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HomeMy WebLinkAboutCOST ESTIMATE PLATS F.Y. 2011 SIDEWALK REPAIR PROGRAM ZONE 10 SIDEWALK REPAIR COST ESTIMATE PLATS SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • ZS eL ST 5-1-1 PROPERTY ADDRESS /12�' �; �;t---5, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - AREA.NEEDING REPAIR V/7/77//77A L = length of•repair needed kp Type of defect !t C (See reverse side for Defect Codes A—F) • ((See below for Defect Code G) *lir ADDRESS: ! 8 I V ' Property Line N i ®Et4 f\ T I WATER SHUTOFF VISIBLE ❑ F-3 CAP BROKEN ❑ „ s St 51 MISSING El LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ►l 5.3 FEET ❑ OTHER — DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES De.„6 INCHES AREA TO BE REPAIRED Gq.ft. 4 In. sq.ft. 5 in. 33,Ssq,ft. 6 in, CODE F — PATCHES YES ❑ NO tg 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 . G Date: 3 -2S-I Q Park Department Review Required ❑ YES SI, 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 . Za9 171k I Sr 31; - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-8-- L' AREA NEEDING REPAIR vl77iii17/7 t L so length of repair needed Type of defect A-11✓ O+ L' (See reverse side for Defect Codes A-F) (See below for Defect Code C) ADDRESS. I pCxv-v WATER SHUTOFF VISIBLE [] BROKEN ❑ MISSING 0 cst Property Line LOCATION OF SIDEWALK 54 FRONT YARD 0 SIDE YARD 0 OTHER maw OF SIDEWALK 0 4 FEET ❑ 5 FEET 1E4.3 FEET 0 OTHER DEPTH OF SIDEWALK 0 4 INCHES ❑ 5 INCHES \6 INCHES AREA TO BE REPAIRED ■q.tt. 4 in. sq.lt. 5 in.Z9I �sq.ft. 6 in. CODE F — PATCHES YES [] NO [ NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an - may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares. • first Inspection and Form Made By:_ _ S .. _ Date: 3 -as- -I Z 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 202- • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' AREA.NEEDING REPAIR r7///7/////Ai L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 20 2- 4-4-"( I isX 70,0 ' // /_/Property/Line /> 5.0 '///7///(7/w/`�f//04 / �� WATER SHUTOFF VISIBLE ❑ CAP 0BROKEN ❑ t J S 4- SIT , 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 X 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 In. '.4 T7 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: 6--S . Date: 3 -ZS-1O Park Department Review Required l23. 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 . 300 b/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR i/IIIIII/ILA L IN length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I I t-r1 I WATER SHUTOFF rac aAA- VISIBLE ❑ u, \ Lo LAE BROKEN ❑ MISSING 0 15.5 Properly Line Oftr41— E t t St St ISECADMI OF SIDEWALK Dit,FRONT YARD ❑ SIDE YARD ❑ OTHER lagni OF SIDEWALK ❑ 4 FEET 0 S FEET RI 5.3 FEET 0 OTHER DEPTH OF SIDEWALK ❑ 4 INCHES csit, 5 INCHES 0 6 INCHES AREA TO BE REPAIRED - sg.ft. 4 in. ' q.t1. 5 In. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO EL 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: S .L Date: s Park Department Review Required 0 YES VI 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 3 1 E Of s+, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND -- L' -.-1 AREA NEEDING REPAIR ViI»IfWA L - length of repair needed Type of defect A/ cY See reverie side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 3 I ' WATER SHUTOFF VISIBLE LSE BROKEN 0 MISSING ❑ 114' L Ir Property -km I s+ c+ arietilal OF SIDEWALK a FRONT YARD 0 SIDE YARD ❑ OTHER . OF SIDEWALK 0 4 FEET 0 5 FEET g 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK Ea 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 741 2 eq.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 an - may be repaired by patching. Ali tither areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: S Dale; - 3 10 Park Department Review Required ] YES ❑NO PERMIT ISSUED NO,., DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: `` , . CODE C — Other' Po+e4}I0.! tf�epk4¢.trrerr+' of S�c7 cwo.W � +ref re 'S 4rC P r e s e_A IC cx s d2.t ek e e4 fly 4-6 e. Q—7 6.n g i rtw• I 1 / J SIDEWALK REPAIR SURVEY FORM � �zeg CITY OF WATERLOO, IOWA A'f`''‘1‘ PROPERTY ADDRESS . 3z 0 E; ) .5 4- ±o gct I3_23_f- u_oli 4 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t=" E' '*-1 AREA NEEDING REPAIR VZ/IIIIl11A L length of repair needed Type of defect L 3 Z gy (See reverse side for Defect Codes A—F) 63 (See below for Defect Code C) ADDRESS. 37 Q I litt* I ( WATER SHUTOFF \ VISIBLE ❑ SAE BROKEN 0 MISSING 0 Property tine I S +. • =CO M OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER _ flf OF SIDEWALK ❑ 4 FEET ❑ 5 FEET tig.5.3 FEET 0 OTHER — DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED - ' `fi q f t. 4 in. ■q.ft. 5 in. ■q.fl. 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 Farm Made By: S C' Date: 3:2 3__ i O • • Park Department Review Required gC 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 , St c+ 39 13— 3-11 —LQ1 ✓ 7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. —0-1 AREA NEEDING REPAIR VZ/17.1ZIZZA L mg length of repair needed n Type of defect j i (See reverse side for Defect Codes A—F) (See below far Defect Code C) ADDRESS. 3 2 1 I ( WATER SHUTOFF VISIBLE ❑ \ • see BROKEN ❑ MISSING ❑ ;3� Pr.. rty Line / . © 5tv,4F 1,12CdT1ON OF SIDEWALK FRONT YARD [.I SIDE YARD ❑ OTHER MIDI OF SIDEWALK 0 4 FEET ❑ 5 FEET P`5.3 FEET 0 OTHER Dom OF SIDEWALK j�XJ11./� 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 77i •q.tt. 4 in. —salt 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 urea* shall be repaired by reconstruction of full sguorls. �J 1 First Inspection and Form Made By: Rs G Date; 7 n 2 / - /6 Pork Department Review Required la,YES ❑NO Jj PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE C — Other' IIi JI 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS gq_I 3 - Z 3 0 0 4 ✓ 8 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR I//T/////si 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- 3-2-7 `n X ADDRESS: -L C+ C:r.) is 0 Property line WATER SHUTOFF VISIBLE El CAP T---) BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK FRONT YARD V-SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET (,5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 54 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 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-Z 'ID Park Department Review Required i YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: • - IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G - Other Pe3r e..� r q\ re kg,t-e.Ken,t- e - S:&2wo.tK },rem roaj's arm re„sGiv`c ce..s cke-ker-nti led by ci4-y e43. nee-r` SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 400 bf* / sr ST - S9 13 -z3 _1-122 _ 0Oi� ✓ 7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR Utszarss/1.1 L s length of repair needed n Type of defect N (See reverse side for Defect Codes A-F) (See below for Defect Code G) 11 ADDRESS. t-j a t_cl n WATER SHUTOFF VISIBLE ❑ SAE BROKEN ❑ MISSING 0 c(.4 ct.0 ' 13:5 Property Line G LOCATION OF SIDEWALK Eet FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET ❑ 5.3 FEET IS, OTHER 415 DEPTH OF SIDEWALK 4 INCHES al 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED /Z-, 1_..sq.ft. 4 in -__sq.ft. 5 in. sq.1t. 6 in. CODE F - PATCHES YES [] NO . NO. OF SQUARES WITH PATCHES._ NOTE. Areas marked with an -F" may be repaired by patching. Ali other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By:- - Z S 1) cr .__ Date: 3"2LI-110 Pork Department Review Required [VI YES ❑ NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE C - Other Pa ¢h4�e�� re_filac8naen _mac 3.7c&2watK i 4re-P reic 4S core, r8,107 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4l0 i E, l; S t sir, S t 3 —23 —_q_12-007 ✓ /® _.. PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I-.— L' AREA NEEDING REPAIR P1zz111,11�i L — length of repair needed Type of defect k lG (See reverse side for Defect Codes A—F) (See below for Defect Code G) `r ADDRESS. q 151 WATER SHUTOFF VISIBLE 0 \ sae BROKEN ❑ MISSING 0 04'5.4 o 5.3 Property line _ „ iP tw 1`. \ S# } . LOCATION OF SIDEWALK 1 FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 5 FEET 0 5.3 FEET OTIi .._._ _ DEPTH OF SIDEWALK a 4 INCHES ( 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 53%S—sq.ft. 4 in.53:s sq.ft. 5 in. sq.ft. 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 of full squares. First Inspection and Form Made By:,..___....__V„..5 D .. Dale: ., 3 2'Lr I t . Park Department Review Required I, YES ❑NO PERMIT ISSUED NO. — DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE G — Other tokerA\4a reek err 5.&eu.it,tK 'sc. 2 c. -I-rer releS rei frese. ..i 4_-, de+erM;Ae�+ 101 c.i-1 Er,,j,.1 ,r-. - SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 1 L . 1 S+ 5 - " _ /1 PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND L' AREA NEEDING REPAIR 1/70I/i/WA 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 I WATER SHUTOFF VISIBLE 0 SeBP • BROKEN ❑ MISSING [D Propert e _ LOCATION OF SIDEWALK [5t FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 4 FEET n 5 FEET 0 5.3 FEET jEt OTHER —L , DEPTH OF SIDEWALK4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED z O_ _.aq.ft. 4 in. •q.tt. 5 in. sq.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 of full squares. First Inspection and Form Made By: :R...YS D G Date: ' 2 II'1® 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 / 0 2 CITY OF WATERLOO, IOWA PROPERTY ADDRESS '/vZ 4-- / 5 f 5 . Bij j -3) 1 - 02 ✓ 12 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --..-i �,\oe AREA.NEEDING REPAIR V///7/////A C L = length of repair needed Q �1,'c+ Type of defect `Ai G (See reverse side for Defect Codes A—F) o (See below for Defect Code G) h lc ADDRESS: qa2 S d qd V skoIe, J . Property Line 3` viii WATER SHUTOFF "' PA VISIBLE ❑ 4 pCAP j BROKEN ❑ MISSING 0 I-r nKl;r1 5i-- - LOCATION OF SIDEWALK FRONT YARD la SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET 0 5 I•Ltl ❑ 5.3 FEET OTHER _ DEPTH OF SIDEWALK ❑ 4 INCHES 0 5 INCHES 6 INCHES AREA TO BE 'REPAIRED sq.ft. 4 in. sq.ft. 5 in. 73,0 sq.ft. 6 in. CODE F — PATCHES YES ❑ NO R 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 Mode By: g .1)Cs Date: .5-2 3 ' 15 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 : - a r CITY OF WATERLOO, IOWA PROPERTY ADDRESS </ Z8 e j S Sf„ 2313 2y -311 _ 025,/ - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' - . AREA.NEEDING REPAIR V7777777/7A L = length of repair needed Type of defect I (See reverse side for Defect Codes A—F) (See below for Defect Code G) >l<11 ADDRESS: 7 3 7P �•� _ Property Line 5 63 WATER SHUTOFF rj VISIBLE ❑ CAP BROKENE. ❑ n d MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET 21 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 4 INCHES ❑ 5 INCHES ❑ 6 INCHES 75. AREA TO BE REPAIRED 1743 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:_ Date: 3 23 J 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 5c 2 bI k .E• z e 5 ' Z.2.1.3.-,2 4—3 22—C�Q to ✓ IS _ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR vizzzzw7a L - length of repoir needed Type of defect (See reverse side for Defect Codes A—r) (See below for Defect Code G) AE-- ADDRESS. { C Ciro} I e WATER SHUTOFF ` VISIBLE ❑ BROKEN 0 MISSING 0 / /D I Property Line f / s /a, et LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET Ca.5.3 FEET 0 OTHER -- DEPT I OF SIDEWALK 0 4 INCHES 0 5 INCHES in 6 INCHES AREA TO BE REPAIRED —.q.ft. 4 in. eq.ft. 5 in. . sq.ft. 6 in. _ CODE F — PATCHES YES 0 NO Cs' NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. Alt other orsoe shall be repaired by reconstruction of full squares. First Inspection and Form Made By:_�._ , kc _.. Date; _ 10 Pork Department Review Required 0 YES (ENO 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 3Z 1 E.e 2" 1 —Z3--1/8-001 V 14 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR P /Z.1/7. l Ns length of repair needed A Type of defect " (See reverse side for Defect Codes A—F) (See below for Defect Code C) -->Kr ADDRESS. 22I WATER SHUTOFF ViSlel E ❑ SAE BROKEN 0 MISSING 0 50'7.2 8,G Property Ling I t. '51i 51i OaCs 1 vet map le LOCATION OF SIDEWALK r21. FRONT YARD ❑ SIDE YARD 0 OTHER OF SIDEWALK ❑ 4 FEET 0 5 FEET (1.2 5.3 FEET 0 OTHER DEPTH OF SIDEWALK tgI 4 INCHES 51 5 INCHES 0 6 INCHES AREA TO BE REPAIRED l41 (C sq.1t. 4 in. ro`t+7■q.1t. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO 54 NO. Of SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. Ali other areas shall be repaired by reconstruction of full squares. First Inspection and Form Mode 8y: �5 _ — Date: -23'1t"J Park Department Review Required YES 0 NO PERMIT ISSUED NO° DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' _ CONTRACT COMPLETION DATE: CODE C — Other K'4 en:/ia\ re-s\q cg viQ A. ¢C S 341.e,..r411c lc +re& r cb ct r es eAi- cLscue-{-e.-r+;e e..41b L G r-7 n.3 i AQQ-( , • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IQWA PROPERTY ADDRESS _:,7( �� ' � is PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-*— L' AREA NEEDING REPAIR wm./.I4/7.1 L — length of repair needed Type of defect A (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. WATER SHUTOFF VISIBLE ❑ BROKEN ❑ MISSING ❑ Property Line LOCATION OF SIDEWALK s FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET 0 S FEET 5.3 FEET 0 OTHER _..._.a.r. — DEPTH OF SIDEWALK 1:21 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED `3'©_sq.tt. 4 in. ■q.tt. 5 in. eq.ft. 6 in. CODE F — PATCHES YES [] NO W 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 Farm Made By: _ D Date: _3-23 /0 Pork Department Review Required ❑ YES aNO 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 4w b/i< PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' —� AREA.NEEDING REPAIR V7//Z7777A L = length of repair needed Type of defect L (See reverse side for Defect Codes A—F) (See below for Defect Code G) ‘ 451‹ ADDRESS: 1111 PCOr.K In CA 1 Property Line11111 WATER SHUTOFF VISIBLE ❑ CAP } BROKEN ❑ I MISSING ❑ 6a„ C+, LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET ❑ 5 FEET ❑ 5.3 FEET 10 OTHER a.5 1 DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES 54._6 INCHES AREA TO BE REPAIRED 5q.ft. 4 in. 5 in. Ss'°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: fR Date: 3 "Z3 - IL' 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 400 hie 4P. � 2 „2 = (22 / 17 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L` -.- AREA.NEEDING REPAIR V///7/77//A 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 tea[)" 11,1 t`. WATER SHUTOFF VISIBLE ❑ how - ie cAP BROKEN ❑ ` Y n j°/ MISSING ❑ LOCATION OF SIDEWALK 0 FRONT YARD ta SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0, 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES IX 6 INCHES AREA TO BE REPAIRED Gq.ft. 4- in. sq.ft. 5 in. Z72,L/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: ZS . .)G Date: 3-23 "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 Ci° f, SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 4 09 b/ E 3 t[N -r • Eci i3-211- .3s14- COY ,/ /7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND La —01 AREA NEEDING REPAIR V7Z/Z/177/A L = length of repair needed !- Type of defect ` ~ (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. � f WATER SHUTOFF VISIBLE 0 BROKEN 0 MISSING 0 Property alftt RArk. Ave. LOCSTION OF SIDEWALK 0 FRONT YARD [.I SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET 121 5.3 FEET 0 OTHER — DEPTH OF SIDEWALK 0 4 INCHES 0 5 INCHES a 6 INCHES AREA TO BE REPAIRED Ag.it. 4 in. sq:ft. 5 in. 24 S.sq.ft. 6 in. CODE F — PATCHES YES 0 NO E NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "E' moy be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made 8y:.... _ `> (7. Date: 3 ®� Park Department Review Required ❑ YES CI 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 WATERLQO. IOWA PROPERTY ADDRESS 5a5J (311.3 _ -1J_3 I a _0 o5 • PARCEL CODE CONTROL-NUMBER CERT, NUMBER LEGEND L' AREA.NEEDING REPAIR r7777r77777A L = length of repair needed !t Type of defect t l (See reverse side for Defect Codes A—F) (See below for Defect Code G) *tr., ADDRESS: S =S tyci Property Line WATER SHUTOFF r) VISIBLE ❑ SAE BROKEN ❑ MISSING ❑ , LOCATION OF SIDEWALK ❑ FRONT YARD gi SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER RCM OF.SIDEWALK IX 4 INCHES ❑ 5 INCHES ❑ 6 INCHES ! / AREA TO BE REPAIRED • ` 4q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO PO 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[Tiaras. 1 ' First Inspection and Form Made By: Cl� Date: 3 -- �' -io Park Deportment Review Required ❑ YES sitNO 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 /QQ h/k E. 4 ' 5r &j PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —� AREA NEEDING REPAIR f////77///7A p, ,2A L = length of repair needed `� e �+ Type of defect l0 e0 4 1° (See reverse side for Defect Codes A—F) (See below for Defect Code G) • ADDRESS: L � U Property Line WATER SHUTOFF VISIBLE [] Di CAP . BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD El OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET El 5.3 FEET g 0-HER _ DEPTH OF SIDEWALK X 4 INCHES ❑ 5 INCHES El 6 INCHES AREA TO BE REPAIRED -9c?'0 sq.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO i'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: R.Sf 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 zzs— ZZ i £•, L.1 fly 5 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V/7/7/77/ZA L = length of repair needed nn Type of defect '1 (See reverse side for Defect Codes A—F) W- (See below for Defect Code G) Kt ADDRESS: 22 ©3 I IM..'0 '> I _1 Li \ e - Property Line WATER SHUTOFF VISIBLE g rhci /teed adj vs+ed1 ,,, DCAP i BROKEN ❑ _ MISSING El LOCATION OF SIDEWALK 2 FRONT YARD ASIDE YARD El OTHER WIDTH OF.SIDEWALK El 4 FEET 0 5 FEET ❑ 5.3 FEET '}Z OTHER _ DEPTH OF SIDEWALK J 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 6/1 Q sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES El NO fg 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 .UC - Date: 3 z 3 ` 1 0 Park Department Review Required ❑ YES S] 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 e .L i3 - A =.15` o10 ✓ 21 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND i-"— L' AREA.NEEDING REPAIR V//lI//lI%ii L = length of• repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ‘1 ‹ ADDRESS: 30 _ \ S 5 D'ASJ2' Property Line WATER SHUTOFF VISIBLE ❑ r3 BROKEN 0 L ct t �i}t MISSING CI LOCATION OF SIDEWALK ❑ FRONT YARD a SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET OTHER DEPTH OF SIDEWALK ®. 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 21e,n sq.ft. 4 In. eq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO 54 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: d Date: 3S '. I Park Department Review Required ❑ YES 51 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`WATERLQO. IOWA . PROPERTY ADDRESS 71 S E ., U 'VI aci 3 :)-1-1 _31t ..01i / PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND k— L' •AREA.NEEDING REPAIR rl7//7/7I//i7 L = length of repair needed Type of defect ( (See reverse side for Defect Codes A—F) (See below for Defect Code G) '< ADDRESS: I INAV I i, ( Lt.) GProperty L1ne`r—� ; iik (t//�V/ � �' / WATER SHUTOFF i VISIBLE ❑ see p BROKEN ❑ MISSING ❑ L-i i�V LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH Or SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER — DEPTH OF.SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES Cr AREA TO BE REPAIRED I pJ`5sq.ft. 4 in. 9q.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 full squares. First Inspection and Form Made By: l ti% . L'(:J Date: 3 •Park Department Review Required ❑ 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 ?Cf l ` `� 5- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-.6-- L' --awl • AREA.NEEDING REPAIR V///77//77il L = length of repair needed Oj Type of defect f I (See reverse side for Defect Codes A—F) — (See below for Defect Code G) >i< ADDRESS: t _ \ ...._, , ,,,,,, • tt Prfolerty Line V i WATER SHUTOFF , D VISIBLE El I It BROKEN ❑ MISSING ❑ r t1 e, LOCATION OF SIDEWALK ❑ FRONT YARD T SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 ,FEET 5 FLU ❑ 5.3 FEET 0 OTHER_ L DEPTH OF SIDEWALK 1 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED q.ft.s 4-, in. 'q.ft. 5 in. gq.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: I I✓ L—C, Date: 3' ee, r10 •Park Department Review Required ❑ YES cij NO 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 �- H / PROPERTY ADDRESS #t, }j U ' " Sf i3-al-307-007 04 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom' L`AREA NEEDING REPAIR vfiivrff A L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) See below for Defect Cod. C) ADDRESS. I I WATER SHUTOFF VISIBLE 0 LSE BROKEN 0 `QG MISSING 0 CLEAN 10 )A -i12 4 '' Property tine 14, 102X10 OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Of SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET OTHER l DEPTH OF SIDEWALK NI 4 INCHES 0 5 INCHES 6 INCHES AREA TO BE REPAIRED •q.1t. 4 in. ■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 shall be repaired by reconstruction of full squares, n First Inspection and Farm Made By: ' Date: "- —10 • Park Department Review Required 0 YES In NO r { 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 sal E. tb 3-11--32 -46 25 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR L - length of repair needed A Type of defect (See reverie side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. Cf l WATER SHUTOFF \ VISIBLE ❑ Sit' BROKEN ❑ MISSING 0 sr Aim L(.`L orb-e11ON OF SIDEWALK (X FRONT YARD 0 SIDE YARD 0 OTHER C t SAW OF SIDEWALK 0 4 FEET ❑ 5 FEET ❑ 5.3 FEET 4 OTHER- - DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED .912q.ft. 4 in. •q.ft. 5 in. 6 in. CODE F — PATCHES YES [] NO NO. Of SQUARES WITH PATCHES.._ NOTE. Areas marked with an -rmay be repaired by patching. All other areas • shall be repaired by reconstruction of full squares. First Inspection and Form Made By: W t t- . E—'F` .,. Date: Pork Department Review Required 0 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 OF WATERLOO, IOWA ,' PROPERTY ADDRESS , ( , ICI L3 -a - 302-©oS PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —64 AREA.NEEDING REPAIR /////Af L = length of repair needed l Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) c d >1<to, ADDRESS: 6 i — 7 Property Line WATER SHUTOFF VISIBLE El/// J `i5.1, CAP al.{,. p BROKEN ❑ MISSING ❑ L. LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET IN OTHER . f DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES ' a✓ l . AREA TO BE REPAIRED sq,ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO JEI 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: -:'26" 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 92C . 4 ► ST eel I1 2.4 oLi _©0a ✓ .Z7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR t /./77/iifA L - length of repair needed Type of defect ' S (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. Z \ANY,4\ l WATER SHUTOFF VISIBLE ❑ ' " cv i Lc.,� sae c)( BROKEN ❑ MISSING ❑ Pr p rty Line TION OF SIDEWALK Ors1 FRONT YARD 0 SIDE YARD ❑ OTHER 3 ► yams OF SIDEWALK ❑ 4 FEET 0 5 FEET ❑ 5.3 FEET IA OTHER 7 Janki OF SIDEWALK 17ZZ 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 5 -,V■q.tt. 4 in. •q.tt. 5 In. •q.fl. 6 in. CODE F — PATCHES YES 0 NO l 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 a uares. First Inspection and Form Mods By: '' Data: Park Deportment Review Required 14 YES Q 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 /5 bik 471-} PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' — • AREA.NEEDING REPAIR V77/777777A L = length of repair needed Type of defect. /� (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: I VAcktr Property Line 1 WATER SHUTOFF--) VISIBLE ❑ (•� CAP BROKEN ❑ MISSING 0 LOCATION OF SIDEWALK ICI FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED c1s.°sq.ft. 4 in. 5 in. sq.ft. 6 in. CODE F — PATCHES YES 0 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: try Date: 3 m2L/ !/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 ,` 1 CI iN WI b, - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR viilZ.17.W t L so length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) :4(.._ L. i 1„ .• ADDREss. i II WATER SHUTOFF wsIBLE ❑ Gee BROKEN 0 MISSING 0 sf CI'P�opartykw U'ni ji;1i///'i) V { '1Z):j)j I ..5t`f . Alm a.11) LOCATION OF SIDEWALK It FRONT YARD 0 SIOE YARD 0 OTHER MIDI OF SIDEWALK 0 4 FEET /L'.l 5 FEET 0 5.3 FEET 0 OTHER DIM OF SIDEWALK 9 4 INCHES 0 5 INCHES 0 6 INCHES -.�p'5✓ AREA TO BE REPAIRED 1 � •q.ft. 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 -r may be repaired by patching. All other areas shall be repaired by reconstruction of full suares. First Inspection and Form Made By:W ( Date: Park Deportment Review Required 0 YES csiNO r ii PERMIT ISSUED NO. DATE:, INSPECTION DATE: ' I IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO* CONTRACT COMPLETION DATE: —11 CODE G — Other I; --/ i I I ,I i • SIDEWALK REPAIR SURVEY FORM CiTY QF WATERLOO, IOWA PROPERTY ADDJESS 434 4 M0 D 5T I'l 3 -a -3°A 6°Y ✓ 4-/ • PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' AREA.NEEDING REPAIR V»i//7/77A L = length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) • ADDRESS: 3 v�i I .. t: _ \ (__07 -.) a ,''? Property Line 1 WATER SHUTOFF VISIBLE ❑ fa '' / BROKEN 0 MISSING 0 . LOCATION OF SIDEWALK 'FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK 0 4 FEET .