le)C74A.1 4w PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —0-1 — \ AREA.NEEDING REPAIR VI/Y/7 777) OZ L = length of repair needed �\\ Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >l<0.. ADDRESS: vfc . I LoT Property Line WATER `SHUTOFF VISIBLE ❑ CAP BROKEN ❑ O f 4 / /jvr MISSiN ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD El OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ( 5.3 FEET El 0-HER DEPTH OF SIDEWALK ' INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED / sqft 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO c2 NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: -55 Date: )� Park Department Review Required YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CRY OF WATERLOO, IOWA PROPERTY ADDRESS ;30 3 Lo G A-tJ A-vL- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - � • AREA.NEEDING REPAIR rV///7i7ll/A t D L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >i< ADDRESS: J 03 7 — Property Line WATER SHUTOFF VISIBLE [] CAP BROKEN ❑ ( .6 Y L 5� MISSING El OF SIDEWALK C FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF•SIDEWALK ❑ 4 FEET ❑ 5 FEET .4 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES fI 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 NOTE: Areas marked with an "r may be repaired by patching. All other areas • shall be repaired by reconstruction of full s uares. First Inspection and Form Made By: Date: 3/z//U Park Department Review Required YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: — IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 3/ 5 Ld GA AtIC • - 89 13 -Z3-Z5e- o t 8 #37 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR W 7iW i'FJA l length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. 31✓ I I WATER SHUTOFF VISIBLE ❑ LAE BROKEN ❑ MISSING 0 Property Line 7 jac.611ON OF SIDEWALK l&FRONT YARD 0 SIDE YARD 0 OTHER Of SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET 0 OTHER ism OF SIDEWALK [ 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 2-aq.tt. 4 in. ■q.tt. 5 in. ■q.ft. 6 in. • CODE F — PATCHES YES [] NO [�/ NC). OF SQUARES WITH PATCHES...__ NOTE. Arena marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction I lull squ ■, ?? 5 first Inspection and Form Made By; 3 Date; 1/z S_1:'/Q Park Department Review Required ❑ YES ONO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT ND' CONTRACT COMPLETION DATE: CODE G — Other' J1 • SIDEWALK REPAIR _SURVEY FORM • CITY OF WATERLOO. IOWA PROPERTY ADDRESS ,,b/ LOGS AJ A��� - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR TIZZ,ZZ ffA L N. length of repair needed Type of defect (See reverse side for Defect Codes A—F) 4 2 (See below for Defect Code C) • ADDRESS. I I (MC WATER SHUTOFF V15tBLE ❑ Gaf sae • BROKEN 0 . MISSING 0 /U° �_ r Properly Line A) L©GA1'/ AJ • LOCATION OF SIDEWALK I FRONT YARD 0 SIDE YARD ❑ OTHER mai OF SIDEWALK ❑ 4 FEET 0 5 FEET CO 5.3 FEET 0 OTHER EPTH D OF SIDEWALK Of 4 INCHES 0 5 INCHES\ 0 6 INCHES • AREA TO BE REPAIRED '� ■q-ft. 4 in. ■q.it. 5 In- ■q.ft. 6 in. -- CODE F — PATCHES YES [] NO JA NO. OF SQUARES WITH PATCHES NOTE. Argos marked with on -r may be repaired by patching. All other areas shall be repaired by reconstruction of ul square IZ /10 first Inspection and Form Made By: 15 Date: Park Department Review Required 0 YES 0 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: 4 • CODE G — Other { I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4 Lc) 8D i - Z�_Z�S- (Di v `e9 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —04 AREA.NEEDING REPAIR t/7I/77//7/A L = length of•repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >t< ADDRESS: Property Line G11 a WATER SHUTOFF VISIBLE ❑ CAP } BROKEN ❑ Qt 5 cb MISSING El 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 S�'Ssq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: t`-%5 DD> Date: 3/Z/ lQ Park Department Review Required %. YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF. WATERLOO, IOWA PROPERTY ADDRESS V/ L.C)6 A'A! AVE PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t""' U —i-I AREA NEEDING REPAIR vizziwief L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) 11 (See below for Defect Code G) t N ADDRESS. 4 I ' WATER SHUTOFF VISIBLE ❑ BROKEN ❑ . MISSING3. ❑ S Property Line A LUGAN v ., LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET ❑ s FEET fo 5.3 FEET 0 OTHER - DEPTH OF SIDEWALK [ \\` 4✓INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 16 ' -AO t. 4 in. ■q.ft, 5 in. eq.tt. 6 in. CODE F - PATCHES YES [] NO [y NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "f mays bet repaired by patching. All other areas shall be repaired by reconstruction of full aqua v. !!,, First Inspection and Form Made By: Date: `�-f / V Pork Department Review Required ❑ YESycl-NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 7 2(a 2-0 6,. /.' A veg 8313 -L4-_ /x- c PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR E/I//771///A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 72 6 /'8 Property Line WATER SHUTOFF ` VISIBLE [] C a CAP BROKEN ❑ MISSINGN ❑ LOCATION OF SIDEWALK ❑ FRONT YARD L y(SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET/_ !SG 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK El 4 INCHES '-C' 5 INCHES/� ❑ 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. Z 5 " sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction ,of full squ e • First Inspection and Form Made By: 1\1 Date: 3lL f i 0 Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 52 LO(.bL1 tlt✓ '� 31L3 —L,_ L8i_ v/5 ✓ /')Z PARCEL CODE CONTROL NUMBER,. CERT. NUMBER LEGEND L' —40-1 • AREA.NEEDING REPAIR V/I/7// lzl L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: tf1-L c Property Une 90' E4MI cAlL WATER SHUTOFF VISIBLE ❑ cto X rj/ CAP BROKEN ❑ LrN COL k) MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 4 FEET ❑ 5 FEET ❑ 5.3 FEET [XI OTHER 5• DEPTH OF SIDEWALK LK.4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 38 I sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may .be repaired by patching. All other areas shall be repaired by reconstruction of fullsquares. f First Inspection and Form Made By: / 1 - l Date: 3/ j/ ( Park Department Review Required ❑ YES pi NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. _5 2 3 ZO(?,k e\ 89 13 — i — /'7 3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom' L' AREA NEEDING REPAIR VZ/Z7Z/iJa L length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) � Cs� J `� 1 ADDRESS. 5 z 3 Z I I WATER SHUTOFF YfStaLE tgi riee BROKEN ❑ MISSING 4'3 Property Line r-� fA A oGA4J A uL LOCATION OF SIDEWALK L)Q FRONT YARD ❑ SIDE YARD ❑ OTHER /tuatJ OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET [h 01 HER J DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES ❑ 6 INCHES } AREA TO BE REPAIRED L. `--2'•q.tt. 4 •n. ■q.tt. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES ❑ NO 7t NO. Of SQUARES WITH PATCHES ._ NOTE. Arens marked with an - may bn repalr*d by patching. All other orsas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 11 Date; 3/Zf, /� Pork Department Review Required ❑ YES q(NO PERMIT ISSUED NO., DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other Ij SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS SZ Lv 6A,1 i] JE . 89 1 zit— iSZ._ cxl ✓ ill PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km— L' --0-i AREA.NEEDING REPAIR 1/T///77///A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) !rr (See below for Defect Code G) r. 4iiii‹._ ADDRESS: _5 z� `V t . D V y5. v y ` � Sag I ek n . Property Line 1k— a it-✓f14 --- WATER SHUTOFF VISIBLE ❑ c tEAAJ W4 LK_ CAP L /S 7- Z BROKEN 0 e )-7-/ /el 7— i`� MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD "NiSIDE YARD ❑ OTHER WIDTH Or SIDEWALK El 4 FEET ❑ 5 FEET #15.3 FEET ftj OTHER 5 1' V DEPTH OF SIDEWALK X 4 INCHES ❑ ❑5 INCHES 6 INCHES AREA TO BE REPAIRED r55' q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES 0 NO P6 NO. OF SQUARES WITH PATCHES -- NOTE: Areas marked with an 'F'' be repaired by patching. All other areas shall be repaired by reconstruction f full squor h First Inspection and Form Made By: / .5" Date: 3/Z/f d Park Department Review Required k•YES 0 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 6fJ b11 L oc j - 81„_I 3 —23—Z3 7 05/ /(.S PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA NEEDING REPAIR vizAwmA L : length of repair needed j( 1 1 Type of defect C� I (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. (14 WATER SHUTOFF W \ LV% VISIBLE ❑ Lee BROKEN ❑ MISSING CI Property Line A. , 6 LQ6AW Atilt • LOCATION OF SIDEWALK (c FRONT YARD ❑ SIDE YARD ❑ OTHER �..r NUM OF SIDEWALK ❑ 4 FEET G7 s FEET 15.3 FEET ❑ OTHER —.— laud OF SIDEWALK c 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED S3 �q.ft. 4 in. , •q.ft, 5 in. sq.ft. 6 in. CODE F — PATCHES YES NO p' NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of fu I squares. First Inspection and Form Mode By:_M._,,,M , T� Date: 3 Z /O Pork Department Review Required ❑ YES //[�NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE C — Other 6022ECrro/t/ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 40 (0 f . Lc 6 A 8g l3 23 _. 