- 5 FEET • 0 5.3 FEET 0 OTHER DEPTH OF.SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES lid ' AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE 'F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES •• 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& Date: ` +/0. Park Department Review Required 0 YES ig 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 5o a 4 L_in 0%' 3 s r s_q _O<rL ✓ 4-i PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --0-1 AREA.NEEDING REPAIR 1l//l77/77. L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 5C� ` 1 V N f Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN El Di MISSING ❑ 111uiti(^ LOCATION OF SIDEWALK r7s1FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET El 5 FEET 5.3 FEET ❑ OTHER_ DEPTH OF SIDEWALK 4 INCHES IA 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 3�,v q.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO FAI 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 ❑ YES 'p 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,c h/k A,JK'y' 37 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —•'! AREA.NEEDING REPAIR L _ length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 14, ADDRESS: I vAC I Property Line ,j 44' WATER SHUTOFF VISIBLE ❑ e CAP BROKEN ❑ i 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 -'' aq.ft. 4 In. sq.ft. 5 in. q.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: Date: 3 ` y -Jo Park Department Review Required 151 YES ❑ NO 'PERMIT ISSUED NO: DATE: INSPECTION DATE: • •� IF UNCOMPLETED: SPECIAL'ASSESSMENT CONTRACT NO: ° CONTRACT COMPLETION DATE: CODE — Other SIDEWALK REPAIR SURVEY FORM . ' CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 3ZJ &//L ,4ivucl y .57 ggi3 _)-1_L(25 _0 -d-r ✓ 144 PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND L. -.I AREA NEEDING REPAIR v/7/UlZf _ L IS length of repair needed A Type of defect (See reverse side for Defect Codes A-F) (Sea below for Defect Cods G) J ADDRESS. 44--)1E- V I 1 C' f�I I I WATER SHUTOFF is 1 VISIBLE 0 . \ . Lae BROKEN 0 . MISSING 0 1 i _ A Property Line i, " 1,10 i . J TION OF' SIDEWALK a FRONT YARD 0 SIDE YARD 0 OTHER MIMI OF SIDEWALK 0 4 FEET lyi 5 FEET 0 5.3 FEET 0 OTHER — DEPTH OF SIDEWALK @Q 4 INCHES 0 5 INCHES 0 6 INCHES Q✓ AREA TO BE REPAIRED ' L _sq.ft. 4 in. ■q.ft. 5 In. ■q.fl. 6 in. CODE F - PATCHES YES 0 NO tEr NO. OF SOUARI ES WITH PATCHES NOTE. Areas marked with an - may be repairsd by patching. All other areas shall be repaired by reconstruction of 10.1 squares. First Inspection and Form Made By:_._ 1 L. •v ._, Date: _ -� Park Department Review Required IS1 YES . ❑NO i 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 303 °-i11�C r PARCEL CODE —r CONTROL NUMBER CERT. NUMBER LEGEND L• -014 AREA.NEEDING REPAIR VZ//ZOO 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 WATER SHUTOFF rjVISIBLE [] ) BROKEN ❑ MISSING ❑ Wzs LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH or SIDEWALK ❑ 4 FEET Ig 5 FEET • ❑ 5.3 FEET ❑ OTHER OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES � 5 AREA TO BE REPAIRED `pi�` sq.ft. 4 in, eq.ft. 5 in. Aq.ft. 6 in. CODE F - PATCHES YES ❑ NO 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 full squares. First Inspection and Form Made By: Date: OG-Park Department Department Review Required 1E1 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 CRY OF WATERLOO. IOWA PROPERTY ADDRESS A � 1 ,5 _�_ _j L 1 PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' AREA.NEEDING REPAIR L = length of repair needed Type of defect r\ (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: \3:,1 3 U ' imve Property Line ` 4 / I'i// .�l" 1 WATER SHUTOFF 1 VISIBLEF-1 ❑ BROKEN ❑ i ri MISSING CI LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET j8, 5 FEET • ❑ 5.3 FEET ❑ OTHER _ DEPTH OF.SIDEWALK sya 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED I_ L sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO 'j 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. -VC /(`�-s 1 _/Q First Inspection and Form Made By: L—(-/ Date: Park Department Review Required `!O 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 Li 0 An k2;,ti S+ . ii L3 -aj - 10°> 0 -3 '' 47 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km— L' --0-1 • AREA.NEEDING REPAIR V///77Z/7/A :D L = length of•repair needed A 3 Type of defect �'n (See reverse side for Defect Codes A—F) (See below for Defect Code G) -J . v �401* ] ADDRESS: Lt ��` + a - G J I cl_ p Property Line _ A rf� {�/ (L, ] WATER SHUTOFF / I V'I VISIBLE ❑ 5.O 5 e 5,0 r-jjCAP `c� '�`"`{ �'I) BROKEN El MISSING El LOCATION OF SIDEWALK t41. FRONT YARD El SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET 5 FEET • ❑ 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES J./• AREA TO BE REPAIRED 390 sq.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 ffuulll squares. First Inspection and Form Made By: t t— Date: 3—a3— I D 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 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS `105 kc n„ 3 _ 0 05 ./ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: '11 CI Property Line i WATER SHUTOFF VISIBLE ❑ , �' 1 P7t4 A BROKER ❑ MISSING ❑ lJi MA�Er LOCATION OF SIDEWALK 0., FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ISN 5 FEET ❑ 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES LtiOj AREA TO BE REPAIRED sq.ft. 4 in. q.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO W 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 fullfu squares. First Inspection and Form Made By: t v .lid Date: 3 r I0 Park Department Review Required ❑ YES tRi 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 it 1 O (lY11 e,n r ` q 1-3- `t--1 G 3 -o ff 4- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t'" t.' AREA NEEDING REPAIR W L b'J'A L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C)41* ADDRESS. LI-t o WATER SHUTOFF vlslnLE ❑ BROKEN 0 MISSING ❑ Properly Line • t{;5 i--kn\coij OF SIDEWALK Igt FRONT YARD 0 SIDE YARD 0 OTHER g OF SIDEWALK ❑ . 4 FEET 0 5 FEET 0 5.3 FEET , al OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES l� if AREA TO BE REPAIRED dam' ■q.tt. 4 in. --ARIA. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES [] NO N0. 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. First Inspection and Form Made By:W .._ Date; 3-A3 -/0 • Park Department Review Required 0 YES NO PERMIT ISSUED NO. DATE:. INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0• CONTRACT COMPLETION DATE: CODE C - Other• • SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO: IOWA — PROPERTY ADDRESS . LT I 1 .toi t :eAAy ,$-k i.13 -91_1oa_003 ✓ �Jse, PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I"-- L' AREA NEEDING REPAIR TZIZZ/ZJIWA L = length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) I ADDRESS. I I WATER SHUTOFF O VISIBLE 0 \\ BROKEN 0 MISSING 0 1 t0.0 A Property Line • • il'hic,F Mil — OF SIDEWALK ,FRONT YARD 0 SIDE YARD 0 OTHER Jstgail OF SIDEWALK 0 4 FEET (a.5 FEET 0 5.3 FEET ❑-OTHER — DEPTH OF SIDEWALK To 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 15`5 q.11. 4 in. ■q.ft. 5 in. .. •q.ft. 6 in. CODE F - PATCHES • YES 0 NO ryi NO. OF SOUARE5 WITH PATCHES • NOTE. Areas marked with an -r may be repaired by patching. All other areas • shall be repaired by reconstruction of Ill squares. _; First Inspection and Form Made By:__„ ` �. / • Dale: Pork Department Review Required gi YES ' t 0 NO PERMIT ISSUED NO. ,,,_ DATE: INSPECTION DATE: • 11 IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO CONTRACT COMPLETION DATE: i CODE C - Other • 'i I I r SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS q 1 t Arkbir\U ._.s-', ga 3 _L0a_onel ✓ 5r PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND tom' L' --.1 AREA NEEDING REPAIR 171/17171/7A I mu length of repair needed A., Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) cOE ADDRESS. 1 I C WATER SHUTOFF VISIBLE ❑ . \ . -ME - BROKEN 0 MISSING ❑ It Property tine _ — _. Pill/I I�i,ar 7-1,1\(...e,n) LOCATION OF' SIDEWALK A.FRONT YARD 0 SIDE YARD 0 OTHER NIM OF SIDEWALK 0 4 FEET tfn5 FEET 0 5.3 FEET 0 OTHER DEE.I8 OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES ii'' AREA TO BE REPAIRED ■q.$t. 4 in. sq.1t. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO VI NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. Ali other urges shall be repaired by reconstruction of full squares. First inspection and Form Made 8y: _� La, Dale: `��"Z 0 Pork Deportment Review Required 'I; YES 0 NO i i PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: , CODE G — Other' I _ I I i 1 I 1 I SIDEWALK REPAIR SURVEY FORM • CITY OF WATERLOO. IOWA PROPERTY ADDRESS 4 I`I A j 3 24.4_ t 0 _001 / 5Z PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR UMW::1MA L - length of repair needed /� Type of defect /� (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 4 t I WATER SHUTOFF VISIBLE 0 \ • sib BROKEN• ❑ -- MISSING ❑ .>-Jar e rl Ijropwty Line `rL i LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Itum OF SIDEWALK ❑ 4 FEET V. 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ©salt. 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 - may bn repaired by patching. All other areas shall be repaired by reconstruction of full�tquarer. First Inspection and Form Made By:_._ "� t'` Date; `I° Pork Department Review Required 0 YES ]NO i PERMIT ISSUED NO. ._ DATE: INSPECTION DATE: '_ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: • — I CODE C — Other. 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA • • - PROPERTY ADDRESS 1/J-4 Ak&teti ✓ , PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L, • AREA.NEEDING REPAIR V,17/77777A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4‹ ADDRESS: 1 �L. Gt"CAN LtJAt-K Property Line . WATER SHUTOFF ' VISIBLE ❑ 31' see r)../• BROKEN 0 MISSING ❑ z,I LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET El5 FEET ' El5.3 FEET 14 OTHER y — DEPTH OF SIDEWALK t) 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE 'REPAIRED •I''3'14/q.ft. 4 in, cq.ft. 5 In. 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: � 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 /a b/h' //AI ,,$T '/• -z3 - z1,9-033' / 54 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR VJJ/Zil'JlA L length of repair needed Type of defect (SSeeee reversebelowfor De side fecfort Defect Codes A—F) \,13 I ADDRESS. I `J" 4-C • I WATER SHUTOFF LQ T VISIBLE 0 \ • Lae BROKEN 0 MISSING ❑ Property fine 3 u ' G L�/�� /A)A L K le60_ 5% LOCATIONOF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER itIM OF SIDEWALK Cf'. 4 FEET 0 5 FEET 0 5.3 FEET ❑ OTHER Zelki OF SIDEWALK 1 INCHES Igp INCHES 0 6 INCHES AREA TO BE REPAIRED 13�`C.q-tt. 4 in. sq.it. 5 in. ■q.tt. 6 in. CODE F — PATCHES YES 0 NO { NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. All other areas shall be repaired by reconstruetio I full mar es. res. first Inspection and Form Made By: S Dale; V2 c//c Pork Department Review Required 0 YES [ /NO PERMIT ISSUED NO. DATE:, INSPECTION DATE: '_ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE C — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS L tie ,62k 6Y Le -1 8g 13-?3-26?_ 55 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR vZOWz»'A L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) Sea below for Defect Cods G) I ADDRESS. I ()A- • ( WATER SHUTOFF . Vr VISIBLE ❑ .tom BROKEN ❑ MISSING ❑ Property Line _� cA 1�1 '8. u • IZ X LC X 5 " Al2.6YLE ST1 jaratillal OF SIDEWALK 03 FRONT YARD 0 SIDE YARD 0 OTHER Ili of SIDEWALK 4 FEET 0 5 FEET ❑ 5.3 FEET ❑ OTHER izenj OF SIDEWALK 54 4 INCHES g 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 72`�■q°ft. 4 in. Gg'p■q.ft. 5 in. ■q./i. 6 in. CODE F — PATCHES YES ❑ NO [ NO. OF SQUARES WITH PATCHES NOTE. Arens marked with an -r moy be repaired by patching, All other areas shall be repaired by reconstruction full squa e. /Z��i� First inspection and Form Made 8y: ..__ Date: / Park Department Review Required 0 YES JJ��( 'NO PERMIT ISSUED N0. 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 j // Z A-26 5 e t3-zL- -0zz 'Se,„ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA NEEDING REPAIR VZZA fi'fA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >4‹ ADDRESS. )'4 — I I WATER SHUTOFF 1SIBLE \ • SAE BROKEN 0 • MISSING 0 tai Property Line • T � �� ; C • jOrAlQy OF SIDEWALK ( FRONT YARD 0 SIDE YARD ❑ OTHER Maid OF SIDEWALK Ci 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER Dem OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2 /q.tt. 4 in. iq.it. 5 in. ■q.it. 6 in. CODE F — PATCHES YES ❑ NO LY} NO. Of SQUARES WITH PATCHES • NOTE. Areas marked with an -r may be repaired by patching. Ali other areas shall be repaired by reconstruction i full squares. First Inspection and Form Made 8y: Date: 5)id ii Pork Department Review Required 0 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 J 446 AP 6 Y LE ST - 8913-23—Z. 5 7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E '-1 AREA NEEDING REPAIR VfffWi/mA 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 VISIBLE ❑ BROKEN 0 MISSING 0 8_I Property line Ais \ • LOCATION Of SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER .ill OF SIDEWALK 4 FEET 0 5 FEET 0 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 0 4 INCHES [)( 5 INCHES 0 6 INCHES AREA TO BE REPAIRED '.`' •q.tt. 4 in. /i 4sq.it. 5 in. ■q.ft. 6 in. • CODE F — PATCHES YES ❑ NOpt_ NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an - may be repaired by patching. All other areas • shall be repaired by reconstruction f ull squ _ 3 first Inspection and Form Made Sy: Date: L • Pork Deportment 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 2 o c J-% PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND I'•" L' AREA NEEDING REPAIR I7/I/I7,7FA L s length of repair needed Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code C) --> ADDRESS. Z 4E I WATER SHUTOFF VISIBLE 0 see BROKEN ❑ MISSING 0 ' Property line LOCATION OF SIDEWALK c4 FRONT YARD ❑ SIDE YARD ❑ OTHER �. TH OF SIDEWALK ❑ 4 FEET 54 5 FEET 0 5.3 FEET 0 OTHER — DEPTFF OF SIDEWALK ( 1( 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ` _sq.tt. 4 in. •q.ft, 5 in. ■q.ft. 6 In. CODE F — PATCHES YES ❑ NO, NO. OF SQUIRES WITH PATCHES NOTE. Areas marked with an 'F" may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares. �� J First Inspection and Form Made By:Y 5 , w 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 OF WATERLOO. IOWA PROPERTY ADDRESS 466b/k $q1 _ _303_o3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR riZOWNWA L length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Detect Code C) ADDRESS. I vt)(CiAI\ ( WATER SHUTOFF BROKEN ❑ MISSING ❑ Prop Line =MON OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER Nganj OF SIDEWALK ❑ 4 FEET 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED sq.tt. 4 in. ■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 bn repaired by patching. All other areas shall be repaired by reconstruction of JO squarer. _. First Inspection and Form Made By: �� _ Dale: .3-- s-10 Pork Department Review Required IS;) YES 0 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 WATERLOO. IOWA PROPERTY ADDRESS 4-03 Rije.\\p, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR vrliZ././. w AL N. length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 11.V WATER SHUTOFF \ VISIBLE ❑ BROKEN 0 MISSING 0 Property Line — A I'l//iql 151)-' �{.1 .i J OCATION OF SIDEWALK 5a FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET 10 5 FEET 0 5.3 FEET 0 OTHER DEEM OF SIDEWALK 4 INCHES t,f 5 INCHES ❑ 6 INCHES f l AREA TO BE REPAIRED �'S•q.ft. 4 in. �Q.�_•q.1t. 5 in. ■q.fI. 6 in. CODE F — PATCHES YES ❑ NO NO. OF SQUARES WITH PATCHES r NOTE. Areas marked with an -r may bn repaired by patching. An other areas shall be repaired by reconstruction of IU squares.First Inspection and Form Made Ely:_._ ,tlff L _ Date: r� `k.5 I- Pork Department Review Required ig 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 . oz r\v?1\e„r PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND E' AREA NEEDING REPAIR ufirZZZZZZ f , L - length of repair needed b Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) "iE ADDRESS. C) i I 1 WATER SHUTOFF _ VISIBLE ❑ S.6e ........L \ . BROKEN 0 . MISSING 0 _. Iproperty tine AC) ._ 1 I'`ri rill/ - ` "- (fir LOCATION OF SIDEWALK L`c,7� FRONT YARD 0 SIDE YARD 0 OTHER OF SIOEWAUC 0 4 FEET a 5 FEET 0 5.3 FEET 0 OTHER _ zem OF SIDEWALK 04 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED l'4.J q.tt. 4 in. —soil 5 In. 2q.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. Ali other urea* shall be reooired by reconstruction of fullll{squares. first Inspection and Form Mods By: 11_7Date: J ~�� • Park Department Review Required Li YES 0 NO .. I PERMIT ISSUED NO. DATE:, INSPECTION DATE: '_ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' _, CONTRACT COMPLETION DATE: CODE G — Other 1 I 1 1 r i • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS JJArij P1 t3 - -3 03 - et, (' PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E. AREA NEEDING REPAIR U»illliiil length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. Lt ),S I WATER SHUTOFF VISIBLE ❑ BROKEN 0 MISSING ❑ Properly line __a 19 S` =MILO OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER 0111 OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK la 1 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 12"-2-6—sq.ft. 1 ;n. ■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 urea* • shall be repaired by reconstruction of�full �squares.) s. first Inspection and Form Made By: 1 e- `'`" Date: ,3 p -lc • 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 PROPERTY ADDRESS 3 ZZ l3 T'nl0 t3�2 3113 -Z3 -235-6Iz- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR v7,17/WMA L — length of repair needed Type of defect (See reverse side for Defect Codes A—r) (See below for Defect Code G) --)1("""- ADDRESS. 3 2Z I WATER SHUTOFF VISIBLE 0 BROKEN ❑ . MISSING Q Property ' e 1/,? A r rz a-rnVoBed 57 LOCATION OF SIDEWALK { FRONT YARD 0 SIDE YARD ® OTHER Num OF SIDEWALK 0 4 FEET Q 5 FEET ❑ 5.3 FEET jI OTHER DFPTtf OF SIDEWALK lT 4 INCHES [,I 5 INCHES 0 6 INCHES AREA TO BE REPAIRED LC/ q,tt. 4 ;n. •q.ft, 5 in. Wi. 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 o / II =quo First Inspection and Form Mode By:_ 5 _ Date: .45 /17 �. Park Department Review Required 0 YES /(j 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 /$0_3 , iA-j-",�0S2 3 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V7//7//77ZA L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) lot". ADDRESS: 7 Q 3 I N c-) Property Line j I T WATER SHUTOFF VISIBLE ❑ Pr CAP BROKEN ❑ MISSING El • LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK [X 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 6sq.ft. 4 in. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO cZ 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 II squares. First Inspection and Form Made By: 775 /�Date: �IL� Q Park Department Review Required 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. IOWA PROPERTY ADDRESS 489 V -p1 c i3 i - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1' AREA NEEDING REPAIR L'Z Illl�ii l mg length of repair needed Type of defect (See reverse side for Defect Codes A—F) See below for Defect Code C) L ADDRESS. 1-3 [ I I I WATER SHUTOFF VISIBLE ef rdie BROKEN 0 MISSING 0 I _ Property tine ._ [/41/ 7 ----� kJ 1j 3cz�T,.lif)-r3 erg ,LQcalfal OF SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER ydgmb OF SIDEWALK ❑ 4 FEET ❑ S FEET } 5.3 FEET 0 OTHER DEPTH OF SIDEWALK Pail 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED �` _•q.tt. 4 in. ■q.1t. 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 reooirsd by reconstruction f full squares. first Inspection and Form Mode By:,_� _— Dale: 3/L3hC) • Pork Department Review Required ❑ YES NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: 4 • CODE C — Other: SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS /0 b% , g.04-/ 4 89 13 -Z3 -ZSS-cr-,3 V- '4 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR Illl//IZMA 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 \ ViSiui.E ❑ BROKEN 0 MISSING ❑ Property Line .s-US`9� , ON OF SIDEWALK i ' FRONT YARD 0 SIDE YARD 0 OTHER . tad Of SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER REenj OF SIDEWALK gg 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 20 23.q.ft. 4 in. •q.1t. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO i 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 By: SD> i's't Dale:• ID 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 jA9 (7ik, 620,00A1 839;1—Z —���—cam ,/ le7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR 1l7l1ZF1IIlA I ` length of repair needed Type of defect (See reverse side for Defect Codes A—F) Sea below for Defect Code G) ADDRESS. WATER SHUTOFF vistaiE Q Si8L' BROKEN 0 _ MISSING 0 Property Line f ge,79 • LOCATION OF SIDEWALK pg FRONT YARD 0 SIDE YARD 0 OTHER yfini OF SIDEWALK ( 4 FEET ❑ 5 FEET ❑ 5.3 FEET ❑ OTHER . OF SIDEWALK 4 INCHES 0 5 INCHES [,] 6 INCHES AREA TO BE REPAIRED 7s5f Z g,ft. 4 en. ■q.ft. 5 in. ■q.ft. 5 in.CODE F — PATCHES YES 0 NO Ea 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 squares. — First Inspection and Form Made ey: Date: 3—Z-D_l Park Department Review Required [] YES rsa NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: ,CODE G — Other. 1 !.i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS ZOO = ie0 Wt4 5-T- ►/ . g913 _ Z3: Zc m4- ✓ 49 • PARCEL CODE CONTROL NUMBER; CERT. NUMBER i9 1f r ilk. --'_ LEGEND L' —" • AREA.NEEDING REPAIR f/I7ll/!(//ii L = length of repair needed Type of defect -----... —� (See reverse side for Defect Codes A—F) (See below for Defect Code G) 1. �1 >< 1 • ADDRESS: - I 1M \ NI- _ 5,...qj COI ) 64 j II M 0 m Property Line WATER SHUTOFF VISIBLE 0 S8E i BROKEN ❑ • r � l L ti--�1 _ MISSING ❑ LOCATION OF SIDEWALK 0 FRONT YARD 1[ iC SIDE YARD 0 OTHER WIDTH Or SIDEWALK rAk 4 FEET 0 5 FEET • 0 5.3 FEET ❑ OTHER _ DEPTH OF.SIDEWALK Pg 4 INCHES ❑ 5 INCHES ! 6 INCHES AREA TO BE 'REPAIRED ��� • Z q.ft. 4 in. sq.ft. 5 in. i L ° q,ft. 6 in. CODE F — PATCHES YES 0 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 full squares. • First Inspection and Form Made By: 6 D 5 .I-6 Date: 3 -e D—I c:' •Park Department Review Required 0 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, IOWA PROPERTY ADDRESS /Z-71 62011(0 I P-Ti at _. - z3 - zo$ 0 01 70 PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND I-n-- L' --•-I . AREA.NEEDING REPAIR V7//Z//7//A L = length of repair needed Type of defect See reverse side for Defect Codes A—F) See below for Defect Code G) 4 Y1 _‹ , / � / f�-- ADDRESS: 7 Z`7 I oLW I Cr tnoP Q d Q w' 'Property Line _ .5,0 tJ j;f it 1.%�I I ij WATER SHUTOFF Hs VISIBLE ❑ / c. \ j \ Pt ! ) CAP BROKEN ❑ MISSING ❑ E P tAirkkO 5' S T LOCATION OF SIDEWALK El FRONT YARD 0 SIDE YARD El OTHER WIDTH Or SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ut' 6 INCHES AREA TO BE REPAIRED .8 2 •7 Sq.ft. 4 in. sq,ft. 5 in. Z�'S q,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: 5 Date: 3/ Z4/'w Park Department Review Required El YES /{2j' 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 AD0 ESS 5- Zoon,O a 2 3- 20k- a?D. ✓ 7/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L —*A AREA.NEEDING REPAIR fl////I//77A L = length of•repair needed Type of defect See reverse side for Defect Codes A—F) See below for Defect Code GC) . tn Q ‹ ADDRESS: 3 Property Une WATER SHUTOFF VISIBLE CAP BROKE' ❑ MISSING ❑ /zoAi2 I^1A-Y 5T. LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET3 FEET ❑ OTHER DEPTH OF SIDEWALK '>4 4 INCHES ❑ 5 INCHES 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. /u 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 squares. 7� First Inspection and Form Made By: 5 Date: ✓/ �J / ,40 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 QF WATERLOO. IOWA PROPERTY ADDRESS .51 BQO in1/4-`� ajJ-23-zo 6 _ca zi 72- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND �. ''"1 AREA NEEDING REPAIR 117l7 1,ZZIA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 5) U I ( WATER SHUTOFF VISIBLE Pr BROKEN ❑ . MISSING 0 Property Line cs 61/41 ti✓� 3 c�kc� l j? RaAOLA)4-Y LOCATION OF SIDEWALK I FRONT YARD ❑ SIDE YARD 0 OTHER Zgjjj OF SIDEWALK 0 4 FEET ❑ 5 FEET 0 5.3 FEET {/ OTHER 5 4 41 aelti OF SIDEWALK ar1 INCHES 0 5 INCHES 6 INCHES AREA TO BE REPAIRED •q•tt. 4 in. ■q.fi. S in. 311 3 eq.ft. 6 in. CODE F — PATCHES YES 0 NO 0 NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an - may bn repaired by patching. All other ursas shall be repaired by reconstruction of f II squares. Z t First Inspection and Form Mode By: -55 Date: 11 L 7 //0 Park Department Review Required 0 YES 0\40 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 3Ro. .9 Io•J q; S- eg 13 2.3 - 2o ,- ool �3 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR W//T//l//A ,\\ L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) h >< ADDRESS: • 44 Property Line WATER :SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSIN; ❑ LOCATION OF SIDEWALK tXJ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET 0-HER ' 7 DEPTH OF SIDEWALK )I 4 INCHES ❑ 5 INCHES ❑ 6 INCHES • AREA TO BE REPAIRED ft. in.s 4 q. q.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES El 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 f II squares. First Inspection and Form Made By: ?) Date: 3 Park Department Review Required ❑ !!!!Y`"`ESS [ 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,oZ R0,4II,4 6/. J3 PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND 1+- L' . AREA.NEEDING REPAIR /7/7///A 112 L = length of repair needed a- Type of defect (See reverse side for Defect Codes A—F) rn (See below for Defect Code G) ui N•;* C ADDRESS: (40'aZ Property Line SX 5,4 h WATER SHUTOFF j VISIBLE ❑BROKEN El MISSING ❑ LOCATION OF SIDEWALK Kt FRONT YARD [ ] SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET [XL 5.3 FEET E4 OTHER — DEPTH OF SIDEWALK [�4 INCHES ❑ 5 INCHES 6 INCHES AREA TO BE 'REPAIRED 49,3 aq.ft. 4 in. sq.ft. 5 in. ZZ'g sq.ft. 6 in. CODE F — PATCHES YES ❑ NO al 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 fullll squares. f First Inspection and Form Made By: g g Date: 3/Z //0 Park Department Review Required ❑ YES 124NO 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 00 QIocK) �'Nl C e . -" 89J3__23_Lj1 _ Da Z / -.7� PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND E' AREA NEEDING REPAIR s/III//J///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. 