2'7_ ozC. /6,6, • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —4 . AREA.NEEDING REPAIR rV///7//777A L = length of repair needed NI Type of defect (See reverse side for Defect Codes A—F) l< E� • (See below for Defect Code G) l< ADDRESS: I � ,. -4rn \ . .0 i ropey , — /// 1 �( WATER SHUTOFF I VISIBLE ❑ C yXyXV,.C_.- Li) CAP Yx`l x S ' BROKEN ❑ _ C�E5TA V7- 5% MISSING El LOCATION OF SIDEWALK lX• FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 4 4 FEET ❑ 5 FEET [ 5.3 FEET ❑ OTHER , DEPTH OF SIDEWALK 4 INCHES El 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 63'0 sq.ft. 4 in. 1�'Osq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction.o full s/wes. I/� First Inspection and Form Made By: `L/-,�j Date: -3 if-4 Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: _. IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other — - SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 1D 3 60 ,A A vz , 33 i)3 _22_ z3_65 3 /,9 PARCEL CODE CONTROL NUMBER CERT. NUMBER - LEGEND k- L' - AREA NEEDING REPAIR V/J 7IZ'l7A L - length of repair needed Type of defect See reverse side for Defect Codes A-F) See below for Defect Code G) -›1‹- ADDRESS. 20_5 f WATER SHUTOFF VISIBLE 0 • \ . Sae BROKEN 0 MISSING 0 id,/ Property Liner `z___.O A } CoGAN Alit-- - LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER r� yam OF SIDEWALK 0 4 FEET 0 5 FEET (r 5.3 FEET 0 OTHER -- DEPTH OF SIDEWALK [ 4 INCHES 0 5 INCHES 0 6 INCHES e AREA TO BE REPAIRED .S 3' ft. 4 ;n. r ft. 5 in. •q q• qA. 6 in. CODE F - PATCHES YES 0 NO [- NO. OF SOUARES WITH PATCHES NOTE. Areas marked with on "F" may Isis repaired by patching. All other areas shall be repaired by reconstruction of squareesss.. , First Inspection and Form Made By: .. Date: _3/z 6 /•�U Pork Department Review Required YES C] NO /Fr PERMIT ISSUED NO. DATE: INSPECTION DATE: • -_ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE G - Other SIDEWALK REPAIR SURVEY FORM _ CITY OF WATERLOO. IOWA PROPERTY ADDRESS ?2(,P - 72 8 La Q,t Ave . - 13`�1�-2 t -Gz,Z.- '� 2®® PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E. AREA NEEDING REPAIR viiiiimt L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) See below for Defect Code C) ADDRESS. I I - WATER SHUTOFF NSWLE ❑\ . LAE BROKEN 0 . - MISSING 0 Property line _ __.a - i pSu (�-- Af-i \/./A.t.-C-- 4Y O+5 ` 4"1 ,5` _ dv_ OF SIDEWALK gi FRONT YARD 0 SIDE YARD ❑ OTHER IiIMI OF SIDEWALK 0 4 FEET Fff 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK pt 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 7°1. sq.tt. 4 in. -sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES 0 NO 0 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. All other areas • shatl be repaired by reconstruction of full squares. First Inspection and Form Made 8y'-LG _— Date: ?? 3 1- o Pork Deportment Review Required 0 YES ( iJO i PERMIT ISSUED NO. DATE: INSPECTION DATE: . • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: I CODE G - Other I 1 . { . _ l SIDEWALK REPAIR SURVEY FORM ! CITY OF WATERLOO, IOWA S M PROPERTY ADDRESS . 6- 6 L a 6 ,v f3-Z -Lc)L_cal ✓ i0� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —04 AREA NEEDING REPAIR 1717/Z//T/A L length of repair needed Type of defect See reverse side for Defect Codes A—F) See below for Defect Code C) ADDRESS. . z,5/ I WATER SHUTOFF VISIBLE ❑Lee BROKEN ❑ MISSING 0 L i/n:R Property Linefze- <� I ra�x� ,V 0/4/Y P 4 7- -s/fiA/,C [� c1;t/ A %+ LOCATION OF SIDEWALK (X FRONT YARD [_I SIDE YARD 0 OTHER —______ WIDTH OF SIDEWALK E3 4 FEET ❑ 5 FEET 0 5.3 FEET ( I OTHER ?, 444-44 I DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 22 • 1_�sq.ft. 4 in. •q.tt. 5 in. sq.ft. 6 in. CODE F — PATCHES YES [] NO [ NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an _F„ may bee repaired by patching. All other orsae shall be repaired by reconstruction of full squares. First Inspection and Form Made By:_. f, �_. Date: 3�•%T /6 Park Department Review Required ❑ YES V NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE C — Other �� SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 6 1 -3 to GA j A-\la" , — PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND I..— U —04 AREA NEEDING REPAIR V7f /77. A I. - length of repair needed ;� / Type of defect eo See reverse side for Defect Codes A—F) er See below for Defect Cody C) to >Kt. ADDRESS. S 1 3 I I WATER SHUTOFF VISIBLE 0 \\ — LW BROKEN ❑ . MISSING ❑ l 20 5 ' _ Property Une _._ — i j C3 \ Lo 64,J qvr • LOCATION OF SIDEWALK ( FRONT YARD 0 SIDE YARD ❑ OTHER y OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0(5.3 FEET 0 OTHER lani OF SIDEWALK 0 4 INCHES {0( 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ■q.tt. 4 in. �.q.tt. 5 in. ■q.fi. 6 in. — CODE F — PATCHES YES 0 NO L13 NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with on -f" may be repaired by patching. All other ureos _ shall be repaired by reconstruction o full squ e. f • First Inspection and Form Mode By: _„+ � Data: VA 9 / o Pork Department Review Required 0 YES I NO PERMIT ISSUED NO. DATE:. INSPECTION DATE: . IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: , • CODE G — Other 1 I i j 1 i I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS t J - LC 6 A ki A Q 9 13-z.3-Z?E5- ►I,D 1®‘17 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I-•-- L' AREA NEEDING REPAIR V/.'UU/ffA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. C7 l 7 I ( WATER SHUTOFF vlsreLE ❑ • SAE BROKEN 0 MISSING 0 Property Uwe =AIM OF' SIDEWALK 1,( FRONT YARD ❑ SIDE YARD 0 OTHER maid OF SIDEWALK ❑ 6 FEET 0 5 FEET 5.3 FEET 0 OTHER DEPTH OF SIDEWALK ❑ 1 INCHES cir 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED •q.tt. 4 ii(n. Z` •q.fl. 5 In. .q.tt. 6 in. CODE F — PATCHES YES [] NO {d}. NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of fu squares ,3/26 //(3 First Inspection and Form Made By: W — Dale; Park Department Review Required ❑ YE yi NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: 4 CODE G — Other. I SIDEWALK REPAIR SURVEY FORM CITY OF WATRL00, IOWA PROPERTY ADDRESS . 824/ L.0 O-iN' A./E. T PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V/III/]IZZA I - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. f ( WATER SHUTOFF VISIBLE ❑ See BROKEN C7 _ MISSING 0 A Property Line r/1 LOCATION OF SIDEWALK (FRONT YARD ❑ SIDE YARD ❑ OTHER yam OF SIDEWALK 0 4 FEET ❑ 5 FEET 45.3 FEET 0 OTHER -- DEPTH OF SIDEWALK 0,4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 7"` q.ft. 4 in. •q.tt, 5 in. sq.tt. 6 in. CODE F — PATCHES YES [] NO • NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an F" may bet repaired by patching, All other areas shall be repaired by reconstruction f full squarer. First Inspection and Form Made By: ? _ Date: . 7 //° Pork Department Review Required [] YES i (40 PERMR ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: 4 CODE G — Other- �__, SIDEWALK REPAIR SURVEY FORM CITY QF WATERLOO. IOWA PROPERTY ADDRESS 83Z Z06A/V/ A Jc', g2 _24-- /o( G0 PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND L' AREA NEEDING REPAIR vlliif1,YA L s length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. t�3 Z ' ( WATER SHUTOFF VISIBLE 0 rase BROKEN A ❑ '5 _ MISSING 0 5,7 Property Line A A C 1.J 1 c CAAid A . LOCATION OF SIDEWALK iZ FRONT YARD 0 SIDE YARD ❑ OTHER rr AM OF SIDEWALK C3 4 FEET 0 5 FEET 5.3 FEET ❑ OTHER -- DEEM OF SIDEWALK 1;4 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 7�'=sq.$t. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES 0 NO I " NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. 1 l First Inspection and Form Made 8y:_ _ 1- Date: •? L`lj, < �o Park Department Review Required Ai YES ❑NO PERMIT ISSUED NO. ._ DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other �,_ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . cS q 6' (,3 GA/J Au C' . 8, 4- to ( _c —‘/ // • PARCEL CODE CONTROL NUMBER CERT. NUMBER ,_ LEGEND 1-0- L' AREA NEEDING REPAIR D////LW/A __ L a. length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) - ADDRESS. 8 ` 6 . -244-* WATER SHUTOFF \ V1518LE ❑ \ .G6e BROKEN 0 MISSING ❑ 5 / _. _ Property Line i ! I c . Lob. rJ l' t)E . =MON OF SIDEWALK igi FRONT YARD 0 SIDE YARD 0 OTHER MO OF SIDEWALK 0 4 FEET 0 5 FEET Fi 5.3 FEET 0 OTHER _ OF SIDEWALK 0 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ■q.tl. 4 in. �` q.ft. 5 In. ■q.ft. 6 in. "'- • CODE F - PATCHES YES 0 NO Lei NO. OF SQUARES WITH PATCHES • NOTE. Argos marked with an "F" may bn repaired by patching. All other areas • shall be repaired by reconstruction f ult squ C 3fZ9 b First Inspection and Form Made Sy: ` Date: / Pork Department Review Required 0 YES [ NO ! PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' - CONTRACT COMPLETION DATE: 4 CODE G - Other' - 1 I • I I ii- . SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO IOWA PROPERTY ADDRESS g 57 L a I`I Ave g 9 (3 —Z3-Z2_8 - oZc. Z4 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR villifziz1t_ t length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. `� 7 I I WATER SHUTOFF Vi5I8LE ❑ • \ • see BROKEN ❑ MISSING ❑ 3./ Property Linn LOr,4 4 A LJ laC6/1 rJ OF SIDEWALK Ca FRONT YARD ❑ SIDE YARD 0 OTHER Qj OF SIDEWALK ❑ b FEET 0 5 FEET T4 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK J:4 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED .sq•tt. 4 ;n. sq.tt. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO [ NO. Of SQUARES WITH PATCHES ._ NOTE. Areas marked with an - may bn repaired by patching. All other areas shall be repaired by reconstruction o uil e u e. 3Jz� / t First Inspection and Form Made By: 5 _ Date; l - Park Deportment Review Required [] YES TIRO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other II SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 859 Lo,z J AJC S9l3 -Z3 - 2 -8- et0 Z13 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' -•-� AREA.NEEDING REPAIR V//%T//T7%ii L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 1<it;it, ADDRESS: 659 I — _ CO • Property Line WATER SHUTOFF VISIBLE 0 CAP BROKEN ❑ MISSING ❑ Lo CAA) Au-C. LOCATION OF SIDEWALK ❑ FRONT YARD L�( SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK [ 4 FEET ❑ 5 FEET ❑ 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK cAd 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 NOTE: Areas marked with an "F may be repaired by patching. All other areas shalt be repaired by reconstruction of fu squares 1 First Inspection and Form Made By: 35 Date: _3/1 26 / ) D - Park Department Review Required 0 YES fy NO -PERMIT ISSUED NO: DATE: INSPECTION DATE: - IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: . CODE G - Other • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 5I i Sf. 39 13_-3_LI Zg _a )3 ,/ 2/5 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR WZMZIZZA L am length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) t.. ADDRESS. 5 r! I I I WATER SHUTOFF VISIBLE ❑ BROKEN ❑ MISSING ❑ Property LieL.5.41 IMMON OF SIDEWALK 151,_FRONT YARD 0 SIDE YARD 0 OTHER AIM OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET ❑ OTHER MEM OF SIDEWALK -5 ,4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Z ,q•tt. 4 in. •q.tt. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO { NO. OF SQUARES WITH PATCHES r_ NOTE. Areas marked with an "F" be repaired by patching. An other areas • shall be repaired by reconstruction of full squares. First Inspection and Form Made By. Q 5 .._ Date: 3-2 —/0 Pork Department Review Required ❑ YES NO i PERMIT ISSUED NO, DATE:, INSPECTION DATE: '_ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other• SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 3 nn t: 'becri S , • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR rizezezWiwit I. - length of repair needed I Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Cods C) ADDRESS. 51 WATER SHUTOFF VISIBLE ❑ BROKEN 0 MISSING 0 5,01 Property U IMMO OF SIDEWALK Ca. FRONT YARD ❑ SIDE YARD 0 OTHER ,pill OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 10 5.3 FEET 0 OTHER - DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ■q.tt. 4 in. ■q.ft. 5 in. ■q.ft. 6 in. — COOE F - PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares.• '— first Inspection and Form Mode By: D Date: 3__2 q -I b Park Department Review Required [] YES lgj NO PERMIT ISSUED NO. _ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO.CONTRACT COMPLETION DATE: CODE G — Other. i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS %'_aj Mo\ (r 1 }, • 3313 _L3— y3‘ — er 7v Z<9 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR. Tl/f1.4,/,IA L i length of repair needed A Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. g i�� WATERS OFF VISIBLE LAE BROKEN ❑ MISSING T '4 i k LI.9 ` Property Line LOCATION OF SIDEWALK 44 FRONT YARD ❑ SIDE YARD ❑ OTHER .�. gm OF SIDEWALK 0 4 FEET ❑ 5 FEET g 5.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2.1ts, C3 __.sq.tt. 4 in. sq.it. 5 in. 6 in. CODE F - PATCHES YES [] NO 54 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on '"F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made Ely:_._.,,,,,11-1-, (:_ _.._.. Data: -; 24 -I L� Park Department Review Required ❑ YES NO PERMIT ISSUED NO. r DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE C - Other — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • PROPERTY ADDRESS g ] / t u b e T r y g_IL5— -o0 2.20 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1•••-' E' AREA NEEDING REPAIR trirrrvii�.l L length of repair needed A Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) • 11NE ADDRESS. j g WATER SHUTOFF p . \ VISIBLE ®,L• ae BROKEN BROKEN 0 • MISSING 0 Ey Property Line • W.V. vLLerry .TrC+✓. =QU MM OF SIDEWALK ) FRONT YARD ❑ SIDE YARD 0 OTHER /MB OF SIDEWALK ❑ 4 FEET 0 5 FEET El. 5.3 FEET 0 OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2921 ■q.fl. 4 in. ■q.tt. 5 In_ ■q.ft. 6 in. • CODE F — PATCHES YES ❑ NO EL NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an `f• may be repaired by patching. AA other areas shall be repaired by reconstruction of full squares. 5-y-to Rs First Inspection and Form Made By:-- R S .D Date; -. 3 -/0 Park Department Review Required ❑ YES 1 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: . • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE C - Other* • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA (/o0 BIocIC) PROPERTY ADDRESS ' — —143(e.-0 / PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA NEEDING REPAIR W/,W/,WA tN L length of repair needed C ewe, fe- i' Type of defect iti\ (See reverse side for Defect Codes A—F) I I (See below for Defect Code C) ADDRESS. WATER SHUTOFF a_Cc1y. • �-� VISIBLE Q rAbe BROKEN 0 MISSING ❑ 75' To c.\ Property Line [5-ui LOCATION OF SIDEWALK [ FRONT YARD 0I SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET M 5.3 FEET ❑ OTHER ____— DEPTH OF SIDEWALK EL 4 INCHES 10 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2 H•' q.ft. 4 ;n./06 0 q.ft, 5 in. nq.tt. 6 in. CODE F — PATCHES YES NO M . NO. OF SQUARES WITH PATCHES ._ NOTE. Areas marked with an F may be repaired by patching. All other areas shall be repaired by reconstruction of full squorer. First Inspection and Form Made By: ' ID P __.__... � �_..�.. Data: :_•G � Park Department Review Required YES 0 NO PERMIT ISSUED NO. _ DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE G — Other __— SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS (36c 8 IocK) /}?vI berry Si-, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -s-j • AREA.NEEDING REPAIR V///77Z/77A L = length of repair needed A ( ,��o- Type of defect v (See reverse side for Defect Codes A-F) . (See below for Defect Code G) ADDRESS: I - As* it. �J Cikcch r i a14> Property Line o'K• WATER SHUTOFF rj VISIBLE ❑ CAP ` BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET • (g, 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES g 6 INCHES AREA TO BE REPAIRED sq.ft. 4- in, sq.ft. 5 in.50G,7 sq ft. 6 in. CODE F - PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may .be repaired by patching. All other areas • shall be repaired by reconstruction of full squares. First Inspection and Form Made By: Q.S Date: 3 2 3-ib Park Department Review Required ❑ YES n NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IQWA PROPERTY ADDRESS 4a9 b`4 Huey S.r- • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom-' L' --►� AREA NEEDING REPAIR vl/Iowsz7X L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. ,I ( WATER SHUTOFF VAN�T VISIBLE ❑ Lee BROKEN ❑ MISSING 0 ept3 _17/4 Property Line _. — _.—. f • M11 — - LOCATION OF SIDEWALK I FRONT YARD Et) SIDE YARD 0 OTHER �M WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET 03 5.3 FEET ❑ OTHER _— DEPTH OF SIDEWALK ❑ 4 INCHES 0 5 INCHES fk 6 INCHES AREA TO BE REPAIRED _ sq.tt. 4 in. _— sq.tt, 5 in. f�q.ft_ 6 in. CODE F — PATCHES YES ❑ NO v.. NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F' may be repaired by potchinq. All other areas shall be repaired by reconstruction of full squores. First Inspection and Form Made By: R5 Pq __.,. Cote: ,,5"Z 3 !O Pork Department Review Required ❑ YES [2} NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: 4 y__CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 112 M 4herr1 Z7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR Itfte7Z.W.M L — length of repair needed A. Type of defect 9f'S (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. q C I WATER SHUTOFF VISIBLE ❑ LAE BROKEN ❑ — _ MISSING ❑ 2,D.11 Property Line r-1 LOCATION OF SIDEWALK [4 FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET R5.3 FEET ❑ OTHER ___.— — DEPTH OF SIDEWALK 0 4 INCHES 5 INCHES 6 INCHES AREA TO BE REPAIRED —.sq.tt. 4 in. —_— eq.ft, 5 in lOn i I mq.it. 6 in. CODE F — PATCHES YES ❑ NO a NO. OF SQUARES WITH PATCHES_ .� NOTE. Areas marked with an -F' may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. P S ld First Inspection and Form Made 6y: �� __ .._. . Cate: . Park Department Review Required ❑ YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO CONTRACT COMPLETION DATE: CODE C — Other• ___.— SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . S © diu/trier r y S- � 3 Z�I -1,51_s03 v- l/0 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR VZZA IZZA L em length of repair needed A Type of defect t 1 (See reverse side for Defect Codes A—F) See below for Defect Code C) ADDRESS. 