1 / WATER SH • • \ VISIBLE is BROKEN 0 CC.-F"-_,A `t,../4 t-ke-- MISSING 0 ZO(. Z cF 4 " _ _ Property Line i 33 ' r 33 I \ .1 \ . _1'EA.h` ( Sr. IMMO OF SIDEWALK j"C FRONT YARD 0 SIDE YARD 0 OTHER J .Q?b OF SIDEWALK 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK (X 4 INCHES 0 5 INCHES 0 6 INCHES • ' ✓ ✓ AREA TO BE REPAIRED sq.ft. 4 ,i{n. sq.ft. 5 in. ■q.ft. 6 in. • CODE F — PATCHES YES 0 NO QU Ni). OF SQUARES WITH PATCHES NOTE. Areos marked with an -r may be repaired\ by patching. All other areas shall be repaired by reconstruction of ul squ /z�!!// First Inspection and Form Made 8y: ( 5 -- Date: il Pork Deportment Review Required 0 YES fNO l PERMIT ISSUED NO. DATE: INSPECTION DATE: 1' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE C — Other. 1 II j •.. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS lion-4' - 8923 _Z3_ 230_ voB -77 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR rl///./ZZ. L = length of•repair needed Type of defect (See reverse side for Defect Codes A—F) if (See below for Defect Code G) -J >t< ADDRESS: (/fie• �` Lo f-- o J _ • 1 Property Line }v WATER SHUTOFF VISIBLE E] CAP y BROKEN ❑ CENTF� ST MISSING El LOCATION OF SIDEWALK El FRONT YARD SIDE YARD El OTHER WIDTH Or SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET EI OTHER -3"J DEPTH OF SIDEWALK [ 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 46 2 .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 rep fired by patching. All other areas shall be repaired by reconstruction o full square First Inspection and Form Made By: Date: 3/z6 f/o -Park Department Review Required ❑ YES gf 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 Cr r ,e677- 1 ?3 - Z35- roe / 7f PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V'/,W7///A L = length of repair needed Type of defect A (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: Zc'7 7�\ I Property Line 23�� / / , WATER SHUTOFF Y�/ T� VISIBLE ❑ A'S CAP $AC C oFCt1PS p BROKEN ❑ On 5T MISSINa ❑ LOCATION OF SIDEWALK ❑ FRONT YARD rea SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El 4 FEET El 5 FEET ❑ 5.3 FEET (t OTHER.3p DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 47 q.ft. 4 In. sq.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. First First Inspection and Form Made By: 13 5 Date: 3/Z4/la Park Department Review Required ❑ 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 2/ 5 CEAr-r6g e9 13 --z3 —Z33 _ovg 7v� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND U AREA NEEDING REPAIR L/llfl////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 I- I t WATER SHUTOFF VISIBLE ❑ SAP BROKEN 0 MISSING 0 O Property Tina S LOCATION OF SIDEWALK 9i FRONT YARD 0 SIDE YARD 0 OTHER 3/1218 OF SIDEWALK 0 4 FEET 0 5 FEET t,.( 5.3 FEET ❑ OTHER -- wpm OF SIDEWALK L1GJ 4 INCHES 0 5 INCHES/ ❑ 6 INCHES AREA TO BE REPAIRED '5 _sit. 4 in. aq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO J1 NO. OF SQUARES WITH PATCHES .r NOTE. Areas marked with an "F" may bn repaired by patching. Alt other urea shall be repaired by reconstruction o f II squaryi. First Inspection and Form Made By:___ / 1-")__5 Date: 344- -//0 Pork Department Review Required g 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 220 C'FA./��2 $7 69 (3_Z-3_z3o_ atr__ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR VlZ7/7i/A L length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 2 Zv vIsWATER SHUTOFF \ �LE • BROKEN 0 MISSING 0 Property Lim 1/4 • sr LOCATION OF SIDEWALK %FRONT YARD C1 SIDE YARD ❑ OTHER OF SIOEWALIC 0 4 FEET ❑ 5 FEET 0(5.3 FEET 0 OTHER DEPTH OF SIDEWALK [ 4 INCHES 0 5 INCHES [] 6 INCHES AREA TO SE REPAIRED Z� •q.ft. 4 ; sq.ft. 5 In. ■q.ft. 6 in. CODE F — PATCHES YES [] NO NO. OF SOUARE5 WITH PATCHES�. NOTE. Areas marked with on -r may be rep fired by patching. All other areas shall be repaired by reconstruction of full squares. ' / • First Inspection and Form Mode By: 5 Date; 3/2-/,,/ (0 j Pork Department Review Required [ YES (]NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: • • CODE C — Other' • Il SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO. IOWA PROPERTY ADDRESS 3 Is ��j(f�,C , 89 1 a-z3-zLz-0G. 0l PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND LI AREA NEEDING REPAIR 717//77./ii t L .• length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 3)5 I I WATER SHUTOFF VISIBLE [] . \ . rde BROKEN 0 MISSING 0 — 1./•.7 P9,4 roperty line — / \c c . Ce Ai7 R -sr- _ LOCATION OF SIDEWALK (4 FRONT YARD 0 SIDE YARD ❑ OTHER yanj OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER 5. V DEPTH OF SIDEWALK 0 4 INCHES li 5 INCHES 0 6 INCHES 5o: 6_ 25.4 , _ AREA TO BE REPAIRED ls q.ft. 4 in. Z sq.tt. 5 in. ■q.ft. 6 in. • CODE F — PATCHES YES NO 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 ful squares first Inspection and Form Made By: .-- Date; 5 f Z 5 /76) Park Department Review Required ❑ YES {(NO — PERMIT ISSUED NO. DATE: INSPECTION//\ DATE: ' . IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: i CODE C — Other° 1 I 1 I-__ i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 19 ee 7 f $7 - 89 LI-z_.1-z3?-c12 .ez PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom" E' AREA NEEDING REPAIR L Z/71/li3 t_ � length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) *-- ADDRESS. 3 L I I WATER SHUTOFF VISIBLE ❑ \\ ree BROKEN 0 'C/ MISSING C)Property Line 4. G ..\--- ' . .1,Jratnal OF SIDEWALK JRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET\ 0 5 FEET 0 5.3 FEET ,E1 OTHER S'T DEPTH OF' SIDEWALK 0 4 INCHES ( 5 INCHES 0 6 INCHES cam/ AREA TO BE REPAIRED sq.tl. 4 ; ZL`J sq.lt. 5 in. sq.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 /z�)/ n First Inspection and Form Made By: 5 Date; / f� 1 Pork Department Review Required 0 YES -,g.NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • 1 IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE C — Other 1 i • IL i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS ,3 2:2 fe--2 ST a.5r3 - z3 - z-3z- g3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L" • AREA.NEEDING REPAIR L = length of repair needed `' Type of defect N (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 17 Cr cal+—' _�; N Property Line WATER SHUTOFF VISIBLE ❑ CRP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD LEI SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET I5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK [ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED •i60 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“ be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Mode By: Date: 3/1 f 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 Co R c SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 7 o c CA/16'7 -AirfciT PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L AREA NEEDING REPAIR VWi'LIMA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. T Q G I I I WATER SHUTOFF VISIBLE ❑ \ • BROKEN ❑ MISSING CI 9•3 titl Property Line • LOCATION OF SIDEWALK l./FRONT YARD 0 SIDE YARD 0 OTHER I OF SIDEWALK 0 4 FEET ',:' 5 FEET 0 5.3 FEET S4 OTHER DEEM OF SIDEWALK LL} 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 50,Z■q•tt. 4 in. •q.it. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES,.—. _i; NOTE. Areas marked with an -r may bn repaired by patching. All other areas shall be repaired by reconstruction of f I squares. � /49first Inspection and Form Made By: f 7/Dais: 3/z Park Department Review Required el( YES ❑NO PERMIT ISSUED NO,, DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE G — Other' .._, • Ii a SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . 71 i eC/ f�i. _5 . • - g91-z3-zv4--ars PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR Uilifi»1Yw 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 /6 1 I ( WATER SHUTOFF VISIBLE ❑ . \ BROKEN 0 MISSING 0 Property tine 5. 3 A - LOCATION OF SIDEWALK (X FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET { OTHER S ' - DEPTH OF SIDEWALK (X 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2-5' g.tt. 4 in. sq.ft. 5 in. sq.ft. 6 in. • CODE F — PATCHES YES 0 NO Pr NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. All other areas — • shall be repaired by reconstruction gill s u first Inspection and Form Made By: Q S -- Date: ?be/4 • Pork Deportment Review Required 0 YES NO i PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' — ' CONTRACT COMPLETION DATE: I CODE G — Other' I 1 I I 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS / /O t &/Ej TW f 5 T E3 13 Z37 - az7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR vZJ 7 zzA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I (1 I I I WATER SHUTOFF \ VISIBLE ❑ BROKEN 0 • MISSING 0 A-L ,t&w r s�11 Property Linn 4./ LOCATION OF SIDEWALK ri FRONT YARD 0 SIDE YARD 0 OTHER _ mob OF SIDEWALK 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK tic4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED IG" 4 in. ■q.1t. 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 I it quares. first Inspection and Form Made By: 5 .Y Date: 3A //O Park Department Review Required 0 YES VINO 1� 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 44e33 Chel-1314:-/- ci, • _ / is30 , PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND -•- L' --4 -1 AREA NEEDING REPAIR 17,7/17i/ZZA — L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) _ (See below for Defect Code C) * ADDRESS. c ?NAL...Li ,)_‘, WATER SHUTOFF VISIBLE 0 \ ' iQk' ' P'(- A‘ . ...,• 5.,1y, BROKEN 0 MISSING 0 A . A Property LinfA_ i --I. 41/I 11/4/11/A lik 10/1 , Y ''V4 '0 csciiy o / . \ . I . LOCATION OF SIDEWALK V, FRONT YARD 0 SIDE YARD 0 OTHER tinj OF SIDEWALK 0 4 FEET bt, 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 1a 4 INCHES 0 5 INCHES 0 6 INCHES 05'5: _ AREA TO BE REPAIRED q.f 1 4 in. -sq.ft. 5 In. --...._e q.f 1 6 in. CODE F - PATCHES YES 0 NO 'p 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..., --C-7- LC> Dale; -3 • Pork Department Review Required gt YES 0 NO _ i PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: , CODE C - Other. , r - I ,. • I r . , SIDEWALK REPAIR SURVEY FORM CM' OF WATERLOO. IOWA PROPERTY ADDRESS /09 ,bik 6 4'y �T • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR V7///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) ADDRESS: VACAKri— Lcri- Property Une " » WATER SHUTOFF VISIBLE ❑ rj Sci9E BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET ria 5.3 FEET ❑ OTHER DEPTH OF.SIDEWALK ] 4 INCHES ❑ 5 INCHES ❑ 6 INCHES q✓ AREA TO BE REPAIRED • ��• sq.ft. 4 in. eq.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: f�-- � Date: 3 ' _ d ll 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 2GY> &/fL CALly .s • -3.(2.2.-aQ . 41112 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-e- E' AREA NEEDING REPAIR VLLffff,A I - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ), i ADDRESS. I ° L` (-1- WATER SHUT SHUTOFF vislait ❑ BROKEN ❑ MISSING ❑ Property Line 5.1 • LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER /am OF SIDEWALK ❑ 4 FEET 0 5 FEET L . 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ? O q ft. 4 4n. ■q.It. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES ❑ NO IN NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. Ail other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By:_._ r1 i r Date: -3 _. 97 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 WTERLOO. IOWA 10 _ PROPERTY ADDRESS _ D 1 o: , , +, 7 1.3 —.1ALI _3 03 _o ao I 441 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I-4— E' AREA NEEDING REPAIR Wf.f fZWA L J. length of repair needed p. Type of defect ° , (See reverse side for Defect Codes A—F) (See below for Defect Code C) 4--->l<- ADDRESS. a u ` /203 I I WATER SHUTOFF \ VISIBLE OK • sae BROKEN ❑ MISSING 0 _R Property Line _ A 56 % ,,, c.--,,,,,j LOCATION OF SIDEWALK i` FRONT YARD 0 SIDE YARD 0 OTHER 21218 OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 0 OTHER DEEIB OF SIDEWALK qt 4 INCHES 0 5 INCHES 0 6 INCHES — AREA TO BE REPAIRED S� q.tt. 4 in. sq.tt. 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. Alt other ursas shall be repaired by reconstruction of full squares. First Inspection and Form Mode By: __.. Date; Park Department Review Required ip YES 0 NO -! PERMIT ISSUED NO. w DATE:, INSPECTION DATE: '_ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE C — Other - i (I I ' ...), __ , SIDEWALK REPAIR SURVEY FORM — CITY OF WATERLOO. IOWA PROPERTY ADDRESS . ; 1 / C`.,:) - PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND L' —'"1 AREA NEEDING REPAIR Llll//zezza — L IN length of repair needed / Type of defect r`t (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. c 9/ 7 I ' WATER .SHUTOFF VISIBLE 0 . \ . LeI' BROKEN 0 . MISSING 0 fI �1 ttL — lrAIiON OF SIDEWALK (FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET 0 5 FEET t-.5.3 FEET 0 OTHER — DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED �6.5 — sq.ft. 4 in. sq.il. 5 In. sq.ft. 6 in. • CODE F — PATCHES YES 0 NO Of 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 uoi s. , First Inspection and Form Made By.Y_ Dale; -, • 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. I 1 I I i- ` i • • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR IMIZZ/li A L a. length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 44* ADDRESS. IC3I WATER SHUTOFF \ VISIBLE 0 BROKEN ❑ MISSING 0 Properly Une }r,//I'// ct LOcialj¢b OF SIDEWALK CSI. FRONT YARD ❑ SIDE YARD ❑ OTHER igni OF SIDEWALK 0 4 FEET 0 5 FEET .5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 2 ` sq.tt. 4 in. ■q.tt. 5 In. sq.fl. 6 in. CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES,..— NOTE. Areas marked with an - may bn repaired by patching. Ali other ursas shall be repaired by reconstruction of 'full squares. First Inspection and Form Made By:—� I v Date; `-)- -15 (O Park Department Review Required [] YES (;i1 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: . IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: • CODE G — Other. I 1 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS d9 C Lill 7 Sr PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' • AREA.NEEDING REPAIR VZ//777///A L = length of repair needed �j Type of defect I II �°' (See reverse side for Defect Codes A—F) (See below for Defect Code G) *.ts,, ADDRESS: 7 _ Property Line _ _ �\ r j ' /7 j WATER SHUTOFF t1C�Jt5;3 i----- VISIBLE 0 . +BROKEN ❑ f / MISSING El LOCATION OF SIDEWALK a 1' FRONT YARD 'SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK 0 4 FEET 54 5 FEET p 5.3 FEET 0 OTHER DEPTH OF SIDEWALK ) ] 4 INCHES d 5 INCHES ❑ 6 INCHES i ` S✓. ✓ AREA TO BE REPAIRED ' i v ' sq.ft. 4 In. 417"-sq.ft. 5 In. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO yi 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 fuUquares. First Inspection and Form Made By: ►t_.i. (.— ' Date: •-` -)5-110 •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 3 ILI PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR I///1WIMA L - length of repair needed A Type of defect (See reverse side for Detect Codes A—F) (See below for Defect Code C) ADDRESS. 3 17 I I WATER SHUTOFF max ❑ BROKEN 0 MISSING 0 Prbptrty Line ///f 5.5 LOCATION OF SIDEWALK Itj FRONT YARD D. SIDE YARD 0 OTHER • jb OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 0, 4 INCHES 0 5 INCHES 0 6 INCHES a`f AREA TO BE REPAIRED . ■q.fI. 4 in. ■q.ft. 5 In. ■q.tt. 6 in. • CODE F — PATCHES YES [„] NO 1I 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: Lt Date: _ _10 • Pork Department Review Required I) 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 ��, 7/3,2 J (°f,A y PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' AREA.NEEDING REPAIR f//////////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 Z022-5 7s> Property Line WATER SHUTOFF VISIBLE El bS BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK in FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET ( 5.3 FEET Cl OTHER — DEPTH OF.SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES < <jj �✓ . AREA TO BE REPAIRED • 33 Qq.ft. 4 in. sq.ft. 5 in. sq.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. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: i Cis Date: d Park Department Review Required ❑ YES It] 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 WATERLOQ, IQWA PROPERTY ADDRESS 34k CA PARCEL eODE _— CONTROL NUMBER CERT. NUMBER LEGEND - L' -- • AREA.NEEDING REPAIR VJZ/Z7/Z727 L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) • ADDRESS: AProperty Line ////I1//A WATER SHUTOFF I ' VISIBLE ❑ t r• O BROKEN SG� L I MISSING ❑ iV • LOCATION OF SIDEWALK ❑ FRONT YARD IA SIDE YARD ❑ OTHER WIDTH OF-SIDEWALK ❑ 4 FEET 5 FEET ❑ 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK V( 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED • sa sq.ft. 4 in. sq,ft. 5 in. cq.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: w Date: 3-a-tf- 16 Park Department Review Required t, YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: • IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • i CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . bl k - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR I////lll//fA L. IN length of repair needed .£" Type of defect to (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I y itL/u Y 1r WATER SHUTOFF `" VISIBLE ❑ _ j J ! LBROKEN 0 IN 7 r!`„e f U a e �` MISSING 0 Property line /4fr-ifI 1o ' j=GEM OF SIDEWALK 0 FRONT YARD Pit SIDE YARD 0 OTHER, j OF SIDEWALK 0 4 FEET tA 5 FEET 0 5.3 FEET 0 OTHER DEEM OF SIDEWALK 115 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ' _. q.fl. 4 in. sq.lt. 5 In. sq.ft. 6 in. CODE F — PATCHES YES 0 NO tst 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 f�squares. L- 7 First Inspection and Form Made By: 11 " .. Date: 3 - 5-/0 Pork Department Review Required 0 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 OF WATERLOO. IOWA PROPERTY ADDRESS (q60 g locK) C [Qy Sf. 3gr3 _ay_ls _. f (17/ PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND E' AREA NEEDING REPAIR W'f/f/WZ/A l - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) Ai* ADDRESS. i VACANT ( WATER SHUTOFF VISIBLE ❑ \ . Lod • see BROKEN 0 MISSING 0 — if----/' i-ti'' riely Wei Li., 11‘-'i‘47 \ • i 7 i -, IP 1 )'\ ti.)1t MI ,QN OF SIDEWALK Et FRONT YARD 0 SIDE YARD 0 OTHER .M OF SIDEWALK 0 4 FEET 0 5 FEET I ,.5.3 FEET 0 OTHER DEPTH OF SIDEWALK ti 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED c L1_q.tt. 4 in. ■q.It. 5 in. ■q.tt. 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 f it squtares. First Inspection and Form Made 8y: 1 `� L C f Data: 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 1 I I . 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 2/8 coG u,Y,a ,4- ,51 1L3 Z 3 - z.8 z- 061, /0/9 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR V7//777777A L = length of repair needed Type of defect k (See reverse side for Defect Codes A—F) • (See below for Defect Code G) 4‹ ADDRESS: I \o 41 th J Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ C.eV 5(pj� ?L- MISSING ❑ LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF.SIDEWALK ❑ 4 FEET \ 5 FEET El 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK ] 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED E.o3 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. l r First Inspection and Form Made By: ' 5 Date: 31 Z5 ! 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 Poi'etYia-k r La-C -s enk o4- sifx2wd�` iFi +rte rn.s4-•t a.re res „t a s I Ci4y eelleteer. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 400 b/k COL \ a 01l 3 -7.1_ZG B-o / / ✓ /0/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V/Il/Ullls L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) `7; /9 I (See below for Defect Code C) vp.c- Lea (01-0^aTA CI " ADDRESS. I U WATER SHUTOFF N VISIBLE D see BROKEN ❑ MISSING 0 LOC g&- ,usNG WALL eoperty !ine • CZ)LAI M.1STA -ST. LOCATIONOF SIDEWALK "`FRONT YARD 0 SIDE YARD ❑ OTHER ZWII OF SIDEWALK 0 4 FEET 0 5 FEET 0/5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 1 INCHES 0 5 INCHES 0 6 INCHES v AREA TO BE REPAIRED Z' � ■q.tl. 4 in. sq.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES [,] NO Q NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an - may be repaired by patching. Ali other ursos / shall be repaired by reconstruction I WI squares, 1 First Inspection lion and Form Made Sy: 2.f .r Dale: 3/zV / Park Department Review Required 0 YES - kl0 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 40Dbik 6,1 L t Y4 15.1—Pc 57— 8, 13__2.1- 208_oi2, ✓ dc)Z. PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND 1-*— L' '"I AREA NEEDING REPAIR Ifffiiviia L v. length of repair needed Type of defect �\ , (See reverse side for Defect Codes A—F) / (See below for Defect Code C) tJ Aft ADDRESS. LG T I I WATER SHLIPOFF VISIBLE ❑ \ Sae • BROKEN 0 — MISSING 0 z 4 �� r3 Lot, k. ReAc ;A,.1 r,j c, I f _ j L_ I _. / Property Unit _ / / l q6` G/_, A Al ill -Lic 1,2=10 OF SIDEWALK 4 FRONT YARD 0 SIDE YARD 0 OTHER IB OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET W OTHER L •Y DEPTH OF SIDEWALK [ 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED I o_ s.it. 4 in. •q.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 be repaired by patching. Ali other areas shall be repaired by reconstruction of full squares.First Inspection and Form Made By: 35 Date: .1/zV /C) Pork Department Review Required fzi YES 0 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 y Zc-71 &ILL -z3 _ z3f-- gaJ l423 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L, • AREA.NEEDING REPAIR rl/I///7/WA L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) t^ >< ADDRESS: 4/2/ O 1 \'‘ - `^ Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ ,A `A-O MISSING, ❑ W LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD D OTHER — WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET I5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK [ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 53 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ 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 ful squares. First Inspection and Form Made By: 3 5 Date: -5/45--k) 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 . 27h-17 Co�t/^-t8_T)A, S1-: f- _ 89 i3 43-2-°8—e(.3 1067� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR Vi'WWf'l« L ss length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. / 7 WATER SHUTOFF vtsre[E ❑ . \ ° gee BROKEN 0 _ MISSING 0 FN r z't" S+o vve, ReA- �l q� 1iJ 4.1 Ploys;Iy tine — 1..-. — GL e4.1 lL-f _ -- 14, (s .®` _ • _LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER D OF SIDEWALK 0 4 FEET ❑ 5 FEET 0 5.3 FEET a OTHER S- DEPTH OF SIDEWALK 1;Ski INCHES 0 5 INCHES 0 6 INCHES V AREA TO BE REPAIRED Z t( `d.t1. 4 jinn. sq.it. 5 In_ sq.ft. 6 in. CODE F — PATCHES YES 0 NO 07 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 WI square 9�j First Inspection and Form Made By:_,_ 5' .-- Date: L/z3 / Park Department Review Required V YES 0 NO _ i i PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE; 4 CODE C — Other j 1 • t 1 1 t I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS zi� / eO Lt1'r r i - 5T '� 8913 _z_3= z _ o`o ✓ `®p, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --41 r AREA.NEEDING REPAIR WI/77I//T4t f L = length of repair needed v 3 Type of defect A, Cr C (See reverse side for Defect Codes A-F) _ (See below for Defect Code G) ri Q(�, II Q \ lEter ADDRESS: / ! t' I ``___ c S 3 24" ,,, tA,Prc� ' ,--yvs /°'7 ..-PropBr£y Line */''----v 5•(7 ,---, . ----1 e L e zi n) l Gt.AAA! t.) 4 L T 1=1 WATER SHUTOFF / R uc VISIBLE ❑ (v 7 0 A CAP _ pj BROKEN ❑ �y� MISSING ElOLJ�M 'k ..'l LOCATION OF SIDEWALK El FRONT YARD S SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET yi 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES pg 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED •4 I' sq.ft. 4 in. S '�sq.ft. 5 in. sq,ft. 6 in. - CODE F - PATCHES YES ❑ NO 4 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 fulll/ quares.First Inspection and Form Made By: / '1-{ 13 Date: 3)a,// /0 Park Department Review Required p YES 0 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G - Other f ofen a.I reip\a.c. rvie.n-j- (a- sidewo,tK i c -free. .00{-s are pr e.s e n+ a' d e i-e wi sin hy C 1 y £A1/43;ne e r- SIDEWALK REPAIR SURVEY FORM C[FY OF WATERLOO, IOWA PROPERTY ADDRESS Jo 3 C'OL um BrA 89t3 -z3 _ C _ ©t- /W7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —"1 AREA.NEEDING REPAIR V77///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: 503 3 1 1 WATER SHUTOFF VISIBLE ❑ A j G f� CAP / Dy BROKEN 0 MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET El 5.3 FEET W OTHER — 35, 5 ` DEPTH OF SIDEWALK "'l 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 3 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES El NO NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an nr 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 )Z Li I /D Park Department Review Required 14 YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: - CODE G — Other C41 RR..E Cr re)/) SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 67a, hi edL c//y),4 .5 1 ecl La-2 3_ 224—o© 3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND Ls AREA NEEDING REPAIR VJZL/Z l JA L length of repair needed Type of defect (See reverse side for Defect Codes A—F) 2 2 (See below for Defect Cods C) J 411* ADDRESS. LTV WATER SHUTOFF vislulE ❑ • zer BROKEN Cl MISSING Property tine 7 5 A ea f,riii i A_)f1 LQciatO OF SIDEWALK 9.4 FRONT YARD ❑ SIDE YARD ❑ OTHER, MUM OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET 0 OTHER nEettl OF SIDEWALK pit4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED '3 '!