520\ • I WATER SHUTOFF VISIBLE ❑ • rn�r See BROKEN 0 -1: MISSING 0 5,0 Property Line -31 7/7 21.1"-A LOCATION OF SIDEWALK g FRONT YARD 0 SIDE YARD 0 OTHER magi OF SIDEWALK ❑ 4 FEET g) 5 FEET 0 5.3 FEET ❑ OTHER DEEM OF SIDEWALK t4 4 INCHES 0 5 INCHES [ 6 INCHES AREA TO BE REPAIRED 1____L�O■q.tt. 4 in. ■q.ft. 5 in. �5'C■q.ft. 6 in. CODE F - PATCHES YES ❑ NO 154 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an 'F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Dods By: 9-S D Date: 3 2 3 1( Pork Department Review Required ❑ YES -0 NO PERMIT ISSUED NO. DATE:, INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO* CONTRACT COMPLETION DATE: , CODE G - Other • i I� . . . . . , ___ ,____. . ,.. ., _ + I SIDEWALK REPAIR SURVEY FORM . _ CITY QF WATERLOO, IOWA • PROPERTY _ADDRESS . 300 gl ocK _ h1iitan Ave. gcl I I—Z -- ' 3 --- V r PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND ' AREA NEEDING REPAIR vi,,lffiiu.1 L 4. length of repair needed j Type of defect See reverse side for Defect Codes A-F) (See below for Defect Code C) r i ADDRESS. telE I A.,C Ct sk* I WATER SHUTOFF VISIBLE ❑ \ . L..--.4 gee BROKEN 0 MISSING 0 40' Tofa. _ Property Line i 5" \ — E , fl1 u I late Ave . I JACIalati OF SIDEWALK Q FRONT YARD 0 SIDE YARD 0 OTHER maw OF SIDEWALK ❑ 4 FEET 0 5 FEET .pk.5.3 FEET 0 OTHER DEPTH OF SIDEWALK • 1SZ 4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED _ q.ft. 4 in. 4L'� q '? ' .lt. 5 in. ■q.lt. 6 in. = CODE F - PATCHES YES 0 NO 0 NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an _F. may be repaired by patching. All other areas • shall be repaired by reconstruction of lull squares. • First Inspection and Form Mods By: s. K S C. Date; 3 -2 L -I Pork Deportment Review Required 0 YES pi NO — 1 PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: , CODE C - Other• i i I I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. . 3 t1-1 L Al v i\czv1 Ave . � l —2.3-43 —C. ' i341- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -1 w'iY-- AREA NEEDING REPAIR vizzzmz/A C e,c,t 0 I. - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. 3 I'l WATER SHUTOFF \ VISIBLE ❑ BROKEN 0 MISSING ❑ f©'' Property line LIO a'OfR I / s,, r' f lv Iiclr. Ave LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER 111118 OF SIDEWALK 0 4 FEET 0 5 FEET tilt 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES E 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 159.D w/q.tt. 4 in. 5 3 ® •q•tt. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO 0 NO. Of SQUARES WITH PATCHES— NOTE. Areas marked with an -F may bn repaired by patching. All other areas • shall be repaired by reconstruction of full squares. ,, First inspection and Form Made 8y:•� 5 i� G Date; . " 2L4 ` lb Pork Department Review Required ❑ YES NO PERMIT ISSUED NO, DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0. CONTRACT COMPLETION DATE: , �i CODE G — Other. .— 1i I.i 1 __ • • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 3163 E. /YIUiian Ave.. gq t3-23-`13-6 tS 235 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR VLIZZ ZIA t. al length of repair needed Type of defect A (See reverse side for Defect Codes A—F) (See below for Defect Code C) XADOREss. 31 4 I I WATER SHUTOFF \ VISIBLE ❑ _. see BROKEN ❑ MISSING 0 p ct Property Line 2 /. /7 77 7/7 — — �. (1"1lrn Ave. OF SIDEWALK BI FRONT YARD 0 SIDE YARD 0 OTHER j OF SIDEWALK ❑ 4 FEET 0 5 FEET 012 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK CS 1 INCHES 0 5 INCHES [] 6 INCHES AREA TO BE REPAIRED /5A.5 sq•ft. 4 in. •q.ft. 5 In. ■q.fl. 6 in. CODE F — PATCHES YES [] NO I NO. OF SQUARES WITH PATCHES • NOTE. Arras marked with on "f may tot repaired by patching, Ali other areas • shall be repaired by reconstruction of full squares. S-q-io Rs =" First Inspection and Form Made By; RS r)cv.- _ _ Date: 3'241-i0 Pork Deportment Review Required � YES (]NO PERMIT ISSUED NO, DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: • CODE C — Other° — 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • PROPERTY ADDRESS /6V / / ki&k.bCsGL ST PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E. -.4 AREA NEEDING REPAIR VJ/LLLWWZA L - length of repair needed /� Type of defect t�► (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. " �� nC, I WATER SHUTOFF VISIBLE ❑ BROKEN ❑ MISSING ❑ 4D _ Property A arditnral OF SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER _ C OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET OTHER_L`1 DEPTH OF SIDEWALK ❑ 4 INCHES 0 5 INCHES 6 INCHES AREA TO BE REPAIRED sq.tt. 4 in. sq.tt. 5 in. !_"�"sq.fi. 6 in. CODE F — PATCHES YES 0 NO V, NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. All other areas shall be reooired by reconstruction of ll squares. First Inspection and Form Mode 8y: C— �� Date; f4`' Pork Department Review Required ❑ YES i}NO j /T — i PERMIT ISSUED NO, DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE C — Other• i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS . Si-. g9 a3-Z -1 ®3 -®®Z may® PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V/77,7,1,7A L as length of repair needed Type of defect d (See reverse side for Defect Codes A—F) "7 Z Z (See below for Defect Code C) ADDRESS. ®e14 I WATER SHUTOFF MOLE 0 See BROKEN 0 MISSING ❑ Property Linn 9'0 4' PriPA Newe,1t 5+. 10CATION OF SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER �J • "d OF SIDEWALK 0 4 FEET ❑ 5 FEET 0 5.3 FEET OTHER '6 .1,1218 OF SIDEWALK 12 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 4'�4 eq.It. 4 in. ■q.ft. 5 in. sq.f1. 6 in. CODE F — PATCHES YES [] NO elf NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Mods Sy:__7-6 L C Dale; 3 '2 3-1 Park Department Review Required ❑ YES ❑NO PERMIT ISSUED NO. — DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other. i - f SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS a I e-I S 4-. xI 1.3 _a _g>v3 -Qao ✓ ��� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR VI////l//!A — L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. i �a ' I WATER SHUTOFF L4 UAL*. VISIBLE 0 Lee BROKEN ❑ MISSING ❑ Property tine i c fi LOCATION OF SIDEWALK rizi, FRONT YARD 0 SIDE YARD 0 OTHER, _ yaw OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET In OTHER L1t �! DEPTH OF SIDEWALK 4 INCHES e INCHES 0 6 INCHES AREA TO BE REPAIRED oq eq.11. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES 0 NO Vi NO. OF SQUARES WITH PATCHES NOTE. Argos marked with an - may bn repaired by patching. All other areas shall be repaired by reconstruction of ull squares, First Inspection and Form Mode Ely: W VC _, Dale: 3__ -1O Pork Department Review Required 0 YES IANO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other' • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 01 Q A I Avg.. PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR VT//TI////A L = length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) '*51‹ ADDRESS: 30 J•� Property Line WATER SHUTOFF r) VISIBLE ❑ CAP BROKEN 0 Lo aj e 4 MISSING 0 • LOCATION OF SIDEWALK El FRONT YARD ICI,- SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET f 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 0 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 5'-5;q.ft. 4 in. eq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO C NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. 444-10 First Inspection and Form Made By: ies DG Date: 3-.2 LI 9O Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other „_____- _ SIDEWALKFORM V F W 1 REPAIR SURVEY W PROPER ADDRESS NUMBER - ©y ✓ CONTROL NUMBER------ PARCEL CERT. CODE L' -4LGD AREA NEEDING REPAIR L � length of repair needed - Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) r ADDRESS. WATER SHUTOFF h ..), ' BROKEN 0 4OKEN e/Qj N . _ . , ,\. �4 S)Q1'' , Pro y Linn „...--"_ _____--_ • � 5” 0SIDE YARDQ OTHER-.----r FRONT YARD 0OTHER 2003 OF SIDEWALK 0 S,.y FEET - _ l ''�'" 0 5 FEET Of SIDEWALK PL.- 4 FEET � 6 INCHES •� 5 INCHES 4 INCH X� ,q,tt. 6 in• r�FP H OF SIDEWALK �q.lt. 5 In. .--'-- f 1.pylJq.tt. 4 in. - WITH PINCHES%..- �— AREA TO BE PATCREPAHES NO VI NO. OF g5U YES- U 3� patching. All other Grade CODE F - mrk -r may bn repaired by P o squares. ��I�-'-' Antos marked with on We;ATE' repaired by reconstruct:__ of lull sq -�- sh_tl be Inspection and Fore_ Mode By:___ -__, y --- NO First insp 0 YES Pork Department Review RequiredINSPECTION DATt PERMS ISSUED CONTRACT NO. • • SPECIAL ^SSESSMENt pA?E; �5 '�- UNCOMPLETED. CONTRACT COMPLETION ���,i et —r. � CODE G - other{e-S eit} SIDEWALK REPAIR SURVEY . . . CITY OF WATERLOO FORM iOWA PROPERTY ADDRESS �3 _ 33 ARC .0 4 2 b_ 0j 7 ✓ �ci e ODE �� LEGEND CONTROL NUBER AREA.NEEDING - CERT, tVUtIBER REPAIR • L' .4 L = length Type of repair needed defect _ See reverse side for See below for Defect C ofect Codesde G) q )—� ki, _ \ ADDRESS: _ N ' G _Property Li �i 4' ,, Li Li.3` iddi-I.O'll 1# /L U■6� WATER SHUTOFF ViSt&LE 0 Y CAP 1 u'1 b r r, BROKEN 0 ���,,,` " —-- MISSING ❑ -LS2CA� OF SIDEWALK 0 FRONT YARD SIDE YARD 0 O ALDTH OF SIDEWALKOTHER _ 4 FEET 0 5 FEET OF SIDEWALK 0 5.3 FEET R 4 INCHES0 OTHER ZETB AREA TO 0 5 INCHES BE REPAIRED •NZ,/0 6 INCHES CODE "F — PATCHES --_sq.ft. 4 in. YES 0 `"s9.ft. 5 in. NOTE: marked NO NO. q.ft. 6 in. Areas with OF SQUARESWITH PATCHES s atl be repaired b an E' may be repaired areas y reconstruction of ,` first Inspection and Formfull squares.atching. All other areas �� Park Department Made By: Review Required Date: _r PERMIT ISSUED ❑ YES � NO IF UNCOMPLETED: DATE: LETED: SPEC INSPECTION DATE: CONTRACT SPECIAL ASSESSMENTCONTRACT NO: — CODE COMPLETION _— G Other DATE: SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS -507 D.A K A v . 