�q-tt. 4 ,n. ■q.it. 5 In. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO [* ND. Of SQUARES WITH PATCHES NOTE. Areas marked with an - may be \aired by patching. Ali other areas shall be reoaired by reconstruction gyp!lfull equ r1 j �a First Inspection and Form Made Ely:_ r" (� 'I,` Date: Pork Department Review Required [ YES ❑NO PERMIT ISSUED NO, DATE:, INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other • ii SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS (0 5 Cod GL_(Z �r PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' `h AREA.NEEDING REPAIR r/7////I/7/A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 14 • 4‹ C ADDRESS: h J A 13 Lp G. Property Line WATER SHUTOFF VISIBLE ❑ BROKEN 0 MISSING 0 C O A/6 &P 5-r LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD El OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES kr6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. eq.ft. 5 in. -7":7' sq,ft. 6 in. • CODE F — PATCHES YES ❑ NO 4 NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" be repaired by patching. All other areas shall be repaired by reconstruction of f II squares. /10 First Inspection and Form Mode By: .$5 Date: /21 Park Department Review Required ❑ YES i0 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 bfk e01, 6.& _ i - 8gl3_-ZI__22g _0 4/0 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I-e— L' AREA NEEDING REPAIR IMM://i7A L — length of repair needed See of defect 5 (See reverse side for Defect Codes A—F) ) (See below for Defect Code C) / 119 ADDRESS. —. X WATER SHUTOFF VISIBLE ❑ . _ \ • 2 FA RC- 1- SAE BROKEN 0 tt MISSING 0 t '� Property Line _ r 1 /1///1/ ' i \ . C S Code>E2 51- IMMO OF SIDEWALK 9/FRONT YARD 0 SIDE YARD El OTHER OF SIDEWALK 4 /FEET 0 5 FEET 0 5.3 FEET 0 OTHER aeni OF SIDEWALK / 0 4 INCHES 14,2c 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ■q.tt. 4 in. ` 7`�'q tt. 5 In. ■q.fi 6 in. CODE F — PATCHES YES 0 NO Ld NO. OF SQUARES WITH PATCHES �; NOTE. Areas marked with an - may be repairedre by patching. Ali other areas shall be reooired by reconstruction II squ Date: V/Zs bo First Inspection and Form Made By: __I Pork Department Review Required 0 YES - pf NO PERMIT ISSUED NO. DATE:, INSPECTION GATE: '_ 1 IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: 4 I+ CODE G — Other. — f 1 .• I I .., SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS z22 ,67ex_ i:0 A/6,&- \ 5.77-/ i/ /I I' PARCEL. CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-11— LI —*-1 AREA NEEDING REPAIR T/7/407/7"./A L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods G) ADDRESS. I 01 C ' WATER SHUTOFF ( '"e i.) \• \ • (-61— VISIBLE 0 SAE . - BROKEN 0 . MISSING 0 . _ 405') pert, Une 0 . Cler__Lk12.42-AL--\(-- LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Mid OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 17.5 0 OTHER-----. _ Zen! OF SIDEWALK W.4 INCHES 0 5 INCHES 0 6 INCHES .265•0 * -- AREA TO BE REPAIRED --t—sq-tt. 4 in. --sq.11.. 5 in_ —____sq.11 6 in. CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may tin repaired by patching. Ali other areas • shall be repaired by reconstruction I ull squ s. . , First Inspection and Form Made By: i - Date: 3 1 zza PO Park Department Review Required pi YES 0 NO PERMIT ISSUED NO. _ DATE: INSPECTION DATE: ' ! _ IF UNCOMPLETED, SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: • CODE G — Other. I _ i I I _ 1 • , . . --- SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3 2 2 Cv�G�A 5T-,I8.,Et3- z - ZZ9- oczq ✓ 11Z PARCEL CODE CONTROL NUMBER CERT. NUMBER -1 LEGEND k— L' —"1 — AREA.NEEDING REPAIR VI/7I/7/77A N L = length of repair needed Type of defect - (See reverse side for Defect Codes A—F) z (See below for Defect Code G) V ., t ... >< ADDRESS: 3 2 -2 ,•— s \ 4.4. ---. \ '¢ o Property Line 4 J •VV . WATER SHUTOFF VISIBLE ❑ CAP , rilBROKEN ❑ CONGE/ sr- - MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD C( SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET fa 5.3 FEET 0 OTHER DEPTH OF SIDEWALK R„ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 21 Z 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 ful squares. // First Inspection and Form Made By: s Date: J/ C!Z w 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 . 4/73 ( AfKC2 5r . . _ 8-513 -0-ZL24 -off 11.3 . PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND LI -1 AREA NEEDING REPAIR V//Illll/!A L I length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) - ADDRESS. /3 I I WATER SHUTOFF VISIBLE ❑ • \ " ME BROKEN ❑ . MISSING 0 7./ _ _ _ Property tine `//,k-i A S ' eo,V 6 ER. _5 1,XXIIMI OF SIDEWALK i FRONT YARD 0 SIDE YARD 0 OTHER .!IPD OF SIDEWALK 1XJ 4 FEET ❑. 5 FEET • 0 5.3 FEET 0 OTHER — DEEM OF SIDEWALK ,\ /06 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Zb sq.tt. 4 in. ■q.it. 5 In. ■q.ft. 6 in. — ` • CODE F — PATCHES YES 0 NO NO. Of SQUARES WITH PATCHES • NOTE. Areas marked with on -r may be repaired by patching. All other areas — shall be raDairsd by reconstruction t �ull squares. �=A� • First Inspection and Form Made By: f"T"� .. Date' ' ,/ 6 • • • Pork Department Revises Required 0 YES [ NO i PERMIT ISSUED NO. DATE: INSPECTION DATE: ' • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• -. CONTRACT COMPLETION DATE: , • CODE G — Other. i _ t I I — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS V77 eaA(G /e 2� eD�3-t_3-za4-ac a f/ 1 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND LI -'-I AREA NEEDING REPAIR U7ii717il.fit L am length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) 1 ADDRESS. 11/'2 I WATER SHIJTOFF viStuLE ❑ SAE BROKEN ❑ MISSING 0 Property Line • LOCATION OF SIDEWALK L FRONT YARD 0 SIDE YARD 0 OTHER Illud OF SIDEWALK Pf 4 FEET ❑ 5 FEET ❑ 5.3 FEET 0 OTHER JJ Lani OF SIDEWALK tL] 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 3 ■q.tt. 4 in. ■qat. 5 In ■q.tt. 6 in. CODE F — PATCHES YES [,] NO NO. OF SQUARES WITH PATCHES,.._.. NOTE. Areas marked with on -r may be repo ed by patching. Ali other areas 3 shall be repaired by reconstruction i till s a. /, First Inspection and Form Made By:_ 5 .� Date: v Park Department Review Required ❑ YES 7 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: 4 CODE C — Other 1 1 • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 309 C 1 5 C- ,yT PC PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' -"! AREA.NEEDING REPAIR r//ll//Il//it L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) • >Kir ADDRESS: Jd 9 I Property Une , WATER SHUTOFF VISIBLE ❑ CAP Di BROKEN ❑ MISSING ❑ L-rn/CC)L A44 57: LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET [r 5.3 FEET ❑ OTHER — \ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED :7(-, I q ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES El NO 9‹ 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: j ,5- Date: 3/ZS7/I/ 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 3 2,7 ()p()pi- c A / f't' _ PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' AREA NEEDING REPAIR V/I///I/I7i1 L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 32 7 ' WATER SHUTOFF vtSiati 0 .rdse BROKEN ❑ MISSING ❑ 5 Property Line 4 C_R cSC_TA/T PL_ LOCATION OF SIDEWALK j1 FRONT YARD ❑ SIDE YARD 0 OTHER WIQIb OF SIDEWALK ❑ b FEET 0 5 FEET' 5.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK EX. 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 2-3 • -aq•tt. 4 in. •q.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES C] NO 04 NU. 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 squ s. First Inspection and Form Mode By: ?, .. Date: � /Z5// 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° �. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 2v 3 DA/4,4' S7 /3 2-4_-- t52 c /17 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND • - AREA.NEEDING REPAIR V7/./7 ./77A- L = length of•repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 201 Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ LOGO/✓ .IE'A , MISSING ❑ LOCATION OF SIDEWALK X FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH Or SIDEWALK ❑ 4 FEET El 5 FLU ❑ 5.3 FEET 0. OTHER _ - 2. DEPTH OF SIDEWALK c2k 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 7b` 5 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 o�/fiII squares. First Inspection and Form Made By: / Date: • 3 z /J v Park Department Review Required E] 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 0 8 rpAit16 _ 89rL- - lSC -c Z1 /I } PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND L' AREA NEEDING REPAIR vifilr7ii7A L 01 length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) i ADDRESS. 20 WATER SHUTOFF \ • VISIBLE ❑ VIE BROKEN ❑ MISSING 0 Property Line A` S ( Wv r j)A J .51-• LOCATION OF SIDEWALK 0+' FRONT YARD 0 SIDE YARD 0 OTHER ..r IDTH OF SIDEWALK 0 4 FEET ❑ S FEET S.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK [l< 4 INCHES 0 5 INCHES 0 6 INCHES C AREA TO BE REPAIRED J ✓_..sq.ft. 4 in. •q.tt, 5 in. eq.ft. 6 in. CODE F — PATCHES YES 0 NO) NU. 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 squarer. , First Inspection and Form Mode B /y:_� .� Date; 2 tz T / Pork 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 `i Or `1� } , PARCEL CODE CONTROL NUMBER ' • __ CERT. NUMBER LEGEND • AREA.NEEDING REPAIR W././7177ii L = length of repair needed 1, Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) O ` ADDRESS: 131 Property Line WATER SHUTOFF Dy VII ❑ SdVI BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK 0 FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET V5.3 FEET ❑ OTHER _ DEPTH OF.SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ___ sq.ft. 4 in. ( I.Ogq.ft. 5 in. cq.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: tL u✓` Date: "� Park Deportment Review Required ❑ YES 5i1 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 5429 b/k' /74-A/6 • - _ /7-67 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom' L' AREA NEEDING REPAIR WiiZ/Z1Z/a L length of repair needed Type of defect 1' (See reverse side for Defect Codes A—F) Po-cy (See below for Defect Code C) r—_i" ADDRESS. I I Vik' i7- ( WATER SHUTOFF VISIBLE 0 BROKEN 0 MISSING 0 Property Line 0,1 LOCATION OF SIDEWALK aI FRONT YARD 0 SIDE YARD 0 OTHER 13218 OF SIDEWALK ❑ 4 FEET 711, 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 1E4 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 60✓q.t1. 4 in. 5 in. •q.ft. 6 in. CODE F — PATCHES YES 0 NO !lJ NO. OF SQUARES WITH PATCHES NOTE. Arsos marked with an - may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares. Forst Inspection and Form Mode By:_.. , r Date: Pork Department Review Required 0 YES INO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0• CONTRACT COMPLETION DATE: CODE G — Other • II J.` SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • PROPERTY ADDRESS . S Z / 1:7,44)c s t - . '39 I3_2 _15 -00b ✓ /Z/ PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND L' AREA NEEDING REPAIR VJi1YZlfL/A _ L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) _. *-- ADDRESS. T G z 0 Pce. WATER SHUTOFF \ • rtk .G6e . '`/ BROKEN 0((� MISSING 0 V y„ .__ A Property Une _ A — I �/ ` ✓,�``/f i/ `/l/ t• /l/ / tii" c.1;/ / \ • De. z LOCATION OF SIDEWALK ha FRONT YARD 0 SIDE YARD 0 OTHER mcii OF SIDEWALK 0 4 FEET 5 FEET • 0 5.3 FEET 0 OTHER aeltt OF SIDEWALK C4 4 INCHES 0 5 INCHES 6 INCHES st � .7b L> Dv - AREA TO BE REPAIRED •q•fl. 4 ;n. •q.ft. 5 in. •q.ft. 6 in. • CODE F — PATCHES YES 0 NO E. NO. OF SQUARES WITH PATCHES • NOTE. Amos marked with an -r may be repaired by patching. Ali other areas _ • shall be repaired by reconstruction of fullf squares. First Inspection and Form Made B S `— Lc' _ Date: — S+/0 • Y'--- Park Department Review Required 0 YES ONO — PERMIT ISSUED NO, DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: I CODE G — Other: I 1 • t I I l SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS /©a t�Pv�S j f 89 i3 _23_ 237 —0(.)_5`✓ ` ZZ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR Vl//IWWlil l NB length of repair needed Type of defect C Z See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. Y ()AC WATER SHUTOFF VISIBLE 0 BROKEN ❑ MISSING 0 Property Line _ /05 . . CGE/4A.1 J4 t(_, IfU D/lA) s Cf) u/1arcID S 57- ,yrjlQy OF SIDEWALK RI FRONT YARD 0 SIDE YARD 0 OTHER JOF SIDEWALK ❑ 4 FEET ❑ 5 FEET CS(5.3 FEET 0 OTHER Y.__. mob OF SIDEWALK 4 INCHES [] 5 INCHES ` 0 6 INCHES AREA TO BE REPAIRED 55 +' 4 in. •q.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES [,� NO DI NO. OF SQUARES WITH PATCHES NOTE. Arens marked with an -f may be repaired by patching. All other areas shall be repaired by reconstruction of ull squares. First Inspection and Form Made By: _ Date: 3/%6//0 Pork Department Review Required [] YES ( NO PERMIT ISSUED NO._ DATE: INSPECTION DATE: '_ JIF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE G — Other Ii • J i I ! SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS. 1 i y &D W ea) s . es 0 -?3-z_v-02_3 1;.3 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND L' AREA NEEDING REPAIR viwztfiiia L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. / /I/ I ! WATER SHUTOFF \ VISIBLE Q . \` S6E BROKEN 0 MISSING 0 5.5 3.� - Property Line _ a _ I \A ,/,i / ,___ . 2C. / EjDvi _ =MO OF SIDEWALK CX FRONT YARD 0 SIDE YARD ❑ OTHER OF SIDEWALK 0 4 FEET 0 5 FEET g s.3 FEET 0 OTHER _ DEPTH OF SIDEWALK tb.i 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 1 ��sq.tt. 4 in. ■q.1t. 5 In. 27` Z q.11. 6 in. CODE F — PATCHES YES 0 NO I i NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. Ali other areas • shall be repaired by reconstruction I lull squopX. first Inspection and Form Mode By: ; Dais: ` (a i I° Park Department Review Required 0 YES (i NO !i PERMIT ISSUED NO._ DATE: INSPECTION DATE: ' _ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: 4 CODE C — Other I I ' t 1 i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS ff-gL A2-c cam, 85'_/3 _ZS 233_ 06).9 174 PARCEL CODE CONTROL NUMBER PERT. NUMBER A LI � L LC `} LEGEND AREA.NEEDING REPAIR r/f//TlllllA L = length of•repair needed Type of defect (See reverse side for Defect Codes A—F) - (See below for Defect Code G) \ ADDRESS: I V � v 0C Jc Cuspate 4 cn tr Property Line \ Q WATER SHUTOFF VISIBLE ❑ JCAP BROKE4D ED Kr-12.D� S� MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER 2 Q / WIDTH OF SIDEWALK ❑ 4 FEET IDEE 5 FT ❑ 5.3 FEET L OTHER )iCJ DEPTH OF SIDEWALK ICJ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 7/' 8 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; /Date: 3/2% a 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 Z33 yCb ArrAS r3 _z3 - ? 6- v/ 9 PARCEL CODE CONTROL, NUMBER CERT. NUMBER LEGEND L' -� • AREA.NEEDING REPAIR t/7//777///A L = length of repair needed Type of defect - See reverse side for Defect Codes A—F) (See below for Defect Code G) h • >Kr v^ _ ADDRESS: I ., tt.,( Property Line e WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ cA :T- LOCATION OF SIDEWALK fZi FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF•SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 73' sq.ft. 4 in. Gq.ft. 5 in. sq.ft. 6 in. • CODE F — PATCHES YES ❑ NO 24 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 squc s.First Inspection and Form Made By: / T Date:J/'/l /*° 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 300 f toc.K Ed wards S-1-4; _ 8q ►I-z1-2Z5-oo3 IUo PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR WWWZ7I?VA L : length of repair needed c Type of defect (See reverse side for Defect Codes A—r) (See below for Defect Code G) 2 Lon ctmow 5 LV\°° ADDRESS. Vacs .\- o WATER SHUTOFF VISIBLE ❑ S�2 • BROKEN ❑ MISSING ❑ /0.S' Property Line 6„ wocc s S+. LOCATION OF SIDEWALK ( FRONT YARD 0 SIDE YARD ❑ OTHER .r r OF SIDEWALK ❑ 4 FEET MI 5 FEET 0 5.3 FEET ❑ OTHER -- DEEM OF SIDEWALK ❑ 4 INCHES 0 5 INCHES (21 6 INCHES AREA TO BE REPAIRED _sq.ft. 4 in. sq.ft. 5 in.-5 r5_ ■q.ft. 6 in. CODE F — PATCHES YES C] NO gl NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bri repaired by patching. All other areas ,nd shall be repaired by reconstruction of full squares. -First Inspection and Form Mode By: .. Date: 7- 10 Pork 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. IOWA PROPERTY ADDRESS Z7JI( D(A/tt-2 D s _- et/3 -Z3 - 23:0 LI ✓ !Z� _. PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND f"""' L'AREA NEEDING REPAIR wzz.zrlmA 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 c �, vISIBLE 0 c „ Ur_ BROKEN ❑ . MISSING ❑ /a G_ Property Line -. 5 3 7 /7141 (-I=I al l G. f C,s C C —' �j el GLr:A^"i EVWP2'D_ 57" LOCATION OF SIDEWALK ?RONT YARD ❑ SIDE YARD ❑ OTHER _ sum OF SIDEWALK ❑ 4 FEET 5 FEET ❑ 5.3 FEET ❑ OTHER —..,_— DEPTH OF SIDEWALK 4 INCHES [] 5 INCHES 6 INCHES AREA TO BE REPAIRED Zb J .q.ft. 4 in. sq.ft. 5 in. 3 q.tt. 6 in. CODE F — PATCHES YES [] NO I* NO. OF SQUARES WITH PATCHES.._._. NOTE. Areas marked with on _F., may bet repaired by patching. All other areas shall be repaired by reconstruction f full s ores. First Inspection and Form Made By: Date: 3(/z-6 /O ,�,/ Pork Department Review Required ❑ YES ONO 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 . 3f� 6DWAW 5 , T- • i3-23-z3Z -ol f /Ze7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E AREA NEEDING REPAIR ul/LfL�WA L N. length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. 1 I I WATER SHUTOFF VISIBLE ❑ BROKEN ❑ 8 MISSING ❑ 4.4 •• Property Ling I G LOCATION OF SIDEWALK PZ FRONT YARD 0 SIDE YARD 0 OTHER ,3QjtJ OF SIDEWALK 0 4 FEET ❑ 5 FEET [ 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 0 4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED q.tt. 4 in. sq.*t. 5 in. sq.ft. 6 in. • CODE F — PATCHES YES 0 N :1 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 tut squares. First Inspection and Form Made By: . _ Date: Pork Department Review Required ❑ YES ONO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: • CODE G — Other• y SIDEWALK REPAIR SURVEY FORM CETY OF WATERLOO, IOWA PROPERTY ADDRESS 322 50 vJAeo_5 (3, -z3 _ 04 PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND L' AREA.NEEDING REPAIR V7////////A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) Q>l< ADDRESS: 32 E.3 Property Line 4`3 l WATER SHUTOFF VISIBLE ❑ CAP BROKEN 0 MISSING 0 L'OLvit57,4 5r LOCATION OF SIDEWALK ❑ FRONT YARD (\SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET ❑ 5 FEET • [ J 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK ck. 4 INCHES ❑ 5 INCHES ❑ 6 INCHES — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES 0 NO pf 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. 2 • First Inspection and Form Mode By: i 1, Date: 5I2-5---1/G Park Department Review Required ❑ YES 15`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 t/// ED Jed/2L_ 5T . - 6,9 Li_z _z(-)6 _o i 130 PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND L' AREA NEEDING REPAIR v«zizzaiia L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 7 / I I WATER SHUTOFF VISIBLE ❑ It yrt ynt 6-� 1 BROKEN 0 MiSSING ❑ ..,-- Pre 6D -2r75 1QCA1iON OF SIDEWALK /L FRONT YARD ❑ SIDE YARD 0 OTHER Wilad OF SIDEWALK 0 4 FEET` C] 5 FEET 0 5.3 FEET [S OTHER ' OF SIDEWALK c4 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 3' q.ft. 4 in. ■q.ft. 5 In. ■q.fl. 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 ureas shall be repaired by reconstruction of ul squares First Inspection and Form Made By:—� 5..� Dale; 3Jz , / /o Pork Department Review Required Q YES NO �i PERIAIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED, SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: , CODE C — Other. I Li 1 SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO. IOWA PROPERTY ADDRESS . //6 E J� /P( j -5T _. 89 9_z3-2o _u i /3/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND ''' L' -"'I AREA NEEDING REPAIR v.fi./1/1/./YA L ■a length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. !/v WATER SHUTOFF VISIBLE ❑ \ ' .C6E BROKEN 0 MISSING 0 Property line - . c.9 LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER o OF SIDEWAi K ❑ 6 FEET ❑ 5 FEET 0 5.3 FEET OTHER S Z DEPTH OF SIDEWALK Oki 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Z sq.fl. ■q.ft. 5 in. ■qn 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 shall be repaired by reconstruction o It ■qu first Inspection and Form Made By: 3/ZC�I ii CD ._ .. Date: - Pork Department Review Required [ YES 0 NO _ PERMIT ISSUED NO. _. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT ND' CONTRACT COMPLETION DATE: i CODE G — Other. _ i j .h T I i I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 7 z3 ED i,.J/12O S -57 E39 i3 —z3—ZP8—00i2 132 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR v/7/.ZWZA L EN length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. �Z3 ' WATER SHUTOFF \ visiaic ❑ BROKEN 0 MISSING 0 4.q A*s Property Line LOCATION OF SIDEWALK 4.FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK ❑ 4 FEET 0 5 FEET A5.3 FEET ❑ OTHER MOB OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 52'S qAt. 4 in. —eq.ft. 5 in. sq.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 shalt be repaired by reconstruction o full squo First inspection and Form Made By: Dale: _ /L<1// 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 ( o Q iocK.) Fran ,1 j 2.9I2—?3--y?2—> (2 ✓ `33 PARCEL CODE CONTROL NUMBER CERT. NUMBER itj � tC- LEGEND k E '"1ff r` AREA NEEDING REPAIR WW1/#'LM5 L Ex length of repair needed \9 4) Type of defect See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I I WATER SHUTOFF �If a_C avVi- VISIBLE 0 \\\ rhea BROKEN 0 MISSING 0 tine r c v.Y1` A Irrjaal OF SIDEWALK a FRONT YARD ❑ SIDE YARD ❑ OTHER g OF SIDEWALK 0 4 FEET 0 5 FEET 12S, 5.3 FEET 0 OTHER DEPTH OF SIDEWALK INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED /P5S— qtt. 4 in. ■q.tt. 5 in. ■q.ft. 6 in. — CODE F — PATCHES YES ❑ NO [ NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with on "I" may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made 8y: R' I) L — Date; 3" 21-1—1 t Park Deportment Review Required 0 YES 6KNO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0. CONTRACT COMPLETION DATE: CODE G — Other. • 1 - SIDEWALK REPAIR, SURVEY FORM . CITY OF WATERLOO. IOWA PROPERTY ADDRESS , , (Q 2 J'-ra. 4.1-1 , c-i--N. ga 13 —23.--.92.1--Lwz V /34 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I'm— E' AREA NEEDING REPAIR 7/7l7l/'1ZIA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Detect Code C) ` ADDRESS. 3�s8 I — I >l<4 I WATER SHUTOFF \ vtsiBLE ❑ SAE BROKEN 0 MISSING 0 �L/Cj Property Line w _ +j 1— 5' /'' re,A11.1tr1 ST, =CUM OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER _. MT/ OF SIDEWALK. ❑ 4 FEET 0 5 FEET5.3 FEET 0 OTHER ,!DEEM OF SIDEWALK 0 4 INCHES vi 5 INCHES 0 6 INCHES AREA TO BC REPAIRED sq.ft. 4 in. sl'1 ■q•ft- 5 in. sq.ft. 6 in. -,. CODE F — PATCHES YES ❑ NO I& NO. OF SQUARES WITH PATCHES• - NOTE. Arras 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 B E S i ._._ Date: 3`2'� I P y' Park Department Review Required 0 YES Ea NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: , — CODE G — Other. 1 I . 1 1 . 1 i i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 60-- &W craw k l St ,• PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' —•h-{ � — AREA.NEEDING REPAIR rl///T/////�l v.. L = length of repair needed ( 11 e Type of defect �1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) 141 ADDRESS: G3 ea-1 c I 120. �-1 Property Line WATER SHUTOFF VISIBLE 5ft ❑ F3CAP " BROKEN ❑ ve' MISSING ❑ LOCATION OF SIDEWALK El FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK El 4 FEET El 5 FELI a 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES 'f'l 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED cf07.6 q.ft. 4 in. /00.7 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 be repaired by patching. All other areas shall be repaired by reconstruction of full squares. • First Inspection and Form Made By: R) . Date: ? 'Z Li -/v Park Department Review Required IX 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 6 7 FLM/\/j LTA/ $T et7 4z9 _oz� l3" PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR viZizz///!A t. length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. 6 l I ( nWATER SHUTOFF \ s18LE BROKEN 0 MISSING 0 r7 Property line Z • i smerQN OF SIDEWALK .FRONT YARD 0 SIDE YARD ❑ OTHER MQjd OF SIDEWALK 0 4 FEET 0 5 FEET 01 5.3 FEET 0 OTHER RUM OF SIDEWALK ❑ 5 INCHES 0 6 INCHES s AREA TO BE REPAIRED �ss��sq ft. 4 in. •q.it. 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, Ali other areas shall be repaired by reconstruction of full squares. 3/2 ,� First Inspection and Form Made By: . / 7� Dote; / 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 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS -72_ s+ ✓ -Z3 - y3i_ 001 ✓ /37 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - AREA.NEEDING REPAIR V///T//ll/�i C' Q� L = length of repair needed Wa•i( Type of defect • _ (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4i ADDRESS: 7 2 1 ( y 4 ! i 5q.z Property Line WATER SHUTOFF VISIBLE ❑ BROKEN ❑ MISSING ❑ i*'rcty0 -1" LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 'gi 5.3 FEET ❑ OTHER — DEPTH OF SIDEWALK 1St 4 INCHES I,5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED JZ3.y sq.ft. 4- in. 1 I.