89 ►3 23- 282— 00 24 • PARCEL CODE • CONTROL.NUMBER CERT. NUMBER LEGEND 1-.1- L' --0-I . AREA.NEEDING REPAIR t/7//07///rI L = length of repair needed Type of defect C) A (See reverse side for Defect Codes A—F) - (See below for Defect Code G) ^i XADDRESS: S07 • ri \ Z iii •I ' LL I ' Property Line V c) %Y!! /ii WATER SHUTOFF VISIBLE ❑ .1 CAP !f BROKEN 0 MISSinG ❑ �AnJKLiNi ST LOCATION OF SIDEWALK Ig. FRONT YARD ❑ SIDE YARD ►t OTHER IZ'r'A>2 WIDTH OF SIDEWALK ►:/ 4 FEET ❑ 5 FEET El 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK g 4 INCHES ❑ 5 INCHES fl 6 INCHES AREA TO BE REPAIRED ‘ q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES El NO NO. OF SQUARES WITH PATCHES — NOTE: Areas marked with an "F may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. y-22-ro eS FirstInspection and Form Mode By: (Y) 6 .EIS Date: 3-ZS-?0 Park Department Review Required ❑ YES (l NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 5) 5 O A 51.- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR rl//%Tl////A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ip ADDRESS: 5 I ,z Property Line �4iJ /4 WATER SHUTOFF VISIBLE ❑ h1 V `s CAP Di BROKEN ❑ QA k ,S,T MISSING El LOCATION OF SIDEWALK ( 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\'gsq.ft. 4 in. q.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO (3I NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: I Y 1 5 � Date: 3)Z.S /i Park Department Review Required ❑ YES [f NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM Cmi' OF WATERLOO, IOWA PROPERTY ADDRESS ZZcj E, Parle_ Ave, 213- 4 _zSa_ oozy/ , 11 PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND 1-..-- L' -0-1 AREA.NEEDING REPAIR i/I/U/////A Sgiv i)t 14,5 L = length of repair needed 1,� 3, Type of defect A 1 (See reverse side for Defect Codes A-F) (See below for Defect Code G) ADDRESS: .T \ CENTEe. a c'A.1i ��17:1- 4t NN� �� Property Line A i 7�;� `�. 11-'S PIA ri WATER SHUTOFF i------, VISIBLE ❑ rn .Ili - CAP ? BROKEN ❑ I F'cor K. Ave . MISSING 0 • LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET ❑ 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK V 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Z52.5 sq,ft. 4 in. gq,ft. 5 in. sq,ft. 6 in. CODE F - PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: > P & Date: 3 4 5 - /0 Park Department Review Required p YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G - Other SIDEWALK REPAIR SURVEY FORM CPI OF WATERLOO, IOWA PROPERTY ADDRESS I v 7 Et ra_ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND f L' AREA.NEEDING REPAIR f///77,///�I L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) X ADDRESS: H0-7 /p< Property Line 9. WATER SHUTOFF VISIBLE ElSi-re eA 1;6' � CRP r 3BROKEN ❑ [ MISSING ❑ I u LOCATION OF SIDEWALK I FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET E. 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES El 6 INCHES AREA TO BE REPAIRED 7Z , I sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑, NO 1:21 NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: -5 Date: 3-2-3 "It) Park Department Review Required ❑ YES JE1 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA Z PROPERTY ADDRESS y®7 E. Park_ Ru c_. gg -2A- 3s £oS I z5� • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND ke— L' AREA.NEEDING REPAIR ► I//77777A L = length of repair needed Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 0 Club (14 t Property Line •1 WATER SHUTOFFF-3 VISIBLE Q ' '� CAP 1I BROKEN ❑ — r) MISSING El t� LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK 0 4 FEET ❑ 5 FEET 5.3 FEET 0 OTHER DEPTH OF SIDEWALK In' 4 INCHES ❑ 5 INCHES 6 INCHES AREA TO BE REPAIRED 53 %. sq.ft. 4 in. sq.ft. 5 in. 2-6°S sq.ft. 6 in. CODE F — PATCHES YES ❑ NO CZ1, NO. OF SQUARES WITH PATCHES —. NOTE: Areas marked with an "F" may be repaired by patching. All other areas • shall be repaired by reconstruction of full wares.First Inspection and Form Made By: S Date: $ ' 2 tom` Park Department Review Required D YES J] NO -PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: . CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS Z o j:7 R-RK • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR VI//777 7A L = length of• repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) XADDRESS: 4`LI Property Line WATER SHUTOFF HVISIBLE El A CAP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK Ye FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET I ! 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK El 4 INCHES [K 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. Z'3�< q.ft. 5 in. q.ft. 6 in. CODE F — PATCHES YES ❑ NO kl NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: mg 6 Date: 5-Z5 -JO Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 2c:)C 8 ; , e-K Qd S9 13 -23 =266- ® a PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --� AREA.NEEDING REPAIR r/7//777777A L = length of repair needed r Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) trj to ADDRESS: Cr) 11, it Property Line 14'14 , f 17. WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK FRONT YARD 134 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 8 4 FEET ❑ 5 FEET Cg. 5.3 FEET ❑ OTHER_ DEPTH OF SIDEWALK TZ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 9O.2 q.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO t NO. OF SQUARES WITH PATCHES - NOTE: Areas marked with an "F" may .be repaired by patching. All other areas shall be repaired by reconstruction of full squares. sl _/p Rs First Inspection and Form Made By: /fib ' g5. Date: 3-OS-)0 Park Department Review Required 9�y] YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS L/oa B JD c>~ Pa r K - g_a 13 --2. -2,g 2-o 1 3 258 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR twizfYiwii L am length of repair needed Type of defect rn I (See reverse side for Defect Codes A—F) See below for Defect Cod. C) ADDRESS. I I PC- ! WATER SHUTOFF \ VISIBLE ❑ SQL' BROKEN ❑ MISSING ❑ CJ 9 •.5 Property Line PC.f-u, Qd _LOCATION OF SIDEWALK gI FRONT YARD ❑ SIDE YARD ❑ OTHER lagTh OF SIDEWALK ❑ 4 FEET ❑ 5 FEET D 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES ,tif 6 INCHES AREA TO BE REPAIRED - =q.ft. 4 in. eq.ft. 5 in S66•4q.tt. 6 in. — CODE F — PATCHES YES ❑ NO 0 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made Ely: m(3 BS Date; 3-1-5 Park Department Review Required CI YES 1521.140 PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO CONTRACT COMPLETION DATE: CODE C — Other I T SIDEWALK REPAIR SURVEY FORM CITY PE WATERLOO, IOWA c--PROPERTY ADDRESS 2,) • PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND L' AREA NEEDING REPAIR TIZZIWWW.1 L mt length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. WATER SHUTOFF VISIBLE . LSE BROKEN — • MISSING 0 — Property Lin /1 e 5.41 LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER SIM OF SIDEWALK 0 4 FEET 05 FEET 0 s.3 FEET OTHER 51ki DEEM OF SIDEWALK VI 4 INCHES 0 5 INCHES 0 6 INCHES ;xi,a-tie AREA TO BE REPAIRED 4 in. t. 5 In. ___—sg.ft. 6 in. CODE F — PATCHES YES 0 NO 0 NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. Ali other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: L- _' Date; Pork Department Review Required 0 YES M NO — PERANT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • PROPERTY ADDRESS. . (Ito &I o c K) u i i1 cy PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND 1� -04 AREA NEEDING REPAIR WILIZ1W A _ L Ea length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) — LA ADDRESS. I — l ,L 4 IU-r- I WATER SHUTOFF \ VISIBLE ❑ \\ �'" sere BROKEN 0 MISSING ❑ Property Linn r _ LEA ) 1 f 5i ' • - �u LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 ilf2th OF SIDEWALK 0 4 FEET 5 FEET 0 5.3 FEET 0 OTHER — DEPTH OF SIDEWALK g 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 475'—sq.tt. 4 in. -■qat. 5 in. ■q.H. 5 in. • CODE F — PATCHES YES ❑ N0 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. All other areas — shall be repaired by reconstruction of full squares. First Inspection and Form Made 6y: Dais: _ ` 10 Pork Department Review Required ❑ YES 'NO PERMIT ISSUED NO. — DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: 4 CODE G — Other i — • • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. 10S_ Okiv.c1 5--)H • s k 3_ILI i 05 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND U AREA NEEDING REPAIR VZ17./ZIMA L m• length of repair needed Type of defect (See reverse aide for Defect Codes A—F) (See below for Defect Dods C) ADDRESS. IC/6 WATER SHUTOFF %imam • . Lee BROKEN 1_1 . MISSING 0 Property Line tz/f, 5. \ (i\v„. LOCATION OF SIDEWALK 03. FRONT YARD 0 SIDE YARD 0 OTHER Mai Of SIDEWALK 0 4 FEET 5 FEET 0 5.3 FEET 0 OTHER Will OF SIDEWALK 0 4 INCHES l) 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ---sq.lt. 4 in. --sq.ft. 5 in. ______sq.fl. 6 in. CODE F — PATCHES YES 0 NO T;71 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with en -r may be repaired by patching, All other areas • shall be repaired by reconstruction of full squares. Te 3 to First Inspection and- Form lAads Li-' Dale: Park Department Review Required 0 YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL. ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other- 1 • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS . i a i (.)\MIN -t—„ e 13—. `f —LQ3 _OLS ; 3 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND L. AREA NEEDING REPAIR VIIIfIIIlIA l length of repair needed A Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) -4(-- ADDRESS. I a t vistaWATER SHUTOFF - \ . . BROKEN 0 MISSING 0 61.1+ Property line \ . . tilInC ) LOCATION OF SIDEWALK 'f J FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK ❑ 4 FEET s FEET 0 5.3 FEET 0 oTHER DEPTH OF SIDEWALK ttl 4 INCHES 0 5 INCHES 0 6 INCHES pp / AREA TO BE REPAIRED I.S■q.tt. 4 ;n. •q.ft. 5 in. ■q.ft. 6 in. - CODE F - PATCHES YES 0 NO tg NO, OF SQUARES WITH PATCHES • NOTE. Areas marked with on -r may be repaired by patching. All other areas • shall be repaired by reconstruction of full squares. - First Inspection and Form Mode By:_- ( Date; 3 -J3 -1 0 Pork Department Review Required if YES 0 NO - i PERMIT ISSUED NO. DATE: INSPECTION DATE: • • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• _ • CONTRACT COMPLETION DATE: • CODE C - Other I • . I I i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 331 S q>c o n fit. 43g i ?H - 15 - 007 2 Li PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND Imo- L' --".4 43 AREA.NEEDING REPAIR I'//7/7/////4 a41 c; L = length of repair needed • ©a Type of defect AIG (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 3 39 +7 Property Line WATER SHUTOFF VISIBLE [] CAP _y BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD M. 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 6,8.Q sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. • CODE F — PATCHES YES ❑ NO g NO. OF SQUARES WITH PATCHES — NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: TE LC.' Date: Park Department Review Required a YS ❑ NO .PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other Po f eni-ZaE r tale ceoexexi+ Q C sId e w a.IK c -Free, rerc-;s a+� preaerl- as -V-er••i; ne_a h f C14y Egg,neflr, SIDEWALK REPAIR SURVEY FORM ' CITY OF WATERLOO. IOWA V PROPERTY ADDRESS . 14 dg _Sc)0)14 S+. • — PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND 1-0 L' AREA NEEDING REPAIR UIIZZIWZ'A L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) — +- LI ADDRESS. O I ( WATER SHUTOFF — VIS�LE ❑ _ • BROKEN ❑ \ . 1 ( 4___,,ki,\,...___,. MISSING ❑ _ Property Unit r _ _ CtzAO WALK — SXin 1Q MQN OF SIDEWALK V_ FRONT YARD 0 SIDE YARD 0 OTHER j OF SIDEWALK 0 4 FEET 15 FEET 0 5.3 FEET 0 OTHER _• iszjH OF SIDEWALK tigt 4 INCHES 0 5 INCHES 0 G INCHES AREA TO BE REPAIRED _aq.ft. 4 in. ■q.ft. 5 in. ■q.11. 6 in. CODE F - PATCHES YES 0. NO WI NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by potching. All other areas shall be repaired by reconstruction of full suouoreei. First Inspection and Form Made By: - Date: `3 if-f 0 Pork Department Review Required 0 YES `�NO — PERMIT ISSUED NO. ._ DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0• _ — CONTRACT COMPLETION DATE: i CODE G - Other 1 I SIDEWALK REPAIR SURVEY FORM CIII QF WWTERLQO. IOWA PROPERTY ADDRESS f 33 ,& ``,t; -; 3 _ 't: { 5 _ pO Z6; PARCEL CODE CONTROL NUMBER, CERT. NUMBER ff LEGEND L' AREA.NEEDING REPAIR r//! A �1 L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ‹?— c3 >f< ty� v ADDRESS: Li 3 Property Line --( WATER SHUTOFF VISIBLE ❑ I j BROKEN ❑ " MISSING 0 J . t 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 aq.ft. 4 in. oq.ft. 5 in. cq,ft. 6 in. • CODE F — PATCHES YES ❑ NO ( NO. OF SQUARES WITH PATCHES 1 NOTE: Areas marked with an "F" be repaired by patching. All other areas shall be repaired- by reconstruction of full squares. ,i— (0 "Tr, First Inspection and Form Made By: Date: 1 Park Department Review Required 'J YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . /3 `.s- 44.d3 iJ3 - - $2/3 -a-z±--00.z- ZZO PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom' L. AREA NEEDING REPAIR - 177ifl777ilA L N length of repair neede5� Type of defect �ftt (See reverse side for Defect Codes A-F) (See below for Defect Code C) Xfo•- ADDRESS. /3O I EilC k( eor GOT WATER SHUTOFF VISIBLE ❑\ . _ sae BROKEN ❑ MISSING 0 S7/PµP /� C/ Propirfy Line ._ 4 rl r S-0 ----v- . _ UPc4 S-r. LOCATION OF SIDEWALK p FRONT YARD 0 SIDE YARD 0 OTHER Elpill Of SIDEWALK `I 4 FEET 0 5 FEET CI5.3 FEET 0 OTHER _ DomOF SIDEWALK rt. 4 INCHES 0 5 INCHES 0 6 INCHES . I AREA TO BE REPAIRED Z " eq.tt. 4 in. ■q.tt. 5 in. ■q.ft. 6 in. - CODE F - PATCHES YES 0 NO [, NO. OF SQUARES WITH PATCHES NOTE. Arsas marked with an -ray be repaired by patching. All other urea/ - shall be repaired by reconstruction of full ■quoros. y -- first Inspection and Form Made B Me 53 Dote: 3-Z5-I' P L Park Department Review Required [� YES 0 NO �`� -Ma '/O _ 1 �l PERMIT ISSUED NO. DATE:, INSPECTION DATE: ' I IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO - CONTRACT COMPLETION DATE: CODE G - Other. 1 I • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. ° I 5i ( v r S9L3-Z3- Ys1-o io ✓ Z7� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR t'rziizmiza L •• length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. e ' I WATER SHUTOFF Lee BROKEN ❑ MISSING 0 • I _ Property Line y J/i LOCATION OF SIDEWALK Pg. FRONT YARD ❑ SIDE YARD ❑ OTHER ItEIH OF SIDEWALK 0 4 FEET 0 5 FEET JD 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 0 4 INCHES 0 5 INCHES 1:8 6 INCHES g%r- AREA TO BE REPAIRED ■q.tt. 4 :n. ■q.il. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO [J; NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -C may be repaired by patching. All other moos shall be repaired by reconstruction of full squares. — first Inspection and Farm Made By: +�` G Date; �i Z`I ' l L' Pork Department Review Required 0 YES ZNO PERMIT ISSUED NO... DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' _J:, CONTRACT COMPLETION DATE: CODE C — Other -_ J 1-- SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA (ioo efocK) PROPERTY ADDRESS S y cct rn o - Z73 PARCEL CODE CONTROL NUMBER CERT. NUMBER _ LEGEND E' f AREA NEEDING REPAIR U1,7,77MA Vv L length of repair needed CVO Type of defect (See reverse side for Defect Codes A—r) (See below for Defect Code C) _ 'SINE ADDRESS. I ! WATER SHUTOFF \ VISEI E ❑ BROKEN ❑ MISSING 0 Property line S ; c .Aee SA-. j,QrianQN OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER ydni OF SIDEWALK 0 4 FEET 0 5 FEET C51. 5.3 FEET 0 OTHER OF SIDEWALK E34 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Z6S._IN A. 4 Sn. ■q.it. 5 in. ■q.il. 6 in. CODE F — PATCHES YES 0 NO ❑ NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. Ali other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By:Y_1(5 Dale; '5 Z S I 0 Pork Department Review Required YES ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: • CODE G — Other i • 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA (/oo Q ior, ) PROPERTY ADDRESS . St C Qrvi o re_ s.4 . - i 13 - 2-3—a,z —.Q1Li 'O Z7 PARCEL CODE CONTROL. NUMBER CERT. NUMBER LEGEND - L' -►� ���� - AREA NEEDING REPAIR U/tl/ W7A �C1" L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) ADDRESS. I I � I G�Co.IN 1 WATER SHUTOFF \ VISIBLE ❑ . • faile BROKEN ❑ MISSING ❑ q3s Property Line • LOCATION OF SIDEWALK 54 FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET 0 5 FEET It 5.3 FEET 0 OTHER DEPTH OF SIDEWALK C 4 INCHES 0 5 INCHES [] 6 INCHES AREA TO BE REPAIRED 227.9 ■q-tl. 4 in. ■q./t. 5 in. ■q.ft. 6 in. _J • CODE F - PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an 'f.. may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made Ely: �5 Dote: 3"Z5 -ID Pork Deportment Review Required IR YES ❑NO PERMR ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0. CONTRACT COMPLETION DATE: CODE G - Other • Ii ( SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 02-00— y Cc pAc,e S+z .$_`113 - Z23- '4%1- ot) 1 V Z7 PARCEL CODE CONTROL NUMBER b'� a.�Q CERT. NUMBER ff LEGEND t"— L' —a-I • _ AREA.NEEDING REPAIR t////ITl// L = length of repair needed Type of defect aTM1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) >1<ii, ADDRESS: ---4:' _ OIL„` Property Line — ^ S,L, 7 — L, WATER SHUTOFF J 0VISIBLE ❑' r---),/ BROKEN ❑ MISSING ❑ '5 I Ca;"tre_ Si-• LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF.SIDEWALK El 4 FEET 15 FEET a 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES X 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in, sq.ft. 5 in. /05-J 7 sq.ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES — NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: R S D Cc Date: 1 `2 q`10 - Park Department Review Required El YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: — 1F UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: — CODE G — Other SIDEWALK REPAIR SURVEY FORM — CITY OF WATERLOO, IOWA 1D PROPERTY ADDRESS 300 ,S ca M Q re_ ' S-, — 8ci/ 23 _y%i_ obz ✓ z77 PARCEL CODE CONTROL NUMBER CERT. NUMBER — t a- , ` Dta LEGEND Im-- L' — 4 ° ' t2' AREA.NEEDING REPAIR V//lZT//7 v) \r`. 