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 squares. First Inspection and Form Made By: . Date: 3'2� ' l0 Park Department Review Required ❑ YES 1S4 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 k- L' AREA.NEEDING REPAIR V,7/,Z7Z77Af L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) l< ADDRESS: 6 SA L vsrrso t/ Ac2wt Y v f O.7 Property Line IG �1 WATER SHUTOFF VISIBLE ❑ 5 cAP ` BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK R(FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET L� 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK Lid 4 INCHES ❑ 5 INCHES/ ❑ 6 INCHES AREA TO BE REPAIRED 5 -7 sq.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" may .be repaired by patching. All other areas shall be repaired by reconstruction of full squares. l/ First Inspection and Form Made By: Date: 3/Z 5—//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 q6 } r,;r; 1; rs. 5 , PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND Io— L' —■-J • AREA.NEEDING REPAIR V7////7/7/A L = length of repair needed QC-°` Type of defect �` _ (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: Ct Property Line WATER SHUTOFF pVISIBLE ❑ CAP j BROKEN 0 MISSING ❑ E (V\u i,ay. c\ve• LOCATION OF SIDEWALK El FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF°SIDEWALK 0 4 FEET 0 5 FEET a 5.3 FEET 0 OTHER_ DEPTH OF SIDEWALK El 4 INCHES ❑ 5 INCHES 6 INCHES AREA TO BE REPAIRED s 4 In G ft. 5 in. I�boy. q.ft. . q. Rq.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: R5 £ CS Date: 3 Park Department Review Required ❑ YES Ea 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 /w b/k F'29-1J1IL/AJ EqI _ 23_ 432_ 01 ✓ /40 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA NEEDING REPAIR r/W/T/////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) >lc ADDRESS: I S C.,��- L�� fl Property Line WATER SHUTOFF D., VISIBLE ❑ CAP BROKEN ❑ cu. 41 i f.h MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ®.SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 54 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK X 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED t°7, Z-sq.ft. 4 in. 'q.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: C Date: 3 -241 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 Fr- "an C+, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND U AREA NEEDING REPAIR w/mizwif L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) I ADDRESS. II Z ' WATER SHUTOFF VISIBLE ❑ r4e BROKEN MISSING ❑ i Property Line Frn�l"tom LOCATION OF SIDEWALK ( FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET OTHER DEPTH OF SIDEWALK 0 4 INCHES tSir 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED _..sq.ft. 4 ;n. 51, 0 aq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES CJ NO-1St NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may be repaired by patching. All other oreass shall be repaired by reconstruction of full squares. First Inspection and Form Made By: _� UG Data: __7-> �D Park Department Review Required 0 YES NINO 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 Zoo bl/ ivieLliV ST. - ;3_;4-i_3 _030 / /4Z PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND L' AREA NEEDING REPAIR 11i7IZ/Z/IIA I. - length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) 41— ADDRESS. 1 IIAA/v>4tt'LCit WATER SHUTOFF \ • L VISIBLE ❑ ()-°).7,41- gee BROKEN ❑ MISSING 0 Property Line r ii/ . li.5. i ;7,f'li1vt OF SIDEWALK c FRONT YARD 0 SIDE YARD 0 OTHER ydQjl OF SIDEWALK 0 4 FEET 0 5 FEET Ai 5.3 FEET 0 OTHER / DEPTH OF SIDEWALK e 4 INCHES ❑ 5 INCHES 0 6 INCHES _J AREA TO BE REPAIRED ` ��■q.tt. 4 in. ■q.tt. 5 In. •q.ft. 6 in. CODE F — PATCHES YES 0 NO y4 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 fuullll a uares, Furst Inspection and Form Made By: i ' t"'t' Date: �'!10 Pork Department Review Required CI YES NO —J i PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0' CONTRACT COMPLETION DATE: i CODE G — Other _I I 11 f SIDEWALK REPAIR SURVEY FORM . 1(z..... — CITY OF WATERLOO. IOWA PROPERTY ADDRESS zo7 r44,( 2-/,tl — 8113 -?4t-ffe- o. L /43 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND EI AREA NEEDING REPAIR vJifiLlIiil I. I length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) •-- ),( ADDRESS. I Ih/�jat3O �-- LL A ( WATER SHUTOFF \ VISIBLE 0 ._ 1QKItiA tor-4. 6"L fee BROKEN 0 MISSING 0 S.► qr9 _. Ib,7 .2.0 Property Line ,e ! mg r 4 A et . , till I-O 1 - L OF SIDEWALK (FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWAU( ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET Q OTHER S• DID PTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED J&Ibq.ft. 4 ;n. •q.ft. 5 In. sq.ft. 6 in. CODE F — PATCHES YES 0 NO CJ 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: 70 t;G • .. _ Dale; Z g7 Pork Department Review Required YES 0 NO PERMIT ISSUED NO, DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: I CODE G — Other .aTTAL g / V 4 ►F TIQEc 2A 5 PIe CITY F�Jr r+�1� 2 — i 1 . i j . .. .. . ,.... SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 20 7 Fro#1,r—i i43'S 6-1--, _ 4311 _act _303_ _o AI v 145 • PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND i— L' —4D-1 • AREA NEEDING REPAIR W/I7777/7A L = length of repair needed c" Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) . . ..*. ADDRESS: v.-,......._ ' _ L„).."-- 4,A <--- \ Ciljj4 •.7-:- _ vr, . . . . AProperty Line C,` A . I . _J. 1641/11 1 Pill I*11/1/I WATER SHUTOFF i----) VISIBLE 0 .1 53 v3ipc - 13 _CAE '' j BROKEN El • MISSING D Foe\kl i VI I , LOCATION OF SIDEWALK vi FRONT YARD 0 SIDE YARD 0 OTHER I ,., WIDTH OF'SIDEWALK 0 4 FEET 0 5 FEET A5.3 FEET 04 OTHER DEPTH OF SIDEWALK zi 4 INCHES El 5 INCHES 0 6 INCHES 1 0 A AREA TO BE REPAIRED . q.ft 4 in. ____sq.ft. 5 in. q.ft. 6 in. • CODE F — PATCHES YES 0 NO t4 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. 2 , ' 1.---' --7 --A -L-LFirst Inspection and Form Made By: 1-f Date: -- Park Department Review Required gl YES 0 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 3 03• 11/N , `0 3 aii_ 31 ),_ cici ,/ i414 PARCEL CODE CONTROL NUMBER • CERT. NUMBER LEGEND AREA NEEDING REPAIR W/.77/7.77/A L = length of repair needed fl Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 3c-33 Pr4Jrty Line ii://I WATER SHUTOFF VISIBLE El • CAP BROKEN El MISSING LOCATION OF SIDEWALK El FRONT YARD SIDE YARD CI OTHER WIDTH OF SIDEWALK El 4 FEET 0 5 htti 5.3 FEET CI OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES El 6 INCHES - V AREA TO BE REPAIRED —sq.ft. 4 in. _sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES El NO Wif 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: -,AL •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 . 3°7 • /45 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND -0- -4,-1 AREA NEEDING REPAIR v.tzi171 .1 L length of repair needed4 Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) ADDRESS. •3 WATER SHUTOFF VISIBLE rdse BROKEN El MISSING 0 C Pro ert Una - I )' ';‘,)S • LOCATION OF SIDEWALK -*Et FRONT YARD 0 SIDE YARD 0 OTHER riIsuil OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 1p 4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED L.L.1...-sq.ft. 4 in. —_---4.1t. 5 in. q.ft. 6 in. CODE F - PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may ba repaired by patching. Ali other areas shall be repaired by reconstruction of fu!rrei. first Inspection and Form Made By: Date: Park Department Review Required 0 YES /In NO •— 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 'a3 1 j,j (u�c,,ll� ` 13 :2a1 - c)03 ✓ / /' PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR V1//77////A L = length of repair needed /C r —o✓, Type of defect V (See reverse side for Defect Codes A—F) (See below for Defect Code G) 3a l 3 as � ADDRESS: tr Property Line ` 1/41 WATER SHUTOFF VISIBLE ❑ X:,3 S� . J/ BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD IA SIDE YARD 0 OTHER LLI WIDTH OF•SIDEWALK El FEET ❑ 5 FEET ft�1 5.3 FEET OTHEt DEPTH OF.SIDEWALK ' 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE 'REPAIRED sq.ft. 4 in. sq.ft. 5 in. cq.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 squ res. r First Inspection and Form Made By: II--� Date: ` }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 449 Wk FRA/UK6//iJ �T PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR srzzzzz, mA L - length of repair needed ; Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) ADDRESS. r � I 9 Z 5 � 1 WATER SHUTOFF N1j r� VISIBLE ❑ '96 . BROKEN 0 . MISSING ❑ Property tine ifacjiMil OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER 131211j OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET OTHER CC' IS MEM OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES 6f INCHES AREA TO BE REPAIRED eq.tt. 4 in. eq.It. 5 in. V7t7'1 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. Ali other areas shall be repaired by reconstruction of fulll squares. first Inspection and Form Made By: J I Date: -a`, f I( Park Department Review Required ❑ YES id 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 4o l-40 1 Fen4 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V/7/Z7//7/A v L = length of repair needed �\ Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: I/O f (7/07 itol< Property Line • WATER SHUTOFF VISIBLE El CAP BROKEN ❑ MISSING ❑ 3rcb S% LOCATION OF SIDEWALK IP FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET I OTHER 6? DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO psi 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: • IV- L%L Date: 3` Park Department Review Required ❑ YES IR 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 92e —LJZe,. ,re-c, I ivx S+ . PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —4 .1 -- . AREA.NEEDING REPAIR r///777I777A L = length of repair needed Type of defect i �`F i (See reverse side for Defect Codes A—F) • (See below for Defect Code G) xy( OD• ADDRESS: + 1 F iIII r' s Property Une -- WATER SHUTOFF VISIBLE ❑ CAP ` BROKEN ❑ MISSING ❑ F—, P r-K Ave. LOCATION OF SIDEWALK ❑ FRONT YARD 0 SIDE YARD ❑ OTHER — WIDTH OF.SIDEWALK ❑ 4 FEET ❑ 5 FEET •Ft 5.3 FEET ❑ OTHER_ DEPTH OF SIDEWALK 0 4 INCHES ❑ 5 INCHES fir/ 6 INCHES — AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. Ogt I sq.ft. 6 in. CODE F — PATCHES YES ❑ NO j'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 of full squares. i First Inspection and Form Made By: s Date: 3 -`: 3 10 •Park Department Review Required 0 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 LO 6 F .,fkl+'vt S , 3 _4y _ 5- - b 1.50 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR //7////Al - r- .m L = length of repair needed /� r Type of defect 1`C �/ (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: l l �--f� �. 14) Property Line WATER SHUTOFF VISIBLE ❑ _gm BROKEN ❑ MISSING ❑ Frail*1 LOCATION OF SIDEWALK ❑ FRONT YARD 0 SIDE YARD ❑ OTHER ri WIDTH OF•SIDEWALK ❑ 4 FEET ❑ 5.FEET ❑ 5.3 FEET ) OTHER S DEPTH OF.SIDEWALK tg 4 INCHES ❑ 5 INCHES fS 6 INCHES AREA TO BE REPAIRED 113 q.ft. 4 in. �q.ft. 5 in. �" ` tq.ft. 6 in. CODE F — PATCHES YES ❑ NO f] 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. q First Inspection and Form Made By: �. L�'i Date: 3 1 10 Park Department Review Required IF 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 S 5 14--t S-t-, T 21 13-2-j-35- 0c)5 ✓ /5/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' ,`. • AREA.NEEDING REPAIR 17777777777A `�M L = length of repair needed --, — Type of defect 'if \ on — See reverse side for Defect Codes A—F) *`A (See below for Defect Code G) ` 144 `� ADDRESS: 5t�_S 'I i t5 .101 � � I \ ,r,"- 4} --.—. --- I ., i Property Line r -I , WATER SHUTOFF VISIBLE ❑ '` BROKEN ❑ E.- F ,� MISSING 0 O.t(�L fit/Vt- _', LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD ❑ OTHER St6 c- WIDTH OF SIDEWALK 0 4 FEET ❑ 5 FEET' 0 5.3 FEET OTHER __r�iu`J� DEPTH OF SIDEWALK .p. 4 INCHES ❑ 5 INCHES J, 6 INCHES AREA TO BE REPAIRED I f y0 sq.ft. 4 in. sq.ft. 5 in. (�c_• s q.ft. 6 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`squares. • First Inspection and Form Made By: ' LC" Date: 3-g 1 --co .J Park Department Review Required 0 YES Er 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 SZS /ron K i;rt S4-. • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —"l • AREA.NEEDING REPAIR 7///177/7M L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) • '1>l< ADDRESS: 3;7'v);pe Property Line clSi ._j WATER SHUTOFF VISIBLE El(,ANJ A L K CAP BROKEN ❑ MISSING ❑ v\ LOCATION OF SIDEWALK Cgt FRONT YARD ►A SIDE YARD ❑ OTHER i ...,? �%i f37 WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET OTHER—IL DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES _ AREA TO BE REPAIRED 113 63 Sq,ft. 4 in. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO XI 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 -"i _/ Park Department Review Required ❑ YES IKNO 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 6jl< /17W2T5dN T _ 0g13 - ?3- �- 001 ✓ /555 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t"- L' -"1 • AREA.NEEDING REPAIR I%////77//7/,4 L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) >< ADDRESS: (/AC Property Line WATER SHUTOFF 5 S , VISIBLE ❑ CAP BROKE) ❑ t? xxQ, 57 MISSING ❑ • LOCATION OF SIDEWALK ❑ FRONT YARD L SIDE YARD ❑ OTHER WIDTH OF SIDEWALK k 4 FEET El _ 5 FEET ❑ 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK [� 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Sq.ft. 4 in. 'q.ft. 5 in. sq,ft. 6 in. CODE F - PATCHES YES ❑ NO pir 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. 2 First Inspection and Form Made By: 13 5 Date: 3/ac // l� Park Department Review Required ❑ YES Z] 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 /50 1-/A22.z5O / --517- e 9 (3-� - i-d3'D /54 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E: AREA NEEDING REPAIR wwwz s f I in length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. /5 6 I I WATER SHUTOFF \ v,SIBLE ❑ BROKEN 0 MISSING• ❑ Property Line 5 �.a 1'�1 l4 A2i2 c jOcisnati OF SIDEWALK C;FRONT YARD 0 SIDE YARD 0 OTHER Of SIDEWALK 0 4 FEET ❑.5 FEET CY 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 5(4 INCHES ❑ 5 INCHES ❑ 6 INCHES ZioAREA TO BE REPAIRED (�_,q.tt. 4 in. •q•it. 5 in. ■q.tt. 6 in. CODE F — PATCHES YES 0 NOX NO, OF SQUARES WITH PATCHES NOTE. Areas marked with an - may bn repaired by patching. Ali other areas shall be repaired by reconstructioa?f full gazes. h/ //� First Inspection. and Form Made e t%j y:.. ' 'S .. _ Oats; / ea. Park Department Review Required ❑lI''YES 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 /51/ /IN V-T-50 1 ST 85L3 _z.2'_Z6 0z.7 J 1�� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR V7ZWZLlf'A L ws length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) I ADDRESS. /5 V _ 1E-- I WATER SHUTOFF vista tE ❑ \ . .rd8e BROKEN ❑ . MISSING 0 4 Li.1 Property tine IS A . Nas� 5-r- =raw OF SIDEWALK ji FRONT YARD 0 SIDE YARD 0 OTHER j „lm OF SIDEWALK 0 4 FEET 0 5 FEET g 5.3 FEET ❑ OTHER DEPTHOF SIDEWALK. C�( 4 INCHES ❑ 5 INCHES 0 6 INCHES .,,I AREA TO BE REPAIRED Z`I■q.ft. 4 ;n. 3q.ft. 5 in. sq.ft. 6 in. Is 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 shall be repaired by reconstruction of full ■q s. 3/7-6 ! /� First Inspection and. Form Made Ely:_ • .� Date: i1 Pork Deportment Review Required 04 YES 0 NO 1 I. • PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. ---III CONTRACT COMPLETION DATE: CODE G — Other. ii 11 , 1 1 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA z Ls PROPERTY ADDRESS g A t er5°A/ 5i _Z4-- kg_ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR wfiiisfiif L s length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect, Code G) ADDRESS. { 205 2/.5 C �� WATER SHUTOFF ,J VISIBLESAE Q J BROKEN El . J MISSING 0 9h . '` Property Line LOCATION OF SIDEWALK c24 FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET "5.3 FEET 0 OTHER DEPTH OF SIDEWALK 0 4 INCHES [ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Si _sq.ft. 4 in. •q.ft. 5 in. eq.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 ureas shall be repaired by reconstruction f full squares. Fiat Inspection and Form Made By:_a.. .5- .__ Date: 3`/� I /O 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 — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS q,..��(7 7 -y7 f 3 -a _ fb3_ Oda /57 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR L = length of repair needed B Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >1<ef, ADDRESS: ! a a tAkiev Property Line/ rvii r WATER SHUTOFF ii $ riVISIBLE ❑ BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK [ FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 5 FEET ❑ 5.3 FEET ❑ OTHER _ DEPTH OF.SIDEWALK 1st4 INCHES ❑ 5 INCHES ❑ 6 INCHES Of 561 AREA TO BE REPAIRED 4q.ft. 4 in. sq.ft. 5 in. 6 in. • CODE F — PATCHES YES ❑ NO p NO. OF SQUARES WITH PATCHES — NOTE: Areas marked with an "P may be repaired by patching. Ail other areas shall be repaired by reconstruction of full squares. 7� First Inspection and Form Made By: t C� Date: Park Department Review Required 0 YES icf. 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 //47 - /149 Zip(ilAj Di - ` eg I -oz- 151 - old /57-,4 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND Li AREA NEEDING REPAIR v/MMZZA L : length of repair needed A^l Type of defect /t (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. 114 7 -//49 WATER SHUTOFF _ \ VISIBLE ❑ \` S.� BROKEN 0 _ MISSING 0 EL_ _. Property Line —C� 1 \ 61 _. LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK [ZI 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER _— DEPTH OF SIDEWALK Ca 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED W .sq.ft. 4 in. •q.ft. 5 in. sq,ft. 6 in. CODE F — PATCHES YES 0 NO K. 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: /� "w. Date: , ., X,A0 Park Department Review Required 0 YES CRt 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 jZp/ - 1Zo3 41,0 , .1 DR • /3-o Z- /54 -017 157 B PARCEL CODE CONTROL NUMBER CERT NUMBER LEGEND U AREA NEEDING REPAIR wzm/ L : length of repair needed Type of defect r( (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. /Zol " IZO I ( WATER SHUTOFF VISIBLE ❑ CAF BROKEN ❑ MISSING ❑ Property Line 5' LOCATION OF SIDEWALK ( FRONT YARD [_.I SIDE YARD ❑ OTHER WIDTH OF SIDEWALK "t 4 FEET ❑ 5 FEET ❑ 5.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK t2r, 4 INCHES 0 5 INCHES ❑ G INCHES AREA TO BE REPAIRED ' q.ft. 4 in. ____sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES CJ NO EL NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F" may bn repaired by potchinq. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By._ pp 1`t Dale: 3/Z'V Z.0/6 Pork Department Review Required [] YES a 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, IOW , PROPERTY ADDRESS 00 b1 k Z �A 377 53913 -23 - 1-130- 0 / ✓ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V///W,7/A L = length of repair needed Type of defect 1 (See reverse side for Defect Codes A-F) (See below for Defect Code G) ADDRESS: Ac>l< ti X � Property Line WATER SHUTOFF VISIBLE ❑ rjCAP j BROKEN ❑ MISSING El Oa. AVP.� LOCATION OF SIDEWALK ❑ FRONT YARD 0 SIDE YARD El OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER — DEPTH OF SIDEWALK 14 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 92-'Z sq.ft. 4 In, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES El NO at 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: ?' Z+l-1-6 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 ?a�e.nk?a` f ef\axe 'tt G sic tw*Ay__ +re& roef$ q.-e, presewk- a.s ote*er.n q.er ., Ci SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS. . t 0 b k / yz rr . PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND E' AREA NEEDING REPAIR VIZZ/ZYMA L - length of repair needed i Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) 3 10'X ADDRESS. I WATER SHUTOFF VISIBLE ❑ • l.—u t ride BROKEN ❑ MISSING ❑ x.I Property tine Cs • e -ram +, OF SIDEWALK FRONT YARD SIDE YARD 0 OTHER OF SIDEWALK ❑ 4 FEET 0 5 FEET Ist.5.3 FEET 0 OTHER DEPTH OF SIDEWALK f. 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 7?; 0 eq.ft. 4 in. ■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 Farm Made By:___ '[\.S r (. _. Date; 3 _24--JO Park Department Review Required ULYES ❑NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: , • • CODE C — Other° ?d#t.r% V r n s ici e w allC i C +ree r c $ 4r- Ip re_s ae e w1.1 er# b C;+-y E l.i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 00 £'/C La j Oki e t4 e. 51- , • 3 - .3-y3 - 60,-1 ✓ l�® PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR viriziW.M L gm length of repair needed Type of defect rl 9'(� ((See reverse side for Defect Codes A—F) (See below for Defect Code C) �r ADDRESS. t� WATER SHUTOFF aCt.� VISIBLE ❑ \ Lc, 4 rhE - BROKEN ❑ MISSING ❑ Property Line Jo I LOCATION OF SIDEWALK R.FRONT YARD ❑ SIDE YARD ❑ OTHER NignI OF SIDEWALK Q 4 FEET 0 5 FEET g 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED .12 0 sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO 01, 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 full squares. First Inspection and Form Made By: _.. __. S Date: 3 `2 ` lb — Pork 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 QF WATERLOO, IOWA PROPERTY ADDRESS 2.8--3 2 �q q C s+, 'f - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-•-• L` AREA NEEDING REPAIR vz/ZZ:zzzZA L = length of repair needed 6 Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. I I WATER SHUTOFF A M V e 1 VISIBLE ❑ . ` Lee F O I9 BROKEN 0 MISSING 0 pc rtLin� Le,1 Property Line 5.5 ad I �_____._ • +ke. S+ . LOCATION OF SIDEWALK E21, FRONT YARD 0 SIDE YARD 0 OTHER manjOF SIDEWALK 0 4 FEET ❑ 5 FEET p 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 0 4 INCHES 0 5 INCHES Rf 6 INCHES AREA TO BE REPAIRED aq.ft. 4 in. eq.ft. 5 in. ZR' sq.ft. 6 in. CODE F - PATCHES YES 0 NO icctNO. OF SQUARES WITH PATCHES NOTE. Areas marked with on "F" may bA repaired by patching. All other oreae shall be repaired by reconstruction of full squares. First Inspection and Form Mode By: R_ „D___,G Date: 3...2-14'+D Pork Deportment Review Required 0 YES 54 NO PERMIT ISSUED NO._ — DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: , CODE G - Other: AsOnctl-V" S i Ck @ , SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 5 0 L .Cole,k 54- • c l3- 23- 433-o0 /b PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR mlz/III,/A L - length of repair needed Type of defect /� (See reverse side for Defect Codes A-F) (See below for Defect Code C) ADDRESS. 5 d I ! WATER SHUTOFF .visiBLE ❑ \ • BROKEN 0 MISSING 0 IZ,6 Property Line .if - • - LOCATION OF SIDEWALK (FRONT YARD 0 SIDE YARD 0 OTHER mid OF SIDEWALK ❑ 4 FEET 0 5 FEET 1 5.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK 0 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED E 5 in. sq,ft. 6 in. CODE F — PATCHES YES C.7 NO j 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 Mode By: KS ,D C-7 Date; 3`2�- /0 Park Department Review Required ❑ YES OtNO PERMIT ISSUED NO. ._._ DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. .r CONTRACT COMPLETION DATE: CODE C — Other° —.— SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 5z Lck 3+ . • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA NEEDING REPAIR Ul///7//l'A L - length of repair needed Type of defect (See reverse side for Defect Codes A—r) (See below for Defect Code G) ADDRESS. 5 a WATER SHUTOFF \ VISIBLE • Q Lee BROKEN ❑ MISSING ❑ 1 i 8 ' Property Line MIN LOCATION OF SIDEWALK 2)- FRONT YARD [_I SIDE YARD ❑ OTHER IDTH OF SIDEWALK El 4 FEET Ca 5 FEET 54 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK R. 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 25,9 ._sq.ft. 4 in. aq.ft. 5 in. sq. t. 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: _. , f� 1 Date: 3 '01 16 Pork Department Review Required ❑ YES f4 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE C — Other _._._ . . . . _ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA _ PROPERTY ADDRESS (,* Lc, ,,,eA4e ..s4-, - 7 an I 3-2_1—A20— 01 a V itorf PARCEL. CODE CONTROL NUMBER CERT. NUMBER _ LEGEND 1-*-- L' AREA NEEDING REPAIR VZ7ZZA — l ... length of repair needed Type of defect A, G (See reverse side for Defect Codes A—F) (See below for Defect Code C) _ Wo" xADDRESS. &3 .... WATER SHUTOFF ViSIBLE 0 . \ BROKEN 0 MISSING 0 t .... Properly Line r*AILI Cs. . 40 'Over Pet,p1--e • i—c.C•el'64'e SA-- LOCATION OF SIDEWALK 51 FRONT YARD 0 SIDE YARD 0 OTHER ItUalil OF SIDEWALK 0 4 FEET 0 5 FEET 15f 5.3 FEET 0 OTHER -- DEPTH OF SIDEWALK El- 4 INCHES 0 5 INCHES 0 6 INCHES —fi. -El-rtz AREA TO BE REPAIRED 13 ,—Agit. 4 in. —sq.lt. 5 in. —._.sq.D. 6 in. CODE F — PATCHES YES 0 NO Qj 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 equores. , . first Inspection and Farm Made By: K..5 £ c."- Date: 3 -2-4-10 . _. Park Deportment Review Required a YES 0 NO ! PERMIT ISSUED NO __ DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: CODE G — Other V°c;/I-eds\--I'o.k rc.pka..c .feka..A-k- 6 4 s-rite_4.-1 kiX. ;C 4-tee roars cur-e, : e r es c.A,4. ct-s ck.e.i-er...si.vd 1)y C14,7 £.15..,.e.g..e4.- 1 I — SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS e 60 LoS PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —4a.1 ' AREA.NEEDING REPAIR 7/7) Wlf/4 L = length of repair needed /y Type of defect $1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) >l<4‘ • ADDRESS: 200 )4OilSE -_ Property Line WATER SHUTOFF VISIBLE ❑ CAP " BROKEN ❑ MISSIN3 ❑ C-C j e -4-Q : . • LOCATION OF SIDEWALK is FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED • 2.7'd 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 "Z '10 Park Department Review Required ❑ YES Ris 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 (306 glacK) L-e.