1.:0 1, — L = length of'repair needed ° Type of defect AI G ��,‘ — (See reverse side for Defect Codes A—F) ° (See below for Defect Code G) ���`�C ��� �• 4. >r ADDRESS: I fl Pcs 0cc7C-e- d ' 3 Property Line .5'5 x `h WATER SHUTOFF — 7 VISIBLE ❑ CAP ., ri BROKEN ❑ MISSING 0 3rd SA-. LOCATION OF SIDEWALK -Q] FRONT YARD [SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET - ❑ 5.3 FEETTHER _ DEPTH OF SIDEWALK IS[ 4 INCHES 0 5 INCHES 6 INCHES — AREA TO BE REPAIRED 3`k,.-- sq.ft. 4 in. sq.ft. 5 in. We° sq.ft. 6 in. CODE F — PATCHES YES 0 NO [A NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of//full squares. . First Inspection and Form Made By: e%- .D Date: 3' 2 z1- go — Park Department Review Required j) YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: . SPECIAL:ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G — Other SIDEWALK REPAIR SURVEY FORM 0 CITY OF WATERLOO, IOWA 2- PROPERTY ADDRESS 300 S cc.�i-i a re_ ( PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR I//////7,VZ L = length of repair needed t _ Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) ADDRESS. I U IdS - OcCk' I WATER SHUTOFF VISIBLE ❑ SSE BROKEN ❑ _s- MISSING 0 62,0 Io2 6'` Property Line 014 LOCATION OF SIDEWALK E] FRONT YARD El SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET Lg.Cg. 5 FEET ❑ 5.3 FEET rits.OTHER — DEPTH OF SIDEWALK ip 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED I2 sq.ft. 4 in. .___ eq.ft, 5 in. sq.ft. 6 in.CODE F - PATCHES YES [,� NO rt NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: R -is) C— Date: 3.-241_ 10 Park Department Review Required ❑ YES NO PERMIT ISSUED NO. - DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , - CODE G - Other ____- SIDEWALK REPAIR SURVEY FORM of CITY OF WATERLOO, IOWA _ PROPERTY ADDRESS 300 Cc( OfF0ce -Si- t PARCEL CODE CONTROL NUMBER CERT. NUMBER _ LEGEND L' _'4.--1 AREA NEEDING REPAIR f/fllWWZZA L = length of repair needed Type of defect A (See reverse side for Defect Codes A—F) (See below for Defect Code G) -- Kit ADDRESS. i I p o -' o c c i C e✓ WATER SI IUTOFF VISIBLE SF nc o BROKEN �+ �,v, h __.____e _.._.e hj MISSING 0 \r Property Line t "fit 6," \b1+ t) Sycamre fit_ _ LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD ® OTHER ._ yfim OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET 151 OTHER ___ DEPTH OF SIDEWALK [ 4 INCHES 0 5 INCHES Di 6 INCHES �`i�3�o+.i�o ✓ AREA TO BE REPAIRED '3_Z.U" sq.f1. 4 in. __.___eq.ft, S in. 33, sq.ft. 6 ire. L'•Q �a1/4-1 I+ CODE F — PATCHES YES 0 NO [i NO. OF SQUARES WITH PATCHES_ NOTE. Areas marked with on "F' may bra repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: ,.,,,R Date: - 2 q-I 0 Park Department Review Required ] YES 0 NO PERMIT ISSUED NO._ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4 5'Y N V/7— &off ✓ 07.E - PARCEL CODE NTROL NUMBER CERT. NUMBER T LEGEND L' ,n AREA.NEEDING REPAIR Il////l////A L = length of repair needed n Type of defect f J" (See reverse side for Defect Codes A—F)(See below for Defect Code G) ,K ADDRESS: 1 Pet f Property Line WATER SHUTOFF VISIBLE ❑ Di CAP BROKEN ❑ �' MISSING ❑ r CA 141,Ofe— �, 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 'L. jq,ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: Ps .b Date: 3 - 0 Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO, IOWA PROPERTY ADDRESS 1 3 ' c C it e ce: S± PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km— L' --4w4 • _ AREA.NEEDING REPAIR ►//I777i7//A .. L = length of'repair needed Type of defect A I G (See reverse side for Defect Codes A—F) — • (See below for Defect Code G) - X ADDRESS: 1, L. ��3`14` I AO o -"‘°r 1 �, .\a Ac � `0 �° + ,,,.. t > ti a, (7.0 ? +, \,14, Prope Line _� A WATER SHUTOFF VISIBLE ❑ 1-----) CAP BROKEN 0 ea •.��(j E_ . r a . MISSING El�,, 3 Si'. •..... LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF-SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET jJ OTHER _ DEPTH OF SIDEWALK 8 4 INCHES 0 5 INCHES ❑ 6 INCHES 0 yP W'-" AREA TO BE REPAIRED •IL L sq,ft. 4- in. .ft sq.ft. 5 in. sq . 6 in. 77`„ vauu'T CODE F — PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES — NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: re-_,--› . bG Date: ? Z 5 to •Park Department Review Required 0 YES 121 NO 'PERMIT ISSUED NO: DATE: INSPECTION DATE: — IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G — Other 3c,;n\ 5e -' G11"3v&d VCuik-- SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. c2ZI hlk 5 y04/ Wier .577 PARCEL CODE CONTROL NUMBER CERT. NUMBER -- LEGEND L' AREA NEEDING REPAIR L - length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. I I WATER SHUTOFF VISIBLE ❑ J BROKEN 0 MISSING 0 5.17(5 Property tine 5 C_Arnik�=-c =alai OF SIDEWALK El FRONT YARD 0 SIDE YARD 0 OTHER j OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET Kig OTHER DIEM OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 3Z2O ■q.tt. 4 in. ■q.ft. 5 in. sq.ft. 6 in. — CODE F — PATCHES YES ❑ NO e NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may bet repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Mode By:—� �5 Dais; '"23.._d 0 • Pork Department Review Required YES at NO PERMIT ISSUED NO, DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO CONTRACT — CONTRACT COMPLETION DATE: 4 CODE G — Other i . ; • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS rjGr7 b/k SyG4NI�J,P - ST" qi3_2. _ fOi _009 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1 1 AREA NEEDING REPAIR vrlliffiiit L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I I WATER SHUTOFF E D. VISIBLE ❑ BROKEN 0 r MISSING 0 Property Line • 5y cctMa.-� eta LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER am OF SIDEWALK ❑ 4 FEET 0 5 FEET ❑ 5.3 FEET I OTHER DEPTH OF SIDEWALK 15:( 4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED `q q.ft. 4 ;n. ■q.it. 5 in. 6 in. CODE F — PATCHES YES [] NO [ NO. or SQUARES WITH PATCHES NOTE. Areas marked with an -F. be repaired by patching. All other areas shall be repaired by reconstruction of full squares, first Inspection and Farm Made By:_Y S Dale: 3 s. Z , (C) Pork Department Review Required 0 YES t7I NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0' CONTRACT COMPLETION DATE: CODE G — Other: —i I If SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS coS --Sy-cct,,,.Ie,re— 3 — , � L .2 _ 1G� cad ✓ &O.Z PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR I/T/777777/A L = length of repair needed A c Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) a ADDRESS: 50 0 e r-j-3 S 1 WA Property Line ‘ WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING El �yecn�e� .S4, LOCATION OF SIDEWALK ❑ FRONT YARD IA SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET El 5.3 FEET gl OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 17Z,0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO `I NO. OF SQUARES WITH PATCHES — NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: fa_'-, D G Date: j` 03_, ID Park Department Review Required ❑ YES ® NO PERMIT ISSUED NO: DATE: INSPECTION DATE: — IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA . � PROPERTY ADDRESS M S cavvke r 3 - - Zy=Zc11 - Q1 0 ✓ Z85 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --0-1 AREA-NEEDING REPAIR V/77777/7/A L = length of repair needed G Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) k>l< ADDRESS: --CO ii �i(z04's 8 ict,v 4.1 Property Line WATER SHUTOFF VISIBLE ❑ CAP r751 } BROKEN ❑ i MISSING ❑ 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 V cw I A" T o p AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. ,IL,° "Jaul�- CODE F - PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: R.5 D Date: 3_2 3-/0 Park Department Review Required ❑ YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other \J Q 4 1 SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO, IOWA PROPERTY ADDRESS 6�) I ,SC- Cr ell G r� 5`f-- a • PARCEL CODE CONTROL NUMBER • CERT. NUMBER . LEGEND L' -0-1 AREA.NEEDING REPAIR V77///////A L = length of repair needed Type of defect G (See reverse side for Defect Codes A—F) • (See below for Defect Code G) kc" ADDRESS: 5o I + �1 ,e?1‹ 7 � v� �}�t r�`�rop�rtpLine !