-f0.yetfe Sf. • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA.NEEDING REPAIR V////77//ZA L ` L,f L = length of repair needed A C Type of defect r I (See reverse side for Defect Codes A-F) 1/49 (See below for Defect Code G)>.(6, ADDRESS: ( ` bkJc.-e.r Vie r l< y (kr Property Line IC` x. /NIA xI WATER SHUTOFF f VISIBLE ❑ CAP • BROKEN ❑ ) LL Cl11 MISSING El L-icy Tkk. -/ 1 LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER_ DEPTH OF SIDEWALK g 4 INCHES ❑ 5 INCHES 121 6 INCHES AREA TO BE REPAIRED Job•O q.ft. 4 in. sq.ft. 5 in. 26•5sq,ft. 6 in. CODE F - PATCHES YES ❑ NO 54 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: k.S U Date: 3 -2 c - lb Park Department Review Required YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G - Other a+er +-;oti reptacerne rd o'C s7CkeW03 4, i s freer roofs are, ?reSen+ CX$ C�eAtratired by C ;'-Y -n.31 neer. SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3061 -- 313 LA ey e -e $, • PARCEL CODE CONTROL NUMBER CERT NUMBER LEGEND L' AREA NEEDING REPAIR V//7W/I/a L : length of repair needed Type of defect (See reverse side for Defect Co es A—F) (See below for Defect Code C) ADDRESS. -30C1 — 3 3 I WATER SHUTOFF hht eeci VI GLCl1u i \ • jr6EBROKEN ❑ MISSING ❑ E,'1 Property Line 1.)L. I (� LOCATION OF SIDEWALK r251 FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 94. 5 FEET 0 5.3 FEET OTHER DEPTH OF SIDEWALK q 4 INCHES [_.] 5 INCHES ❑ 6 INCHES �'`AREA TO BE REPAIRED '0_sq.1t. 4 in. _sq.ft, 5 in. ng.tt. 6 in. CODE F — PATCHES YES ❑ NO b & 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: F--4) Date: 23 —/P_, 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 • •'•evv/ri a.1 rep<<a.ce. _ 37�@.art��It i -e. /`be.k$ mire, Fe is s,k �L s de ec t• 1 v �i t e J i•1 . 1t —�"' SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4a9 b/k L-Ayr- 5-T • g3.1a_2._3s6_aa / i PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR vi/illi,z,X L : length of repair needed Type of defect .._ (See reverse side for Defect Codes A—F) (See below for Defect Code G) ‘°*._ ADDRESS. WATER SHUTOFF r48 VISIBLE [] II CA BROKEN ❑ MISSING ❑ Property Line /A I Lct LOCATION OF SIDEWALK 54 FRONT YARD El SIDE YARD ❑ OTHER IdarB OF SIDEWALK C 4 FEET ❑ 5 FEET 0 5.3 FEET M OTHER �. DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES . 6 INCHES AREA TO BE REPAIRED _sq.tt. 4 ;n. r_ Y aq.1t. 5 in. r Q. q.ft. 6 in. CODE F — PATCHES YES [] NO fgt 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 . ._ Dote: „1:23',�� Pork Department Review Required 0 YES r2 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 4a0 bIk jf5- e ojT. PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' t„,) • AREA.NEEDING REPAIR WI/777777A L = length of repair needed Type of defect 11 1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: ( V Att* ra L /Property Line �f✓/j�� — — WATER SHUTOFF VISIBLE ❑ 6:1 CRP ` BROKEy ❑ MISSING ❑ 3r 5 - LOCATION OF SIDEWALK <' FRONT YARD 53' SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET figl 5.3 FEET ❑ OTHER — DEPTH OF SIDEWALK 0 4 INCHES ❑ 5 INCHES .4 6 INCHES AREA TO BE REPAIRED c.3+[ sq.ft. 4 in. 5 in. 63) sq.ft. 6 in. CODE F — PATCHES YES ❑ NO 12t 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)3-1 t`.0 Park Department Review Required ja YES ❑ NO 'PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other t??• rcv}; replccew.e..$ ¢C- s `�e-v-) IL'� -E-rep d`�S 4re, t'r nfise 'is �Q,\l M " er in t� 1S1 Chit GA4inQ -r . SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS n Z L et,Fc E,tei � _c-�-, gQ 13 - z i - 353- 0e i' ✓ /70 m • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1+-- L' --*-I ..�-/-- AREA.NEEDING REPAIR V77777717/A L = length of repair needed / Type of defect Af , �,�� 1(Ppi3 2 See reverse side for Defect Codes A-F) c See below for Defect Code G) } , >l<4s4 ADDRESS: I s 1z -a Qc ? C ( INN) 1 ,7 rf�` \ 144 \\\\\.‘ . Property Line C\`G 6 `X \ q,‘ °� WATER SHUTOFF ` VISIBLE 0 1 4 � V' r+ CAP ' C 17.. c Ki�'/ / _} BROKEN ❑ MISSING 0 Lac'e1 Ve St- % LOCATION OF SIDEWALK 0 FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET ' OTHER _ DEPTH OF SIDEWALK 14 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED (='Z._ : 9 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: Z S .l G Date: s`"Z-C_lb Park Department Review Required 121YES 0 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G - Other Pa4er14-i a, f eela<e-eAn.ewt ®f ;Ae.,4-04..1 K ;C free, ratAs 4te.- 're...S elk as rk eA e.r.K;n tct b CIA-1 e ria :n e er- 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4/ S Lc c-,,,je++e s+. 39iz - J Q 5 ✓ /7/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' �C °,\ i AREA.NEEDING REPAIR ,W, 1 '' ‘ L = length of repair needed v\a. Type of defect 1t� (See reverse side for Defect Codes A—F) E. O P (See below for Defect Code G) ADDRESS: 12S \_ _ \ . V CA , \ r Sys _ �'� —r f7 S 'f. Property Line WATER SHUTOFF � VISIBLE ❑ 1.0 X J.0 i BROKEN El MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD I . SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET MOTHER _ DEPTH OF SIDEWALK X 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED L2-7,0 sq.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: IS D C- Date: 3 -23 /n Park Department Review Required ❑ YES 'ik 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 ,5ZZ PROPERTY ADDRESS . 5 I Ca Lea carp :1 }e j} - S9 13 z9_-3. t—vv. ✓ 6-7, PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND k— L' -A AREA NEEDING REPAIR viiz,iY»it I : length of repair needed A Type of defect (See reverse side for Defect Codes A—F) See below for Defect Code C) ADDRESS. ,5 /w $ _ I 5 Ito-s Z z 0 WATER SHUTOFF \ VISIBLE ❑ . \\ BROKEN ❑ Ik• NL.D MISSING 0 ci.l)t4.4.1 Ip:L�rA•ep 6, Property tine ve it', ,7,„, _ . 0.. -.\------ , _ Le,ct:y ea-ke. S4 : - LOCATION OF SIDEWALK I'FRONT YARD 0 SIDE YARD ❑ OTHER Mad OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET OTHER OF SIDEWALK 121, 4 INCHES 0 5 INCHES a 6 INCHES AREA TO BE REPAIRED ZT 6 eq.tf. 4 in. •q.tt. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO I I NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. Ali other areas shall be repaired by reconstruction of full squares. 7 First Inspection and" Form Made By: �+S b Cs • _._ Dale: 3_2 3 -/O Park Department Review Required a YES 50 NO i PERMIT ISSUED NO. DATE:, INSPECTION DATE: _ IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE C — Other 1 I I t-.__ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO.. IOWA PROPERTY ADDRESS 5 IT] - 5. 1 L� Aye e -y ail 3 —c I ► V /73 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V7i'Y7 71 A L - length of repair needed Type of defect /7 (See reverse side for Defect Codes A—F) (See below for Defect Code C) 14*I ADDRESS. -�2 l I WATER SHUTOFF VISIBLE ❑ sae BROKEN ❑ _ _ MISSING 0 .5>`I 1X fp.Cd Property Line , s, La coe+Te 5+. LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER b OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET 14 OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED -78' 'iq.tt. 4 ;n. ■q.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 'guoresn • First inspection and Form Made By:_ _ R. Date: A • 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 OfTY OF WATERLOO. IOWA PROPERTY ADDRESS 5) 5 3+ . 3 _ :,310_0lo / /74 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND • AREA.NEEDING REPAIR V7//777777A L = length of repair needed Type of defect (v (See reverse side for Defect Codes A—F) (See below for Defect Code G) p...41>l< _3 ADDRESS: 0 757-7- • i • Property Line WATER SHUTOFF p} VISIBLE ❑ Sd BROKEN ❑ �� L� MISSING ❑ V ). 11'\lr\ LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER k WIDTH OF'SIDEWALK El4 FEET 0 5 FEET ❑ 5.3 FEET t4. OTHER _2 L ,E1 Isami OF SIDEWALK 4 INCHES ❑ 5 INCHES 4 6 INCHES °✓ 4 in. AREA TO BE REPAIRED t Q ft ��� q. q,ft. 5 In. c q.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: .. (X./ Date: `� —AC, 10 Park Department Review Required p' YES a NO PERMIT ISSUED NO: DATE: INSPECTION DATE • IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other — SIDEWALK REPAIR SURVEY VFORM (�ITY QF' WATFRI � PROPER?Y ADDRESS --C3Co �i vvt� ' =13-41 "- -�- ✓ CONTROL NUMBER CERT. NUMBER PARCEL. CODE • LEGEND k-- `, -•A AREA NEEDING REPAIR L .s length of repair needed ' Type of defect ------ (See reverse side for Defect Codes A-F) (See below for Defect Code C) \0' I ADDRESS. ___-Q- I h J --)\\ I ( WATER SHUTOFF 1 w51eLE ❑ - r vT�, BROKEN ❑ ��� f � � MISSING ❑ ......_L \ . ,, Property tine �_- -.--_ __ ___ // jai r, \\,-1 mt.,— J7----- jjrialfai OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER CI FEET 0 5 FEET 5.3 FEET CI OTHER - � of SIDEWALK 2211:1 OF SIDEWALK 0 4 INCHES ❑ 5 INCHES [] 6 INCHES ter.©+ it. 4 gin. +q.it. Sin- +q.tt. 6 in. AREA TO BE REPAIRED q' CODE F - PATCHES YES ❑ NO 7i'C NO. Of SQUARES WITH PATCHES.__----- ay b' repaired by patching. NI other areas NOTE. Areas marked with an feconstruction of full squares. shall be repaired by � " ��' li ,_,_ We: — fkst Inspection and Form Made By:___ Park Deportment Review Required 0 YES (q NO PERMIT ISSUED NO..___. ATE - INSPECTION DATE: IF UNCOMPLETED. SPECIAL CT ASSESSMENT CONTRN ACT NO' CODE G - Other i I 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATER nn iOWA PROPERTY ADDRESS //o h Jr�. ( L17\i 60 ^� $T 13 _2_3_285_003 ✓ /7',, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND �... L' AREA NEEDING REPAIR Ufl,iuZZ I. length of repair needed Type of defect 1 3 7 (See reverse side for Defect Codes A—F) (See below for Defect Code G) iii -4(-- ADDRESS, Jc:r N . i ._ _. Property Line 0 ' e t.c'-tki W/1-Li(_ NO P/i.x) . L. /./coL r/ ,5 f 1 GarEI I OF SIDEWALK I(FRONT YARD 0 SIDE YARD 0 OTHER molti Of SIDEWALK 4 FEET 0 S FEET 0 5.3 FEET 0 OTHER— TH OF SIDEWALK k,4 INC ES H f 0 5 INCHES 06 INCHES AREA TO BE REPAIRED Z�d . �q.tt. 4 in. •a:1AL 5 in. Aq.tl. 6 in. CODE F — PATCHES YES 0 NO ji< NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. All other areas — shall be repaired by reconstruction o t II equ i75First Inspection and Form Made ey:. 1/4-6 /Dale: /0 Pork Department Review Required 0 YES PINO 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 (CD S L_I i4Ca--a-{ '✓ gD 13 z3 -z,,�- 003 ✓ /77 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V77/I/7///A L = length of repair needed Type of defect J (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4>Kr.. ' ADDRESS: 105 - 4. J _ \ J C -Ac _ 'A -( - 3 o i� , Property Line 3 WAc-K_ —..__`, I ' < < WATER SHUTOFF Z5 Q 9 as VISIBLE ❑ n o . of S f----) CRP 4h .5 BROKEN ❑ MISSING El LOCATION OF SIDEWALK FRONT YARD VS S E YARD ❑ OTHER WIDTH OF SIDEWALK Ca 4 FEET ❑ 5 FEET ( 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK X 4 INCHES let. 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED �' q.ft. 4 in. 345`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: NC3 6.D, Date: 3 -?-4_ /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 e . SIDEWALK REPAIR SURVEY FORM - CITY OF WATERLOO. IOWA PROPERTY ADDRESS 1 f 5 i cc LAl �7/ 899/3 -L2-0._ _5r-cam. ✓ / 7 tg PARCEL CODE CONTROL NUMBER CERT. NUMBER _. LEGEND 1-.1-- L AREA NEEDING REPAIR v././Z, IYA_ L •- length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. // 5 I I WATER SHUTOFF \ VISIBLE ❑ BROKEN 0 • MISSING 0 Property tine i &l, S ' L LEAni viALA' L.z-A(co LW ST IMM O OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Itund OF SIDEWALK k. 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER _ — DEPTH OF SIDEWALK • PI 4 INCH5S 0 5 INCHES 0 6 INCHES 7 4-(.,e% AREA TO BE REPAIRED iq.tt. 4 in. ■q.tt. 5 in. iq.ft. 6 in. • CODE F — PATCHES YES 0 NO q NO. OF SQUARESWITH PATCHES NOTE. Areas marked with an - may bn repaired by patching. Ali other areas — • shall be repaired by reconstruction o 1 II equ � /� First Inspection and Form Made By: Date; f/� / Pork Department Review Required 0 YES 'NO i PERMIT ISSUED NO. DATE: INSPECTION GATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: • CODE C — Other i I 1 1 I • ; SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS LTl1/Cu b/ / PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR vf7,,LtZ A L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 13 I + WATER SHUTOFF \ VISIBLE BROKEN ❑ MISSING 0 Property line 15 y C1 cA rJ c.J CO L AI 5 I- E OF SIDEWALK (FRONT YARD 0 SIDE YARD 0 OTHER NILO OF SIDEWALK 1.1 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 1(4 INCHES t'y 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ' ■q.fl. 4 in. 2. ■q.It. 5 in. sq.fl. 6 in. • CODE F — PATCHES YES 0 NO 14 NO. Of SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. All other areas shall be reooired by reconstruction full ■qu /� h • First inspection and Form Made By:_ __ Dale: Pork Department Review Required [] YES ONO PERMIT ISSUED NO. ._._ DATE:. INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: 4 • CODE C — Other i • SIDEWALK REPAIR SURVEY FORM CETY OF WATERLOO, IOWA PROPERTY ADDRESS f/ 7 •4fA/c z.I\/ i7 E 13 - Z5 Col ✓ / O PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR ///f/7/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: Property Line 1 S �5 ' cGe-A , . /�id1� WATER SHUTOFF W VISIBLE ❑ CAP 111 BROKEN ❑ MISSING D L CA/(o 3[ LOCATION OF SIDEWALK (FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK C 4 FEET ❑ 5 FEET ❑ 5.3 FEET ❑ OTHER — DEPTH OF SIDEWALK 4 INCHES C4 5 INCHES ❑ 6 INCHES 6od � v ✓ AREA TO BE REPAIRED '2 Gq.ft. 4 in. 'G' sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO Uci 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 II squares. First Inspection and Form Made By: 3 5 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 52_5 Lxt7cc>l-A/ _yr 3q 13 23 z7c,_ 000 igi PARCEL CODE CONTROL NUMBER- CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR VZZ/Z7////A L = length of repair needed Type of defect n (See reverse side for Defect Codes A—F) �� h • (See below for Defect Code G)>l<30 ADDRESS:32 I Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ LiJCG!--N _ LOCATION OF SIDEWALK ❑ FRONT YARD ,SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET El 5 FEET [X- 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK W4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED '56 7 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 o f II squares. First Inspection and Form Made By: Date: 3 Jt Park Department Review Required ❑ YES 0 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 50 - L. --A' z,'ll 577 / 8 t3_ - ?3 - 232- 602 / ®gz PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --44 _ AREA.NEEDING REPAIR V/////////A L = length of repair needed Type of defect J (See reverse side for Defect Codes A—F) (See below for Defect Code G)>l< k. ADDRESS: (50 3 I -ki NJ IG o L \ . .-. .... , N `.') N 4,1 Property Line I'.1 i- ' WATER SHUTOFF VISIBLE ❑ C) A T CAP . BROKEN CI MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD kSiDE YARD ❑ OTHER WIDTH OF•SIDEWALK ❑ 4 FEET 0 5 FEET QQ5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES D 6 INCHES f' 9.1 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 shall be repaired by reconstruction of full squares. First Inspection and Form Made By: , Date: 3 )2.5 io •Park Department Review Required X YES Of 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 / /ram/o GA/ 5T: 69 _5 #33 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA NEEDING REPAIR V77/7////A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >i< ADDRESS: 60 / `\ .� Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ CEAfrek LOCATION OF SIDEWALK [ FRONT YARD El SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET ( 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK ❑(4iNCHES ❑ 5 INCHES El 6 INCHES AREA TO BE REPAIRED ' ,5 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: 03 13 $ Date: 3/)2-5/i2O Park Department Review Required ❑ YES [eNO -PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other CO R t?F.C 71.reAl SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS L2,6 Lrd C oL N `jT e 5 t3 Z 3- Z3c__ 00i v/ lei PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —404 AREA.NEEDING REPAIR V///77/777A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) l< ADDRESS: 6 Property Line Cietk uCy WATER SHUTOFF t/ VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ /VG2 LOCATION OF SIDEWALK ❑ FRONT YARD L SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El FEET ❑ 5 FEET � 1/ 5.3 FEET CI OTHER — DEPTH OF SIDEWALK [N INCHES Et INCHES ❑ 6 INCHES AREA TO BE REPAIRED 74/ 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 squares 1 First Inspection and Form Made By: ? Date: 3/ 1/Q Park Department Review Required [X YES ❑ NO PERMIT ISSUED NO: DATE: INSPECTION INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 35o bl k Lc261AAJ 4Ye.;:7 83 a_ -z _ 2a _°1.5 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - \\ • AREA.NEEDING REPAIR r/I//TI/l//A , r L = length of repair needed \\\ Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) Y1 >Koh. ADDRESS: Lot Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ 1 oG\/J I� LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET I 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK K( INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED T i%`aq.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" may be repaired by patching. All other areas shall be repaired by reconstruction of full squares.First Inspection and Form Made By: Y lS 7). Date: *5 110 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, IOWVA PROPERTY ADDRESS 50 3 LQ G Ail A-(i-- • S 9 k3 -Z - zee- old Ct� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t"' L' -"I � • AREA.NEEDING REPAIR rll/ll///77A l^ L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) >i< ADDRESS: 3 7 N Property Line WATER SHUTOFF VISIBLE ❑ CAP r-jj BROKEN 0 A 26 _ MISSING ❑ LOCATION OF SIDEWALK C"FRONT YARD 0 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 77' 7 q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO)3 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 s uares. First Inspection and Form Made By: 3 5 Date: 3Z-//0 Park Department Review Required Or 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 31.E to 6..A I\/ 4.Jc- e� [ 8 107 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E' AREA NEEDING REPAIR VLZLLLLLLLA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 3 15 I ' VIWATERSIBLE SHUTOFF \ . Sete BROKEN 0 MISSING 0 c/ Property Line r Pr =AIM OF SIDEWALK &FRONT YARD 0 SIDE YARD 0 OTHER �1ydjani OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET 0 OTHER j DEPTH OF SIDEWALK [ 4 INCHES 0 5 INCHES 0 6 INCHES �JI AREA TO BE REPAIRED �j< sq.tt. 4 ,n. •q.it. 5 in. ■q.fL 6 in. CODE F — PATCHES YES 0 N0 [ NO. OF SQUARES WITH PATCHES NOTE. Areas marked with on -r may be repaired by patching. All other areas shall be repaired by reconstruction / full squ s. — first inspection and Form Made By: 3 5 .._ Date: 3'/Z 3 �' Q 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 SIDEWALK REPAIR .SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS '07 6//c LOG A ik AL1 [39 1_3 _13_zg5 _Di l 000 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND E: —0-1 — AREA NEEDING REPAIR mizilliil.4 L •• length of repair needed Type of defect (See reverse side for Defect Codes A—F) U 2 I - (See below for Defect Code C) ADDRESS. I I (/ 1 C ( WATER SHUTOFF VISIBLE ❑ \ Ld� S� F BROKEN 0 MISSING 0 /Or I Property Linn LOGA/I Ad'. LOCATION OF SIDEWALK C,/FRONT YARD 0 SIDE YARD 0 OTHER — J OF SIDEWALK 0 4 FEET 0 5 FEET CO 5.3 FEET 0 OTHER MEM OF SIDEWALK ii 4 INCHES 0 5 INCHES` 0 6 INCHES — AREA TO BE REPAIRED •q.ft. 4 in. ■q.1t. 5 in. ■q.ft. 6 in. • CODE F — PATCHES YES 0 NO 16 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 ul square 1zo//� First Inspection and Form Mode By:� -- Dais: Pork Department Review Required 0 YES 0 NO i i PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: + • CODE G — Other. 11 1 _ I ' i j SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4o `> C-.cD G 4 89 t _ `' 7e9 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' --4■-1 • AREA.NEEDING REPAIR V///777/7/ii L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >t< • ADDRESS: 4 J I s Property Line I Gl a WATER SHUTOFF VISIBLE ❑ G CAP BROKEN ❑ t—AAR_Qt S�� k MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD J- SIDE YARD ❑ OTHER WIDTH OF.SIDEWALK ❑ 4 FEET ❑ 5 I•ELI V 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK CE' 4 INCHES ❑ .5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED _S3.Ssq.ft. 4 in. �q.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: DO> Date: 3/Z /i 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 QF WATERLOO. IOWA PROPERTY ADDRESS 8R La.-z - E-00 ‘7 /'2® PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t""' L' AREA NEEDING REPAIR V 7/JfffZ A L - length of repair needed Type of defect (See reverse side for Defect Codes A—P) �^ (See below for Defect Code C) 401EN ( ADDRESS. ill I ( WATER SHUTOFF VISIBLELAE 0 BROKEN ❑ MISSING 0 3. S Property Line A L C G A A/ LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER Num OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET 0 OTHER — DEPTH OF SIDEWALK EX 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ✓� `--2q.tt. 4 in. •q.ft. 5 in. eq.ft. 6 in. CODE F — PATCHES YES NO Ey 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 aqua s. �� First Inspection and Form Made By: Dale: Pork 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 7 2 fo 2.0 6,17/ A„ " 83 13 -e-4- - l.6- L PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —•-1 AREA.NEEDING REPAIR f///IIIT///ii L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 7Z 6 c7 •4 _ Property Line WATER SHUTOFF VISIBLE ❑ C rj CAP r BROKE`J ❑ 1)4 N G MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD [/ SIDE YARD CI OTHER WIDTH OF SIDEWALK El FEET ID FEET_ [/` 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK El INCHES 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. 2 5 "LI 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: Date: _4_// 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 _St: SL-k_ LOC9A-ki Poje-- / /'7Z PARCEL CODE CONTROL NUMBER>, CERT. NUMBER -1.1, _..._... • LEGEND w— L --4 .1 ^.1 \.. AREA NEEDING REPAIR V///77/7//A kr; \\ --- L = length of•repair needed Type of defect _ (See reverse side for Defect Codes A—F) (See below for Defect Code G) 1-V • -- ...„ t ADDRESS: I ----- th/C. , "q \ (..-b1--- •t A.1,472_ Crp-ts„c---4TCY--E..- -.....) ... Property Line 90' e4-A1 04-LC -4 WATER SHUTOFF VISIBLE 0 li / dzi 96 ,,e v D • ,,, BROKEN 0 MISSING 0 LOCATION OF SIDEWALK Cil FRONT YARD et SIDE YARD ED OTHER WIDTH OF SIDEWALK IM 4 FEET 0 5 FEET 0 5.3 FEET kr OTHER _!.': DEPTH OF SIDEWALK CX._4 INCHES 0 5 INCHES 0 6 INCHES 1 / AREA TO BE REPAIRED 3(2...1._".sq.ft. 4- in. _______sq.ft. 5 in. sq.ft. 6 in. ° CODE F — PATCHES YES CI 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: —6) Date: 3/24' i ( 0 Park Department Review Required El YES 81 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.2 3 L : AUK 89 13-z3-2-0 c—Old— !'i3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR vrlU>iiiiA L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) Ji-kt A� V �1�€ � �i� � ADDRESS. Z 3 WATER SHUTOFF' VISIBLE ® . rase BROKEN ❑ . MISSING 23 .3 --1 — — Property tine rl O. I - • • ,..�/ z a c,,a,J A �L LOCATION OF SIDEWALK p FRONT YARD ❑ SIDE YARD 0 OTHER glind OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET i2I OTHER 5 ' Dam OF SIDEWALK 0 4 INCHES 0 5 INCHES 0 6 INCHES -- AREA TO BE REPAIRED 23 4 in. ■q.it. 5 In. •q.ft. 6 in. CODE F - PATCHES YES [] 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 lull squares. • First Inspection and Form Made Date; 3/Z6// Park Deportment Review Required 0 YES RNO 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 _3-24, Lo(,4 r✓ 4✓E. • f 89 z4__ /s z.- 1 ✓ 1111 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t"' L' — AREA.NEEDING REPAIR WZ///7//7A L = length of repair needed Type of defect -~ See reverse side for Defect Codes A—F) ,� (See below for Defect Code G) a,; )44i<__ ADDRESS: Z� ( \ x) V V t . SHRv6iF Property Line k-- ig it 1fN - WATER SHUTOFF VISIBLE ❑ C L E,f it! AM L/( CAP k /5 7. Z D BROKEN ❑ 0.fS�A /ti 7— fr. El • LOCATION OF SIDEWALK 0 FRONT YARD (4J SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FEET [t. OTHER 51.V QEPTH OF SIDEWALK ( 4 INCHES El 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED f 55 sq.ft. 4 in. ______sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES El NO Pi 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 fill' squar First Inspection and Form Made By: / Date: 5/21 /0 Park Department Review Required j 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 67 Al LUGS J A / • 8ti 3 _Z3_237 05 /1" PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR Wi/W,1I�Iif L - length of repair needed Type of defect 3 I (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I VA f. I WATER SHUTOFF LV T VISIBLE [Q BROKEN Q MISSING ❑ / ) Property tine LO Ad Ali • LOCATION OF SIDEWALK Er FRONT YARD ❑ SIDE YARD 0 OTHER Num OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ( 5.3 FEET 0 OTHER -- DEPTH OF SIDEWALK ET 4 INCHES 0 5 INCHES 6 INCHES AREA TO BE REPAIRED 53 q.ft. 4 in. eq.ft, 5 in. sq.ft. 6 in. CODE F — PATCHES YES [] NO pl NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bet repaired by patching. All other areas shall be rewired by reconstruction of fu I squares. / First Inspection and Form Made By:— _.., W "05 Dale; 3/Z-‘2 1./ Pork Department Review Required [] YES [(NO PERMIT ISSUED NO. _ DATE: //INS_PECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: 4 CODE G — Other e02REGrva/v SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS (, n / A LJ- t39 /3 ?3 . 