/S` km Imo,-i-io+ ci, ,'�c• d.)4.. • `i,45..0 t•t ZIN WATER SHUTOFF VISIBLE 0 e. CAP " BROKEN ❑ MISSING ❑ E. , PRr k Avc. . LOCATION OF SIDEWALK ❑ FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ' ❑ 5 FEET • ❑ 5.3 FEET Igi, OTHER _ • DEPTH OF SIDEWALK g 4 INCHES 0 5 INCHES ❑ 6 INCHES Vcu i+ T f' — ✓' ✓ AREA TO BE REPAIRED 242 S sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. to`I.S Vt u t CODE F — PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. . First Inspection and Form Made By: e S Cr Date: 2) 2 3` 10 Park Department Review Required D YES R NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other V at ‘ A -ref refQ.cyr SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS ZG9 6/k T7hMP5a,cd ,4NE• rI3 23- 1-13y- 01.6 ✓ .i;34 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -81-1 - AREA.NEEDING REPAIR V///777///A L = length of repair needed q� Type of defect }`-� (See reverse side for Defect Codes A-F) J (See below for Defect Code G) a A ADDRESS: a �`� /2*--- 1 G< ctA , LoA- u v ,5-I a Property L — _ ✓ . _ — ✓� WATER SHUTOFF VISIBLE ❑ CAP • \ BROKEN ❑ MISSING 0 7"ti cv,,,c,s ev,, Ave. LOCATION OF SIDEWALK ❑ FRONT YARD Et SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET X 5.3 FEET ❑ CTHER _ DEPTH OF SIDEWALK rg 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED -514•I q.ft. 4 in. Sq.ft. 5 in. cq,ft. 6 in. CODE F - PATCHES YES ❑ NO 1% NO. OF SQUARES WITH PATCHES_- . NOTE: Areas marked with an "F" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: �'-a D (-:` Date: 3 "2 Li _)Cl Park Department Review Required Igi YES 0 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other SIDEWALK REPAIR SURVEY FORM • CITY OF WATERLOO. IOWA 30o .Block PROPERTY ADDRESS /h a ,v, son Ave.; • - PARCEL CODE CONTROL NUMBER CERT. NUMBER `K IA LEGEND f•-• \t?OY" .-t f AREA NEEDING REPAIR Vllllll/I/�i ,tr i'� L M. length of repair needed Type of defect j (See reverse side for Defect Codes A—F) 3 LI (See below for Defect Code C) ADDRESS. I f I WATER SHUTOFF \ Q ! VIS�LE \\♦ • LAE BROKEN ❑ MISSING 0 30 I — Property Li ler T 11G•N‘ps,y . Pe- LOCATION OF SIDEWALK a FRONT YARD 0 SIDE YARD ❑ OTHER . D OF SIDEWALK ❑ d FEET ❑ 5 FEET SZ 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK Er 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 1Si' q ft. 4 in. •q.lt. 5 in. _ ■q.ft. 6 in. CODE F — PATCHES YES ❑ NO 0 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F may be repaired by patching. All other areas _. shall be repaired by reconstruction of full squares. .; First Inspection and Form Mods By: J h) 6, Date; _3`"2 tl-1 b Park Department Review Required O7�YES ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: la IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE C — Other. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY. ADDRESS . .; iq •T hc;wfscr. Ave ,, iZ - As {a_Z3- 4.35-0ii Ztf37 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR wrzi W.fiA ,_, y _ L � length of repair needed r Type of defect f i---�' (See reverse side for Defect Codes A—F) (See below for Defect.Code C) AEADDRESS. 3 `I f — I f WATER SHUTOFF VISIBLE 0 . \ . Lee BROKEN .❑ u MISSING 0 p rty Line 0 )/ e.2 . .1- I\G,".. ,,5 cNek P v LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER jmad OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 0 OTHER IMEIU OF SIDEWALK +5A.4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 159'O q.ft. 4 ;n. ■q.ft. 5 in. sq.ft. 6 in. _t CODE F — PATCHES YES 0 NO 0 NO. Of SQUARES WITH PATCHES— 1 NOTE. Antos marked with an - may be repaired by patching. All other urea* shall be repaired by reconstruction of full squares, First Inspection and Form Mode 8y._ R_S 10�7 _ Date;• _ 3 2 —� Park Department Review Required YES 0 NO PERMIT ISSUED NO. DATE: _ INSPECTION DATE: • SPECIAL ASSESSMENT CONTRACT NO. J. IF UNCOMPLETED. SCONTRACT COMPLETION DATE: 4 CODE G — Other. i I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . : J`- Lh,`; ttnut PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND t''" L' AREA NEEDING REPAIR VffffllfffA I - length of repair needed 11. Type of defect r (See reverse side for Defect Codes A-F) (Sea below for Defect Code C) ADDRESS. i 11 — l WATER SHUTOFF n VISIBLE 0 \ . ii:V1 silk BROKEN 0 MISSING 0 . :-:_.. Property Line j 1 1"/ . 0� L Of.aal OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER AQD OF SIDEWALK 0 4 FEET 0 s FEET 0 5.3 FEET OTHER DEPTH OF SIDEWALK It 4 I✓✓N//CHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED °`S�q.ft. 4 in. ■q.ft. 5 in. ■q.ft. S in. - CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an - may be repaired by patching. All other areas shall be repaired by reconstruction of.full guars. _,, -ci First Inspection and Form Made By: t ` -- _ Dale: L. • Pork Deportment Review Required 0 YES ` NO — i PERMIT ISSUED NO. DATE: INSPECTION GATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: • CODE G — Other• 1 • i '..—: i- 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 3 U Al i,i- $ \- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-0— L' AREA NEEDING REPAIR vi1Z&Yf7ia L. N. length of repair needed a Type of defect / , (See reverse side for Defect Codes A—F) See below for Defect Code C) ADDRESS. �'3 R I i WATER SHUTOFF VISIBLE ❑ Si5P BROKEN ❑ MISSING 0 • Property Line /1 t 5.0 • tit)('-.A 12C,8110 OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Yani OF SIDEWALK 0 4 FEET 0 S FEET th 5.3 FEET 0 OTHER DEPTH OF SIDEWALK r 4 INCHES 0 5 INCHES 0 6 INCHES �G AREA TO BE REPAIRED '5■q.tt. 4 in. .q.tt. 5 in. •q.ft. 6 in. CODE F — PATCHES YES ❑ NO g.1 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an - may be repaired by patching. Ali other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: __ Date; Park Deportment Review Required 0 YES NO PERMIT ISSUED NO, DATE: INSPECTION DATE: 1 IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE G — Other ji'i —t C SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS LH S WA(it1t c Ski i g2-I3 _ 31 3_ coi v Z ) 7 _ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —04 ` r AREA.NEEDING REPAIR VI7/,27Z 1 L = length of repair needed , I! 3 Type of defect 1 See reverse side for Defect Codes A—F) (See below for Defect Code G)>iii‘t LJJ y� h ADDRESS: 1 ` S c-' \ SE 75\;41cip operty Linq ,V�//%�'// f/ // ;//( WATER SHUTOFF (1I f r j� I J(l�C>1 VISIBLE 0 /11(c.) ta'O1 3,5 N CAP l 5 y n r / BROKEN ❑ MISSING 0 LOCATION OF SIDEWALK ;} FRONT YARD 0 SIDE YARD cgrt OTHER t=,+ksi dQ WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET /5.3 FEET I J OTHER 51t l DEPTH OF SIDEWALK NI 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 0_�q,ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO 'MI NO. OF SQUARES WITH PATCHES -- NOTE: Areas marked with an "F' may be repaired by patching. All other areas shall be repaired by reconstruction of fulls uares. First Inspection and Form Made By: 1` LC Date: 3 ~a4 -1 Park Department Review Required 0 YES 0 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: "" IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: — CODE G — Other • • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 3(j I1/4)?4/14Li'i 1 t, • ticii 3 41-19 a _oL . ✓ • 300 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L` AREA NEEDING REPAIR W 'Uiif. L • length of repair needed A Type of defect See reverse side for Defect Codes A—F) (See below for Defect Cods G) ADDRESS. .303 I I WATER SHUTOFF VISIBLE ❑ \ • sit _ BROKEN ❑ MISSING ❑ Propertyne OF' SIDEWALK WI FRONT YARD 0 SIDE YARD 0 OTHER NUM OF SIDEWALK 0 4 FEET . 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 G INCHES AREA TO BE REPAIRED .. sq-t1. 4 ;n. ■q-ft. 5 in. =q.fl- 6 in. CODE F — PATCHES YES [] NO Ia. NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an -r may bit repaired by patching. All other areas _ shall be repaired by reconstruction of full squares. First Inspection and Form Made Ely: 1.c • Date: 3- ± -'o • Park Department Review Required YES ❑NO PERMIT ISSUED NO. ._ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: 4 CODE G — Other • • I .. ..... SIDEWALK REPAIR SURVEY FORM ...... CITY OF WATERLOO, IOWA PROPERTY ADDRESS 30ii VJ-ziActh 0-..., . . • - — 9 _ -Li ' ., 13 ___ Loi_ooi i 30f PARCEL CODE CONTROL NUMBER CERT. NUMBER — ° LEGEND -0- L' -*-1 AREA NEEDING REPAIR V7ZIZZZIZZA — L 4. length of repair needed A Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) — **--- ADDRESS. •-)‘-.." I WATER SHUTOFF \ VISIBLE 0 . Lee ..... BROKEN 0 • MISSING El I Proihrty Line — ! . 5.0 5•C' .• .- CD .k/IkIl 4'1, -t 1 Ck- LOCATION OF SIDEWALK ISEI FRONT YARD 0 SIDE YARD 0 OTHER Inglii OF SIDEWALK 0 4 FEET I 5 FEET 0 5.3 FEET 0 OTHER .- maul OF SIDEWALK -1P 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 5 _ sq.ft. 4 in. —sq.ft. 5 In. ___--sq.11. 6 in. .- CODE F - PATCHES YES 0 NO 131. NO. OF SQUARES WITH PATCHES / • NOTE. Areas marked with on -r may bn repaired by patching. All other areas ' shall be repaired by reconstruction of full squares. ' - First Inspection and Form Made By . .., Date: ,• - • : it' Lk/ .•: Park Department Review Required yl YES Ei NO — i PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. ..... CONTRACT COMPLETION DATE: 1 ! CODE G - Other i i . ... I . .. It ! — - . 1 SIDEWALK REPAIR SURVEY FORM CI.TY OF WATERLOO. IOWA PROPERTY ADDRESS 3 e-11 PARCEL CODE CONTROL NUMBER " CERT. NUMBER LEGEND +— L' — • AREA.NEEDING REPAIR T//77/////ZA L = length of repair needed Type of defect ( l (See reverse side for Defect Codes A—F) • ((See below for Defect Code G) V ' >4‹ ADDRESS: Prop t Une �'%I'1 WATER SHUTOFF VISIBLE ❑ (1:1 CAP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET is'5 FEET ❑ 5.3 FEET ❑ OTHER _ .DEPTH OF.SIDEWALK i 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 NOTE: Areas marked with an "r may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: �C. Date: 3—1 i— 0 Park Department Review Required YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: _ CONTRACT COMPLETION DATE: CODE G — Other