2y7 ozc, /6,� - PARCEL CODE CONTROL NUMBER CERT. NUMBER J LEGEND L' — — AREA.NEEDING REPAIR V'//I%7Tl/1i L = length of repair needed Type of defect - See reverse side for Defect Codes A—F) id �� (See below for Defect Code G) 7T< ADDRESS: Cn ,� ( — ] , \ ..-__-• t--% / •<-.; rope y /// I ( WATER SHUTOFF VISIBLE ❑ C `1y`lx G V� CAP 7ixq /e BROKEN ❑ MISSING 0 Ci-fe TA)(IT 57: LOCATION OF SIDEWALK 14 FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 4 4 FEET ❑ 5 ftEJ [ 5.3 FEET 0 OTHER — DEPTH OF SIDEWALK 1 4 INCHES rA 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED •65.Q sq.ft. 4 in. /6'`°sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO J"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 o full ses. //D First Inspection and Form Made By: / Date: -3 /7-4 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 GO Z t_._o GA.. { s3,5 tl _ Z4= /51_ cb3 d /9 7 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND te- L' -41 —`----- - AREA.NEEDING REPAIR %/////////,■ L = length of•repair needed L41. © J Type of defect Q (See reverse side for Defect Codes A-F) ~-________ , (See below for Defect Code G) 4 / , -, -kX ADDRESS: & Z- I d -,s , LI t P- \ 4Qo 0 U Property Lane _ ____ . 1 WATER SHUTOFF VISIBLE ❑ Di CAP 4 BROKEN 0 MISSIN S ❑ LOCATION OF SIDEWALK ❑ FRONT YARD 0'SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET fa 5.3 FEET 0 0-HER_ DEPTH OF SIDEWALK 4 INCHES 0 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,'4 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 of full squares. , First Inspection and Form Made By: t'\CS e, Date: 3_0. -/0 Park Department Review Required a 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 — / a 6A 4 Au6 aq ..-73-?37_ o20 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR viffllwlm L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 70 / WATER SHUTOFF VISIBLE ❑ .GiSP BROKEN ❑ MISSING 0 5,z f _ /Property Line A LOIN /J6 LOCATION OF SIDEWALK at FRONT YARD ❑ SIDE YARD 0 OTHER yfigib OF SIDEWALK ❑ 4 FEET ❑ 5 FEET C(5.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 2.7 r _sq.ft. 4 in. •q.ft, 5 in. Wq.ft. 6 in. CODE F — PATCHES YES ❑ NO L1. NO. OF SQUARES WITH PATCHES...r NOTE. Areas marked with an -r may bn repaired by patching. All other ursos shall be repaired by reconstruction of full I ores. First Inspection and Form Mode By:_ r6Z // 5 Dale; 3 K) /� Pork Department Review Required ❑ YES SNO • 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 6 D 6 Ac iti 4 U� 13 — —z37-6 5 3 PARCEL CODE CONTROL NUMBER CERT NUMBER LEGEND U AREA NEEDING REPAIR i7/IIILIIIIA L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. /d I I WATER SHUTOFF VISIBLErde [] . BROKEN C7 MISSING Q 0-7 Property Line A • Co C AL) -a LOCATION OF SIDEWALK ,/Lr FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 4 FEET 0 5 FEET Er' 5.3 FEET 0 OTHER —.— DEPTH OF SIDEWALK Cp< 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED S.3' _spit. 4 in. •q.ft, 5 in. eq.ft. 6 in. CODE F — PATCHES YES al 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 squares. First Inspection and Form Mode By:te . Date: _3/Z 6 /70 Pork Department Review Required I 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 . 72Cc - 728 Loyoi Ave . _ -cU— Zoo PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND LI - �. AREA NEEDING REPAIR 171/7,17ZZIA L is length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) 41)K"— ADDRESS. I WATER SHUTOFF sAE BROKEN ❑ MISSING 0 Property cane Su GI Aa S \ 4a a td-I �s' acifill ON OF SIDEWALK JRI FRONT YARD ❑ SIDE YARD ❑ OTHER OF SIDEWALK ❑ 4 FEET Zr 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK tp 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 761. sq.11.- 4 in. . ■q.lt. 5 In. sq.fl. 5 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 urea* shall be repaired by reconstruction of full squares. First"Inspection and Form Made fay: -- Bale: 3 I- K) 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 • i • i . SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 7 3 5 Loy GA N , u r< PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR tV//IT-///7A v L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) M ADDRESS: 7_5 5 L'A CD 5 Property Line WATER SHUTOFF VISIBLE ❑ CAP / BROKEN ❑ MISSING ❑ VA 2DS _fl- LOCATION OF SIDEWALK ❑ FRONT YARD Ii SIDE YARD El OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET L 5.3 FEET El OTHER DEPTH OF SIDEWALK [ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO 8E REPAIRED i2S sq.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" may be repaired by patching. All other areas shall be repaired by reconstruction of full quares.. First Inspection and Form Made By: Date: 3 7/0 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 PROPER'!❑ ADDRESS 7 LI 9 Ej A k1 AJ L 8913_ - 27.. 22 UzZ ZOZ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND u-- L' AREA.NEEDING REPAIR r/7///7/7//A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) >1(b. ADDRESS: U i i-(-A'✓e � ``1 Property Line 25,7 ri 1 /s r , WATER SHUTOFF VISIBLE ❑ • J e CAP DiBROKEN ❑ L oG4 r A Je MISSING ❑ LOCATION OF SIDEWALK [ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET Of OTHER 5 DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES 6 INCHES AREA TO BE REPAIRED q.ft. 4Off in. sq.ft. 5 in. 13 . q,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 o full s uares. First Inspection and Form Made By: Date:�/Z 10// •Park Department Review Required 0 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 � b/ ' L 64,4/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR UZ&Z slr/A L : length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) 3 2- u vA44* C . ADDRESS. ' / I WATER SHUTOFF VISIBLE 0 SSE BROKEN ❑ MISSING 0 J C f Property Line _ /G,3 Z064/4 L J LOCATION OF SIDEWALK cij FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ b FEET 0 5 FEET ( /5.3 FEET 0 OTHER -- DEPTH OF SIDEWALK ❑ 4 INCHES (5(1 5 INCHES C] 6 INCHES AREA TO BE REPAIRED �sq.ft. 4 ;n. . •q.ft, 5 in. sq,ft. 6 in. CODE F — PATCHES YES ❑ NO [ NU. OF SQUARES WITH PATCHES NOTE. Areas marked with on "F" may bA repaired by patching. All other areas shall be repaired by reconstructio f full squares. • First Inspection and Form Made By: 'j / ..� Dale: __, 3 /2_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 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA • z Y M PROPERTY ADDRESS 8047 L v 6 4 no A W ✓ - La9t3 - -LoL-0.l1 ✓ %4:241' PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t'" L' AREA NEEDING REPAIR wernz 7A L - length of repair needed Type of defect 1, See reverse side for Defect Codes A—F) (See below for Defect Code G) _ 41-)1E ADDRESS. WATER SHUTOFF l VISIBLE 0\ . LAP v BROKEN 0 MISSING 0 e. k 4" tot L17 itie Property tape �j r.'' - ._.. ___. __ - -- ..-�..._...�°��_ -� erg S f -i TAi-nii,✓c '4// G/2 LA.T ,,'A, c 4./_0 - . L(Jv 4 A/ . V1"- _ LOCATION OF SIDEWALK [ FRONT YARD 0 SIDE YARD 0 OTHER idgm OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET I1{ OTHER �' �J 4 LL DEPTH OF SIDEWALK r 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 21. 1�q.ft. 4 in. aq.ft. 5 in. eq.ft. 6 in. CODE F - PATCHES YES 0 NO EK NO. OF SOUARES 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:,.. _' 5- ... Date; /24 1e _ 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 --- SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 1 -3 to (�/� A- J PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR Yill/l i A $, L. us length of repair needed e2);% Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) /'. ADDRESS. U ► 3 ( �""", WATER SHUTOFF VISIBLE ❑ BROKEN 0 MISSING ❑ 20 • 5 Property line • jLo 64n1 glrE • 1OCATION OF SIDEWALK I FRONT YARD ❑ SIDE YARD 0 OTHER l OF SIDEWALK 0 4 FEET 0 5 FEET 0/5.3 FEET 0 OTHER Meiji OF SIDEWALK 0 4 INCHES [0( 5 INCHES (] 6 INCHES fr AREA TO BE REPAIRED •q.ft. 4,ten. j-�q.1t. 5 in. •q.ft. 6 in. CODE F — PATCHES YES [,] NO Lf NO. OF SQUARES WITH PATCHES— NOTE. Arena marked with an -r may be repaired by patching. All other areas shall be repaired by reconstruction o full aqu s. tio First Inspection and Form Made By: .rf Date: 31z9 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 I 1 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS e 17 Lc 6 A k.) A! F e 9 13--3--Z?E5—6 I,,D /06, PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND I-0- L' - AREA NEEDING REPAIR V///!//I!/.t L v length of repair needed Type of defect (See reverse side for Defect Codes A-F) Sea below for Defect Code C) ADDRESS. 69l7 WATER SHUTOFF vistat.E ❑ \ • SAE BROKEN ❑ MISSING 0 Property Line _ 3 �.iI 2 ._ / ) C r\\ . LO( " A-& IQULTICIN OF SIDEWALK cit FRONT YARD ❑ SIDE YARD 0 OTHER if OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET LO OTHER — _ DEPTH OF SIDEWALK ❑ 4 INCHES cill5 INCHES 0 6 INCHES AREA TO BE REPAIRED ■q.tt. 4 in. . 2' -sq•11. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES 0 NO 14 NO. Of SQUARES WITH PATCHES NOTE. Arsos marked with an -r may be repaired by patching. All other areas _ shall be repaired by reconstruction of fu squares /26 //C First inspection and Form Mode By:,...� _ Dale: Pork Department Review Required 0 YE 0 NO - I i PERMIT ISSUED NO, DATE:, INSPECTION DATE: ' _ • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: I CODE G - Other _ r j i • i _ r 1 SIDEWALK REPAIR SURVEY FORM CITY QF WATERLOO. IOWA PROPERTY ADDRESS g Z 3 L O 6A A v& . • 89 i3 _ZZ8 _oi3 zo7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR V7417l/"ZZZA L in length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADOREss. 8 Z I I WATER SHUTOFF v, ❑ BROKEN ❑ MISSING ❑ g � ► 3 .5 • Property Line 111- Cf LO6 ki A i/ • aramOF SIDEWALK I FRONT YARD 0 SIDE YARD ❑ OTHER 2112111 OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET ❑ OTHER DE OF SIDEWALK I 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED '-'Zq.ft. 4 ;n. ■q.ft. 5 in. 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 H squares. First Inspection and Form Made 8y:. _ _�. Date; 31 z(a) 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 82 L 6,1N A/E. • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND tom-- L' AREA NEEDING REPAIR vifiiilfli t L — length of repair needed Type of defect (See reverse side for Defect Codes A—P) (See below for Defect Code G) } ADDRESS. P2 ` ( WATER SHUTOFF \ VISIBLE 0 BROKEN ❑ MISSING 0 A 1 Property line t//�t f`.4/G c 6; rt/ A _ s LOCATION OF SIDEWALK CFRONT YARD ❑ SIDE YARD 0 OTHER Nun OF SIDEWALK ❑ 4 FEET .❑ 5 FEET P5.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED '`°` _ sq.ft. 4 in. eq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES [] NO jki 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 sq uares. First Inspection and Form Mode By: r!.; J `_" . Date: Pork Department Review Required L] 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 OF WATERLOO. IOWA PROPERTY ADDRESS 832 z o c ,V A d e9L-z4-- /o( —oc9 . ZO9 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR viiZ77./7 .t L s length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) ADDRESS. 83 z ' WATER SHUTOFF VISIBLE ❑ . LAE BROKEN 0 li `S MISSING ❑ //�6- 2- >(� j,c/ Property Line A 1.7d I I-1 A 2 e)CAA) A(1. . LOCATION OF SIDEWALK FRONT YARD [_I SIDE YARD 0 OTHER .r IDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET 5.3 FELT 0 OTHER _._. DEPTH OF SIDEWALK Vi 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 'Usq.ft. 4 ;n. .*q.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO g 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 of full squares. First Inspection and Form Made Ely:r,.._.. ._ ?4 Date: /10 Pork Department Review Required YES 0 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 8,7 U L,c7 &A AVfi e513 _a-_toL_00 Z/O PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND U AREA NEEDING REPAIR Llll//iY/lif L length of repair needed Type of defect (See reverse side for Defect Codes A—P) (See below for Defect Code C) ADDRESS. e -f o WATER SHUTOFF VISIBLE ❑ BROKEN 0 MISSING 0 `Y / Property tine . LOCATION OF SIDEWALK % FRONT YARD 0 SIDE YARD 0 OTHER um OF SIDEWALK 0 4 FEET 0 5 FEET ( { 5.3 FEET 0 OTHER -- DEPTH OF SIDEWALK ( 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Z "�_sq.tt. 4 in. •q.it, 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 aqu res. /29First Inspection and Form Made By: 19,5 Date: 5 v . Pork 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 E (t€ GA Au ' 0, t3--z-4-_ to ( - z_/ i0 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND LI AREA NEEDING REPAIR I1:1171/ll/IA L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) ADDRESS. e T G I I I WATER SHUTOFF VISIBLE ❑ zee BROKEN ❑ MISSING ❑ 5. `f Property Line C. Lo cJ pw , BIN OF SIDEWALK 14 FRONT YARD ❑ SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET ❑ 5 FEET 5.3 FEET ❑ OTHER mizni OF SIDEWALK 0 4 INCHES 5 INCHES 0 6 INCHES AREA TO BE REPAIRED •q.f1. 4 ��n. zg� q.ft. 5 in. •q.ft. 6 in. CODE F — PATCHES YES 0 NO LY NO. Of SQUARES WITH PATCHES NOTE. Areas marked with an - may be repaired by patching. All other areas shall be repaired by reconstruction t ull squares?)5 f first inspection and Form Mode By:_._ Date: 31Zi / /0 Ji Pork Department Review Required ❑ YES 94 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: JIF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE G — Other. i I f##� J! • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLQO, _IOWA PROPERTY ADDRESS e 57 L O(4 A tJ . ' g99l3 -Z3-.ZL8 - oZ_ T1�� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - AREA NEEDING REPAIR virrmizia L I length of repair needed Type of defect (See reverse side for Defect Codes A—F) - (See below for Defect Cods.C) ADDRESS. S 7 ` ' WATER SHUTOFF VISIBLE ❑ \ . SASE BROKEN 0 MISSING 0 5-l Property line /% - C / \ ----- LorAnl AU-r- - LION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER Mb OF SIDEWALK 0 4 FEET 0 5 FEET qi 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK Fvf 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2:2` —sq.t►. 4 in. •q.tt. 5 in. ■q.tt. 6 in. CODE F — PATCHES YES 0 NO [ NO. Of SQUARES WITH PATCHES • NOTE. Areas marked with on - may be repaired by patching. Ali other areas shall be repaired by reconstruction a ull s u s, 3�z /f • First inspection and Form Mode By: ,Y 5 -- Date: • Park Deportment Review Required 0 YES ONO - PERMIT ISSUED NO. DATE: INSPECTION DATE: — IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: 4 CODE C — Other. 1 j 1 1 I i i I""` SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 859 LD6.AAJ Ad , 3913 Z3 - ?Zg_ c)t0 ZI3 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' —•-I • AREA-NEEDING REPAIR V//777////A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ._>1+ ADDRESS: 659 I • Property Line WATER SHUTOFF' VISIBLE EJ CAP BROKEN ❑ LO GA q llt MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD LXSIDE YARD ❑ OTHER WIDTH OF SIDEWALK [ 4 FED- ❑ 5 FEtI ❑ 5.3 FEET ❑ OTHER — DEPTH OF SIDEWALK [ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ' �.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO Cgi 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 squares First Inspection and Form Made By: 35 Date: 5 126 ij 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 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS LI 3 -4 5 1}i u) e ci l Sf . - — g3 13-Z.3--y-3-6i. / Z/4- PARCEL CODE CONTROL NUMBER CERT. NUMBER — LEGEND L' AREA NEEDING REPAIR L'ZZ//M./A — L •s length of repair needed Type of defect A j G--- (See reverse side for Defect Codes A—F)(See below for Defect Code G)C) — ` XADDRESS. `I WATER SHUTOFF VISIBLE Si _ \ . .Ctie BROKEN 0 • MISSING ❑ 1,3' ?.6 f Property `n G M 0\Dzi- -y s-ti- , jarjaal OF SIDEWALK `g,FRONT YARD 0 SIDE YARD 0 OTHER gj Of SIDEWALK 0 4 FEET 0 5 FEET ( 5.3 FEET 0 OTHER DEPI OF SIDEWALK 15Z12, 4 INCHES 0 5 INCHES 0 5 INCHES 83 AREA TO SE REPAIRED -- Z sq•tt. 4 in. sq.it. 5 in. ■q.ft. 6 in. • CODE F — PATCHES YES 0 NO p. NO. Of SQUARES WITH PATCHES NOTE. Antos marked with an - may be repaired by patching. All other areas shall be repaired by reconstruction of full squares. G�++ ,- Dale: 4' �'�'1 f first Inspection and Farm Mode By:_ _ F `� Park Department Review Required 6 YES 0 NO i • PERMIT ISSUED NO. DATE:, INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other poi-err-ha-1 replctcerneirk- of S►deWo-\ i }rte roofs are , prtsen-4- qur �e- -ervi.i Feel by C;-1ry _Cni:rtg9..r-. i j SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 51 \)e,-r4 Sf, • 3113_Z3—LIZg _013 ,/ 2/� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -+-1 AREA NEEDING REPAIR GW17,../MA L NI length of repair needed p Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ti ° ADDRESS. 5 1 I ` WATER SHUTOFF \ VISIBLE D • Sae BROKEN ❑ MISSING 0 • Properly Lice .a' — O -MTMON OF SIDEWALK It FRONT YARD 0 SIDE YARD 0 OTHER . MO OF SIDEWALK 0 4 FEET ❑ 5 FEET 5.3 FEET 0 OTHER DEPTH OF SIDEWALK flik 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Z ° 4 ,n. ■q.tt. 5 In. ■q,i1 6 in. CODE F — PATCHES YES [] NO a NO. Of SQUARES WITH PATCHES.,—. NOTE. Areas marked with an -r may be repaired by patching. All other ursas _ • shall be reooired by reconstruction of full squares,First Inspection and Form Made By:_ S D G Date: 3-2 Li 'it) Pork 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 n1 v i b cq-1 1213—23— — QL— Z!(p PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t' AREA NEEDING REPAIR vilzuwrizdi L s length of repair needed I Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. 53 WATER SHUTOFF visret£ ❑ See BROKEN ❑ . MISSING 0 S,o i Property Li�e _ r/A ` T ION OF SIDEWALK FRONT YARD 1 j j 0 SIDE YARD ❑ OTHER, - • jO OF SIDEWALK 0 4 FEET 0 5 FEET 5.3 FEET 0 OTHER-- DIM OF SIDEWALK ,R 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2q.f1. 4 in. --a 5 in. ■q.fl. 6 in. 2-6 CODE F — PATCHES YES ❑ NO p. NO. OF SQUARES WITH PATCHES NOTE. Argos marked with an - may bn repotted by patching. Ail ether areas shall be repaired by reconstruction of full squares. � . _ • first Inspection and Form Made By:.W D Date: 3--2 -Ib� .ems, Park Department Review Required ❑ YES 1�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 ADDRESS 65 u j\De r ri 5+. sa 13 -23 412 - 010 / Z./7 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR Ci771/77/7/A L = length of repair needed Type of defect �-- (See reverse side for Defect Codes A—F) (See below for Defect Code G) '' 51( ADDRESS: ec,5 czZ M � Property Line WATER SHUTOFF VISIBLE ❑ CAP 1 BROKEN El10v \Dtcrl MISSING ❑ 1 LOCATION OF SIDEWALK ❑ FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET f2f 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ' �O sq.ft. 4- in. sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES_ 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: CZ- 5 D�s Date: 3 Z LI -l e 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 SIDEWALK REPAIR SURVEY FORM CITY OF WATTRLOO, IOWA PROPERTY ADDRESS 740 �t v l 10e r r <5°i-- • SiR 13—Z3--y35"—e° 2- 7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-4.— L' AREA NEEDING REPAIR Vf Z.'ZiW'A L - length of repair needed A Type of defect / I �- (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 7� I I WATER SHUTOFFi ►h VISIBLE 3 \ • riee BROKEN ❑ MISSING 0 Property Line // Q/F4 Cr • fl1 toIer-r1 C+ 1 LOCATION OF SIDEWALK IfRONT YARD 0 SIDE YARD 0 OTHER 232.18 OF SIDEWALK 0 4 FEET 0 5 FEET 151i S.3 FEET 0 OTHER DEPTH OF SIDEWALK E 4 INCHES 0 5 INCHES [] 6 INCHES AREA TO BE REPAIRED J ' Q ■q.tt. 4 in. sq.tt. 5 in. sq.ft. 6 in. • CODE F — PATCHES YES [] NO a 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:—__�5 J �� Dale: 3 -04-10 Park Department Review Required jf YES C3 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: CODE C — Other Pn'Pe\ a.I reltacekot r'C o� STG ewc=.t4., ifr 4-ree roofs are p res ✓t - a.S d ", .,n Qd 6Y Cmi E rt�4 ry ee r SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS % _2) tAl \ r r_20 13 _ 23— 43 — eoS 7 V 9 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t-" L' AREA NEEDING REPAIR of/ZZI?,7 L — length of repair needed Type of defect A (See reverse side for Defect Codes A—r) - (See below for Defect Code C) ADDRESS. WATER SI OFF VISIBLE Lite BROKEN ❑ MISSING •9 Property Line rig LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET SO 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 21°,t, _sq.ft. 4 in. •q.ft. 5 in. *q.ft. 6 in. CODE F — PATCHES YES [] NO a NO. OF SQUARES WITH PATCHES .� NOTE. Areas marked with on "F" may be repaired by patching. All other oreas shall be repaired by reconstruction of full squares. First Inspection and Form Mode By:_ . R� _�= „W Date: Pork Department Review Required ❑ YES ONO 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 � j be,r,� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR ''` L = length of repair needed (, Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Cede G) ADDRESS. 9 7 0 6 WATER SHUTOFF VISIBLE 0 ruse BROKEN ❑ MISSING 0 _ i-If) Property Line _ . . . . _.. N1v��zrr+i St _ LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 0 S FEET '`4 5.3 FEET D OTHER DEPTH OF SIDEWALK4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 212.O q.ft. 4 in. sq.ft. 5 in. +q.ft. 6 in. CODE F — PATCHES YES 0 NO 0 NO. OF SQUARES WITH PATCHES m� NOTE. Areas marked with an "F" may he repaired by patching. All other areas shall be repaired by recanstruetioN of full squares. First Inspection and Form Mode By: X-C. D Dale: ` � -i Q Park Department Review Required 54 YES 0 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 (loo EIoc.K.. PROPERTY ADDRESS 1 v �t, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L • ' `k� AREA NEEDING REPAIR Ul/f�lfl� �`' L = length of repair needed ��� Type of defect — a � (See reverse side for Defect Codes A—F) I (See below for Defect Code G) ADDRESS. L-� WATER SHUTOFF VD.00.A • VISIBLE ❑ S9e BROKEN ❑ MISSING ❑ To#&\ O' Property Linn / 51i \ LOCATION OF SIDEWALK 13 FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET Ti 5.3 FEET 0 OTHER DEPTH OF SIDEWALK Et 4 INCHES $L 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 2c �'�q.ft. 4 in.10(°''''q.ft. 5 in. _eg.ft. 6 in. CODE F - PATCHES YES [] NO rA NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an "F' may be repaired by patching. All other oreass shall be repaired by reconstruction of full squoresi. First Inspection and Form Made By: � Date: = -i 0 _.. Park Department Review Required la 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 (300 8 iocK) My! IDerry Si-, ' _ ii2ii_ ' I_ act ✓ �Z; / - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km-- L' --+-j • — AREA.NEEDING REPAIR V7//7W///A n L = length of repair needed A ( ,�eo- Type of defect , L/ � w. (See reverse side for Defect Codes A-F) . (See below for Defect Code G) ADDRESS: I pl>l< PQrKyn k. y C krtr, tail( 90' `9 Property Line Li(:),5 T o•K. WATER SHUTOFF H/ VISIBLE ❑ CAP _ BROKEN ❑ wry/ j yp- MISSING El S . LOCATION OF SIDEWALK El FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET El 5 FEET /2 5.3 FEET 0 OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES ig 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in.,506•7 sq ft. 6 in. CODE F — PATCHES YES El NO IS1 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 . b(.7"` Date: 3 `2 3-)b Park Department Review Required 0 YES 1E1 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: _ CODE G — Other SIDEWALK REPAIR SURVEY FORM 1 Or 2 CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3Z t{ G i hit.- ,S+, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND — L' - • AREA.NEEDING REPAIR V//7/77777A L = length of repair needed Type of defect i m (See reverse side for Defect Codes A-F) (See below for Defect Code G)<19 ADDRESS: 44 - f -7:ZOO nJ fNJ Chti{C1. 5.0 17 Property Une WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ 3r LOCATION OF SIDEWALK El FRONT YARD ❑ SIDE YARD (t OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET (Pi 5.3 FEET Efr OTHER L DEPTH OF SIDEWALK .®, 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 30t 3 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: Ks D G- Date: 3 4 2 3 -1Ci Park Department Review Required I!. 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 2 OF 2. — CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3Z9 0 t.3)j2e re- S-{--, gz=1I3-2. 53- 00 Z PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND Imo' L' AREA.NEEDING REPAIR r////f//I//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) >lc ADDRESS: 32-9 C�t1v \ par iLjn (G4- c 5 I Property Line _ R)31 5.2 i _ i�/ 7/ X I WATER SHUTOFF l VISIBLE ❑ Cr CAP - ., Di BROKEN ❑ MISSING ❑ /i`(uieirrzi +. LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET JZ.,5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK A, 4 INCHES ❑ 5 INCHES D 6 INCHES AREA TO BE REPAIRED Bd; sq.ft. 4 in. sq.ft. 5 in. q.ft. 6 in. CODE F - PATCHES YES 0 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: 1`-S D C— Date: 3 Z3 - 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 PO+en*Tex.( re c ka. ettent Gf sidewkiK ; e. o fre- raf_s �c.r pre.se A- qS ct,,t.V2r.K77 et Let k ei;-/ £AGi Heel- ft v SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4 9 blk MUL��y SZ- • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR r/17/7 /A L — length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) I ; ADDRESS. I x\ ^l ( WATER SHUTOFF UACA N�T VISIBLE ❑ BROKEN 0 MISSING ❑ I � (0,3 Jj 4 Property Line • IvfuLa4 y 5? ,LQ,QATION OF SIDEWALK a FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 S FEET 15.3 FEET ❑ OTHER -- DEPTH OF SIDEWALK ❑ 4 INCHES 0 5 INCHES fik 6 INCHES AREA TO BE REPAIRED _sq.ft. 4 in. •q.ft. 5 in. {.16.1keq.ft. 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 of full squarer. First Inspection and Form Mode By._g5 D4, Dote: , -Z 3 -/0 Pork Department Review Required ❑ YES [l NO PERMIT ISSUED NO. .� DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other w--- SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS L/ « in‘:bet-fl PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND +-- L' --- AREA NEEDING REPAIR L — length of repair needed nn Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. q I I WATER SHUTOFF VISIBLE ❑ BROKEN LJ --- ,, MISSING 0 ao.41 Property Line LOCATION OF SIDEWALK a FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET R5.3 FEET 0 OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES 6 INCHES AREA TO BE REPAIRED _-sq.ft. 4 en. sq.ft. 5 in. IcF . .sq.it. 6 in. CODE F — PATCHES YES [] NO N 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. P i Cale: 3� 3` IC Park Department Review Required 0 YES {4 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. _ CONTRACT COMPLETION DATE: e CODE G — Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 5 b/,s' Maw ey 5r eTi.5 -?`. = 35,E- val z7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -� AREA.NEEDING REPAIR Vl7.777777. A L = length of repair needed Type of defect A (See reverse side for Defect Codes A-F) (See below for Defect Code G) ADDRESS: I (` c 114 tA Property Line ^ /6e0 11110 C�� 1 WATER SHUTOFF ' l t VISIBLE ❑ CAP " p BROKEN ❑ MISSING ❑ Mui g6-ga y 57; LOCATION OF SIDEWALK pp FRONT YARD [V SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ICI 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED q.ft. 4 in. sq,ft. 5 in. Za 7sq,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 of full squares. First Inspection and Form Made By: Q :D& Date: 3-23 - /0 Park Department Review Required 0 YES al 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 .c2© /yI Ujker r-y S-- . - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-*-- L' AREA NEEDING REPAIR vfiw_zzm.I _. 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. 520--)1i,„ I WATER SHUTOFF �/� ALE ❑ Sete _ BROKEN .0 MLSSING ❑ c1.5'x 12. ). ,o ` Property Line _____"_,,_\ v,. fi, , . 6„ ,i.) _ r///a, ;-:-c • f l'1 v\ €.1-,--1 s+. =UM OF SIDEWALK g FRONT YARD 0 SIDE YARD 0 OTHER mad of SIDEWALK 0 4 FEET lig 5 FEET 0 5.3 FEET ❑ OTHER - DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES cs( 6 INCHES AREA TO BE REPAIRED J21 t ■q•t1. 4 in. •q.tt. 5 in. Z�`C gq.ft. 6 in. CODE F - PATCHES YES 0 NO IA NO, OF SQUARES WITH PATCHES NOTE. Argos marked with an -r may be repaired by patching. All other urea. shall be repaired by reconstruction of full squares. • first Inspection and Farm Made By: I 5 0 c.s Dale: 3 `2 3" id Pork Department Review Required 0 YES in NO - PERMIT ISSUED NO. ._ DATE: INSPECTION DATE: . IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: 4 • CODE G - Other- 1 f 1 I • �. 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS zoo E, • \ L.L A K/ / S9 I - 23- 11-Q 1Z ✓ ZSO PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND �+-- L' —r-, AREA.NEEDING REPAIR VZ/ZZ.//////i L = length of repair needed (� Type of defect /"� (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: Z 0 Q Property Line WATER SHUTOFF " pVISIBLE [] CAP BROKEN ❑ U 1 l C* `% Ave MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET 0 OTHER DEPTH OF SIDEWALK ❑ 4 INCHES 0 5 INCHES 6 INCHES AREA TO BE REPAIRED 7-7' .I sq.ft. 4 in. sq.ft. 5 in. 77, � sq.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 of full squares. First Inspection and Form Made By: c r Date: 3 25-it) Park Department Review Required ❑ YES ix 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. 21 0 E. ()Au 1 I r v` Ave 1 _ PARCEL COOS CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR plllllllllA - L - length of repair needed R �.r Type of defect f See reverse side for Defect Codes A-F) (See below for Defect Code C) AE--I ADDRESS. WATER SHUTOFF v15loiE ❑ \ ' -We BROKEN 0 MISSING 0 roperty. Line .__.. .arAn I / / 7, ...\__________ . ON Of SIDEWALK a FRONT YARD 0 SIDE YARD 0 OTHER UM Of SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET it3 OTHER c 4 y ,gam OF SIDEWALK f 4 INCHES .Y" 5 INCHES 0 6 INCHES AREA TO BE REPAIRED gzt •g.tt. 4 in. 51' •q.ft. 5 in. ■q.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. First Inspection and Form Made By:__ E., b L- --- Date; —2-.5- 10 Park 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 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY -ADDRESS 300 g)ocK E I tlar Ave PARCEL CODE CONTROL NUMBER CERT. NUMBER f N LEGEND �+- L' t,)6 t� AREA NEEDING REPAIR wifrnmdi L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. JAE— IN.ek(C.A.A. l WATER SHUTOFF VISIBLE ❑ L gee BROKEN D . MISSING D yo' T afn,1 Properly Line / s.i E.. , r11 i L ANC • larADQN OF SIDEWALK ESI FRONT YARD 0 SIDE YARD ❑ OTHER OF SIDEWALK 0 4 FEET 0 5 FEET • 5.3 FEET 0 OTHER L. Dont OF SIDEWALK 4 INCHES E4 5 INCHES 0 6 INCHES AREA TO BE REPAIRED I'° .. •q.ft. 4 in. Y'-'' sq.ft. 5 in. . • sq.ft. 6 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 squares. first inspection and Farm Made By._ I� S G • Dale: 7-2" -1 t. • Pork Deportment Review Required ❑ YES 'NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE G — Other. i Ii • • — t SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 0 3 1111 u i 1 ci,r, Ave gq - 2_3- y35= 0 to 55 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' • AREA.NEEDING REPAIR V7/7//7,Z L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) V (�' (See below for Defect Code G) I ADDRESS: © 3 v y 1 �. 1, Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ c e 7 4-4-e 5 LOCATION OF SIDEWALK ❑ FRONT YARD 15Z1 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET OTHER 510 I ' DEPTH OF SIDEWALK 4 INCHES .5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. 17'O sq.ft. 5 in. sq.ft. 6 in. • CODE F — PATCHES YES ❑ NO IR 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: D Date: 3 Z' - /v Park Department Review Required ❑ YES I 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 107 L. Ave 6,1 1 2-1 - q31 - 0 dL ✓ ZJ?(,0 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V///////T/A L = length of repair needed Type of defect Ci/ (See reverse side for Defect Codes A—F) d 4 (See below for Defect Code G) ADDRESS: LI Property Line WATER SHUTOFF VISIBLE ❑ CRP BROKEN ❑ MISSING El LOCATION OF SIDEWALK FRONT YARD pi SIDE YARD ❑ OTHER ._ WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES la 6 INCHES AREA TO BE REPAIRED Gq.ft. 4- in. sq.ft. 5 in. j7°' I sq.ft. 6 in. • CODE F — PATCHES YES ❑ NO 541 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 is Date: 3 -74 Park Department Review Required ❑ YES 51 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: - CODE G — Other SIDEWALK REPAIR SURVEY FORM - OITY OF WATERLOO, IOWA PROPERTY ADDRESS 110 0 E, in u 1 ttn Ave . gcl!3 -.23 _ .Y32_ 011 ,s Z37 PARCEL CODE CONTROL NUMBER �/CERT. NUMBER _ LEGEND ki- L' —a-I AREA.NEEDING REPAIR W.//I/Il/1ii L = length of repair needed c .9 M Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: 08 ,� , <___ Id NI -o • Property Line - WATER SHUTOFF VISIBLE E] CAP BROKEN 0 in I I car. A�t v MISSING El LOCATION OF SIDEWALK ❑ FRONT YARD in, SIDE YARD ❑ OTHER WIDTH OF•SIDEWALK ❑ 4 FEET ❑ 5 I.Eli 12105.3 FEET 0 OTHER _ DEPTH OF SIDEWALK M 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED -1 I u t( sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES ❑ NO N. 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 . .1) c, Date: .-2q-/D •Park Department Review Required E] 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, IOWA PROPERTY ADDRESS N t,;e �.s-} $2/3 - - loa- ooi✓ Z3,8 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' . AREA.NEEDING REPAIR V//jj7�I/A L = length of repair needed Type of defect -,Pr (See reverse side for Defect Codes A—F) (See below for Defect Code G) ! - >Kw ADDRESS: 9 a 3 1 w ,.) n., Property Line WATER SHUTOFF VISIBLE ❑ CAP } BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET (SI OTHER f['1 DEPTH OF SIDEWALK 4 INCHES ] 5 INCHES ❑ 6 INCHES y C1 f3 AREA TO BE REPAIRED �`� sq.ft. 4 in. 1 �� 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: L - Date: 3-a 4 1° Pork Department Review Required ❑ YES 54 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 ;6v< &14-1.66/- ST _ $Li3 `( - QS -6a , ✓ 059 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1. L. —0-1 AREA NEEDING REPAIR Vlll/////IA L so length of repair needed /, Type of defect t 1 (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I C� I 11/ WATER SHUTOFF VISIBLE 0 BROKEN 0 MISSING 0 t-tD Property Line1/74 A • • LOCATION OF SIDEWALK It, FRONT YARD 0 SIDE YARD 0 OTHER maw OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET bi6 OTHER Iti DEPTH OF SIDEWALK ❑ 4 INCHES [] 5 INCHES 6 INCHES AREA TO BE REPAIRED eq.ft. 4 in. ■q.ft. 5 in. ..!'."''q.ft. 6 in. CODE F — PATCHES YES [,] NO NO, OF SQUARES WITH PATCHES NOTE. Argos marked with on "F" may be repaired by patching. AS other areas shall be repaired by reconstruction !!!.....pi squares. • First Inspection and Form Made By: L C __.. Date: • Pork Department Review Required ❑ YES yj NO PERMIT ISSUED NO,.. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: , T CODE C — Other. I a .i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS ( l `e't S -}-. PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I"' t AREA NEEDING REPAIR v477illIZZA L - length of repair needed Type of defect 1 (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I I WATER SHUTOFF VISIBLE (] C Li LAi L K SAE BROKEN ❑ _ MISSING 0 Property Line ^ ._ Akuielt irtrAjION OF SIDEWALK I FRONT YARD ❑ SIDE YARD ❑ OTHER a f 111)111 OF SIDEWALK 0 6 FEET ❑ 5 FEET 0 Si FEET OTHER DEPTH OF SIDEWALK ,` 4 INCHES t7§1 5 INCHES ❑ 6 INCHES t3 -� sq.tt. 4 in. ' AREA TO BE REPAIRED t3jeq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES 0 NO VI NO. OF SQUARES WITH PATCHES..._ • NOTE, Arsoe marked with an "F" may be repaired by patching. Ali other areas • shall be repaired by reconstruction of full squoros. first Inspection and Form Made By:_.� Date: Pork Department Review Required [, YES In 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 , 4, N 2 i e-I S+. . - i 03 PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND k- L. - AREA NEEDING REPAIR V//7//I/7./w L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) .. ADDRESS. f a l I WATER SHUTOFF _ • CLEAN Wk VISIBLE 0 BROKEN ❑ MISSING 0 ._ Property Unit 7 __ �. ._ 07..... P l'I j,QCagN OF SIDEWALK T", FRONT YARD 0 SIDE YARD 0 OTHER i kji lagiti OF SIDEWALK CI FEET 0 S FEET 0 5.3 FEET OTHER `1`' ,DEPTH OF SIDEWALK • 01 4 INCHES 4INCHES 0 6 INCHES AREA TO BE REPAIRED 30g* iq.ft. 4 in. ■q.lt. 3 in. ■q.ft. 6 in. • CODE F — PATCHES YES 0 NO 7A NO. Of SQUARES WITH PATCHES • NOTE. Arens marked with an -rmoy be repaired by patching. All other areas shall be repaired by reconstruction VII s`quarres. First Inspection and Form Mode By:: • w • Dale: 3 V A3-i 0 Pork Department Review Required ❑ YES 121,NO f PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0. CONTRACT COMPLETION DATE: i CODE G — Other' I { I . r__ SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 300 b 1/? OAK kb"- - a a. 3 —Z.3-4Z7 _005 ./ 1,110 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-e- L. -+-I AREA NEEDING REPAIR I//II//71ZZt L I. length of repair needed Type of defect f (See reverse side for Defect Coles A-F) (See below for Defect Code C) ` 3 2 I ADDRESS. -- I WATER SHUTOFF Gar u Je � VISIBLE 0 '-- See 'ire BROKEN 0 MISSING 0 0 yiI Vr`' Property line Or 0(.. AVe � .I.PrArlati OF SIDEWALK aFRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK tgl 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER muff OF SIDEWALK 54 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED / / zoq.tt. 4 in. ■q.ft. 5 in. ■q.fi. 6 in. CODE F - PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES..._. NOTE. Amos marked with an "r may bn repaired by patching. All other ursas shall be repaired by reconstruction of full squares. First Inspection and Form Mods By: .._ G Y Date: 3 -2 Pork Department Review Required 0 YES ONO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0• CONTRACT COMPLETION DATE: ! �ilacewnex��'- air s� tw.iK CODE G - Other. o �•��4, r 4p �� �re4. r oo t5 art. resent+ 45 rie.+Q.rrwtftex( by Ci4-, �00%, neer . SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3 0 I °col, PS.►e 8q_1 3- 23- 422- 003 ✓ � PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR C/// //A f i L = length of repair needed Oe-° Type of defect U3 \\L (See reverse side for Defect Codes A-F) 6 (See below for Defect Code G) Ikt4'>1< ADDRESS: acc-61 Property Line �® _ WATER SHUTOFF VISIBLE 0 CAP BROKEN ❑ MISSING ❑ I- c-CL1 PA-Vti LOCATION OF SIDEWALK ❑ FRONT YARD J SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET • 05.3 FEET ❑ OTHER — DEPTH OF SIDEWALK fk 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 371.0 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: S D (,- 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 3Z I Oct . Ave_, • al 13 —2 —y2-1— y ✓ 044- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' —+-1 AREA NEEDING REPAIR TI.//1MIZZA L so length of repair needed Type of defect J )v See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS. 3 I I WATER SHUTOFF VISIBLE 03 rTf k • t BROKEN ❑ MISSING CI v 7 G 13.2 Pro Ay U�i / 5# \r CO�c Ave4 jacjilgaf OF SIDEWALK 21,.FRONT YARD ❑ SIDE YARD 0 OTHER OF SIDEWALK 4 FEET 0 5 FEET 0 5.3 FEET ❑ OTHER OF SIDEWALK 4 INCHES El 5 INCHES 0 6 INCHES AREA TO BE REPAIRED /1et..1_sq.ft. 4 ;n. .c2 Bsq.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an - may be repofrsd by patching. All other areas shall be repaired by reconstruction of full squares. ,} first Inspection and Form Made By:...a KS .f) Date: •g 'ZLI-tom Pork Department Review Required ❑ YES tSNO J PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE; • CODE G — Other; Pc e v c'ica rt l4ce.-"Ae_n4 ew4.{iC 4 free. rao+S re Ij frese/14. as c e.4-e.rk•+;Ked by C,;47 1 • • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 6.) L�c.k Ave • • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V//////l//A L = length of repair needed Type of defect 1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) >1 ADDRESS: 3 z6 '�( 2. ci Property Line WATER SHUTOFF rjVISIBLE 0 CAP BROKEN ❑ MISSING ❑ vl t 1'r 1 S+ • LOCATION OF SIDEWALK %FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK M 4 FEET ❑ 5 FLEA ❑ 5.3 FEET ❑ OTHER — DEPTH OF SIDEWALK SRI 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Gq.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 squarre�ess�.. First Inspection and Form Made By: DG+ Date: 3 —Zy — 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 . 408 J0-,K Ive PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' -� AREA NEEDING REPAIR rtzliwm7.� L - length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 21 v S WATER SHUTOFF visa E ❑ riee BROKEN ❑ MISSING ❑ Property Line (O o. Axe =MO OF SIDEWALK 54 FRONT YARD ❑ SIDE YARD 0 OTHER yittgo OF SIDEWALK 1Se 4 FEET ❑ 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK tRi 4 INCHES [j 5 INCHES 0 6 INCHES AREA TO BE REPAIRED !I&sq.ft. 4 in. •q.tt. 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. ILL 3 -zq- /O First Inspection and Form Made By: W �� Date; Park Department Review Required 0 YESI 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/2 I Oaf A-ve 13 -.' :3 _ 4 2&_ a i`7 z 4 7 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t-e- L. AREA.NEEDING REPAIR V//77/////A L = length of repair needed Type of defect A j C- (See reverse side for Defect Codes A-F) (See below for Defect Code G) No* ADDRESS: 2 I'14' 4.0, Property Line 8.4ti 3` `&i.0`ii� _ �� T 134E WATER SHUTOFF i /J. �1�t�{. VISIBLE ❑ CAP BROKEN ❑ MISSING ❑ LOCATION OF SIDEWALK El FRONT YARD s. SIDE YARD ❑ OTHER WIDTH OF-SIDEWALK * 4 FEET El 5 FEET El 5.3 FEET ❑ OTHER , DEPTH OF SIDEWALK 134 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED •/9zi©Gq.ft. 4 in. aq.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 Date: 3-Z Li-/0 Park Department Review Required ❑ YES [i 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 O.7 6/AK Ave. g9 1. - ' 3-282- 69041 Z4 PARCEL CODE CONTROL NUMBER CERT, NUMBER LEGEND 1-+— L' --awl • AREA.NEEDING REPAIR VjllT/ZWA L = length of repair needed Type of defect C1 A (See reverse side for Defect Codes A—F) (See below for Defect Code G) N **X ADDRESS: -�0 • _ \ \ .... V . Vie( .3 M e.I ' L1•I r Property Line V t. ;T V WATER SHUTOFF I VISIBLE ❑ Vf CAP 11 BROKEN 0 MISSING ❑ FR ANKt_IN s-i LOCATION OF SIDEWALK 12 FRONT YARD 0 SIDE YARD bili OTHER Z z A 2 WIDTH OF SIDEWALK ►ii 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK `i 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES El NO ile 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. Li-22-/® teS First Inspection and Form Made By: (Yl a• E: S. Date: 3-2.S-I o Park Department Review Required 0 YES ►4 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 51 5 85/3 _ - Z3. = -Qo 5i0 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km-" L' AREA.NEEDING REPAIR 17777 /A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) "1 (See below for Defect Code G) >1<)3,;,) ADDRESS: 5 Property Line 1/i 1 /4 WATER SHUTOFF DVISIBLE ElNJV p`'s CAP i BROKEN ❑ CA k S,T• MISSING El LOCATION OF SIDEWALK a FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 4 FEET ❑ 5 FEET ❑ 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED - ' 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" may .be repaired by patching. All other areas shall be repaired by reconstruction of full squares. ) 1 First Inspection and Form Made By: M5 J Date: 3 Z /J C) Park Department Review Required ❑ YES (x 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- - Pcvr ( A vt'_- ' 89. 13 —25_10 1 _ oo / ‘Z ® PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L. AREA NEEDING REPAIR vollfilifJA L - length of repair needed g tyclA s vl K Type of defect -' �I� � (See reverie side for Defect Cores A-F) (See below for Defect Code C) ADDRESS. I OZ-1 i 0 I , WATER SHUTOFF Pq{tC „ VISIBLE ❑ • LSAE \ o-Vi BROKEN ❑ ck MISSING 0 F Property Line ��•� .G _ Ar ,-,- / A. ______ illIlltflIllrfftrEg - zee ci.(- • _____ . . )C YL. A. t • 3 tt` 121 1 OCATION OF SIDEWALK is, FRONT YARD 0 SIDE YARD 0 OTHER JOF SIDEWALK 0 4 FEET CI5 FEET 0 S.3 FEET ❑ OTHER - j $EM OF SIDEWALK El4 INCHES ❑ 5 INCHES tii 6 INCHES J AREA TO BE REPAIRED eq-f1. 4 in. -■q.ft. 5 in.2160'esq.ft. 6 in. CODE F - PATCHES YES 0 NO..0 NO. Of SOtlARES WITH PATCHES NOTE. Areas marked with an -rmay be repaired by patching. All other areas {' shall be repaired by reconstruction of full squares, Ii First inspection and Form Made By:..,__ b C.i- Date; 3 _ Z 3 Pork Department Review Required 0 YES Er NO i PERMIT ISSU ED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: I .1; j CODE G -- Other I ' Ali 1 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 2_z9 E Pert. -j, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-e— L' —.'- AREA.NEEDING REPAIR. rail///////A ,i\C Li,S i. L = length of repair needed �:� 3;3` Type of defect A I (See reverse side for Defect Codes A—F) (See below for Defect Code G) 117 XADDRESS: 1 �� & I CE�;C011 \I 7 1 e 0 t ` 1r \ :5 i0-j % o � Property Line 1} 3' kt,. 11-.5 114 q WATER SHUTOFF VISIBLE 0 1l/i7 CAP BROKEN ❑ ` Etir� MISSING El A vP . LOCATION OF SIDEWALK ❑ FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 0 5 FEET ❑ 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK ``, 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED Z'SZ,5* gq,ft. 4 in. sq.ft. 5 in. q.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 B : > • ' - /0 p y G Date: 3 `.� `� 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 . PROP ERN ADDRESS v[ q e -a - "3 '- QO± I CONTROL JNUMBER CENUMBER � 1 PARCEL CODE LEGEND \ • AREA.NEEDING REPAIR L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) �p s , I J ....)\4' ADDRESS: \ �� 1 \9' zio N 5 . - • Property Lim__ WATLR SHUTOFF VISIE3LE ❑ jO. 'x LI°O' CAP BROKEN ❑ • MISSING ❑ l�QT N OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF.SIDEWALK ❑ 4 FEET 0 5 FEET ❑ 5.3 FEET . OTHER— D PTH OF SIDEWALK _ 4 INCHES ❑ 5 INCHES ❑ 6 INCHES ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. AREA TO BE REPAIRED q' , CODE F — PATCHES YES 0 NO E4 NO. OF SQUARES WITH PATCHES_---- NOTE: Areas marked with an "r may be repaired by patching. All other areas shalt be repaired by reconstruction of full squares. �3 _l First Inspection and Form Made By:_ �S . ( Date: Park Department Review Required 0 YES 0 NO -PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL CONTRACT COMPLETIONSESSMENT ODATECT NO: CODE G — Other SIDEWALK REPAIR SURVEY FORM GfTY OF WATERLOO IOWA PROPERTY ADDRESS Z 2' PARCEL CODE . �� CONTROL NUMBER CERT, NUMBER LEGEND AREA_NEEDING REPAIR L� — —1 L = length of repair needed t Type of defect (rSee reverse side for De cef tt Cod A—E(See below for Defect Code Gres 1 �_ ADDRESS. 110 7 I I / .s L I N t Property Line Ij i WATER SHUTOFF VISIBLE 0 1-------) CAP A i1 BROKEN ❑ �'P`? ° MISSING ❑ 6 10CA.1o, OF SIDEWALK Z FRONT YARD 4 SIDE YARD SIDEWALK �YIDTH Or 0 OTHER • 0 4 FEET 0 5 FEET CI 5.3 FEET 0 OF SIDEWALK OTHER • .._ 4 INCHES ❑ 5 INCHES AREA TO BE REPAIRED -7_ , � 6 INCHES q.ft. 4 in. — CODE F — PATCHES YES sq•ft. 5 in. — �q,ft. 6 in. NOTE: 0 NO . „ NO. OF SQUARES Areas marked with an " llWITH PATCHES shall be repaired by reconstructiobn of repaired full s by patching. All other areas First Inspection and Form4uares° Made By:_ Z. L Park Department Review Required Date: '��� it..) ❑ YES I 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 ;;tom PROPERTY ADDRESS y0 7 E. Park_ AJ C.-. Z3 La -2-J- 354 °e ✓ �5� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km— L' AREA.NEEDING REPAIR t/T////////A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: Li 0 (14, ,.,..r 0 Property Line �• WATER SHUTOFF VISIBLE r 11' /1 1 . CAP I 1 I BROKEN ❑ raD i MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD D OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET Ef 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK fEr 4 INCHES ❑ 5 INCHES t5e71. 6 INCHES AREA TO BE REPAIRED ✓ rs sq,ft. 4 in. �q.ft. 5 in. 4±...S 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 sq)uores. First Inspection and Form Made By: k, Date: 25 Park Department Review Required ❑ YES .. NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: CODE G — Other g -- -_ I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 5 1rewsk— V 5E --Q --351- J 05 ✓ �j,11- PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND ' I.' AREA NEEDING REPAIR L IlifZa 1 L. - length of repair needed I_ Type of defect / See reverse side for Defect Codes A—F) (See below for Defect Code C) _ --)r cc J.- ADDRESS. J-- i I ' WATER SHUTOFF VISIBLE El SIE BROKEN ❑ i i MISSING 0 ._ Property Line _ J I/ v_ii.c.\\ . i-i' - Av e-- =MN OF SIDEWALK rii FRONT YARD 0 SIDE YARD 0 OTHER, .202121 OF SIDEWALK ❑ 4 FEET. 0 5 FEET ttr 5.3 FEET 0 OTHER DEPTH OF SIDEWALK • 0 4 INCHES pl 5 INCHES 0 6 INCHES -1 AREA TO BE REPAIRED iq.ft. 4 in. : q.1t. 5 in. ■q.ft. 5 in. CODE F — PATCHES YES 0 NO t 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 *quotes. First Inspection and Form Made By: . .1 fL --- Dale: '•) Pork Department Review Required 0 YES ONO • PERMIT ISSUED NO. • DATE: INSPECTION DATE: • • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: CODE C — Other . I I I 1 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS av iv/4 /m< • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND km-- L' -' AREA.NEEDING REPAIR t7//77/7///ii L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: VAC— L/— 4e Property Line WATER SHUTOFF VISIBLE: ❑ CAP • BROKEN ❑ �7 14 �5 MISSING El LOCATION OF SIDEWALK PI4 FRONT YARD ❑ SIDE YARD ❑ OTHER _ WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET N. 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK ❑ 4 INCHES IX 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED � � %1.ft. 4 in. q.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. First Inspection and Form Made By: Mg 1'5 Date: 5 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 � b/k pAg1 ie6 . 81 ,_3 ✓ 0.560 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA.NEEDING REPAIR V///l //A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) M (See below for Defect Code G) L„1 -x >K ADDRESS: � gr vAC• I �,� " Lot 4 Property Line ae si WATER SHUTOFF l 'l VISIBLE ❑ ZIv� 9 i CAP p BROKEN ❑ MISSING ❑ t1TrCA ST LOCATION OF SIDEWALK FRONT YARD ti SIDE YARD ❑ OTHER WIDTH OF SIDEWALK M 4 FEET ❑ 5 FEET 14 5.3 FEET ❑ OTHER— DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE 'REPAIRED 4 in, 5 In. sq.#t. 6 in. CODE F — PATCHES YES ❑ NO1% 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: 1.4 . Date: 3/25 11 C7 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 CF ILOF WATERLOO "OWA PROPERTY ADDRESS 30,o et. A- Y I). e -2.3 ... 2gZo / Z ZS? --• CONTROL NUMBER CERT. NUMBER PARCEL CODE LEGEND L, AREA NEEDING REPAIR V A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: ( . .40* - \ \, Z., c N. Property Line (•3_ . WATER SHUTOFF I7 ' VISIBLE ❑ ,' ¢ BROKEN ❑ MISSING ❑ COLu/14 =A _5 LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF'SIDEWALK 0 4 FEET ❑ 5 FEET ` 5.3 FEET El OTHER — DEPTH OF SIDEWALK 4 INCHES ❑ 5 INCHES ❑ 6 INCHES •ZZ,0/ R ft. 5 in. sq,ft. 6 n.< AREA TO BE REPAIRED cq.ft. 4 in. q CODE F — PATCHES YES ❑ NO ❑ NO. OF SQUARES WITH PATCHES NOTE: Areas re paired with ane"r may constructi ben repaired dgbyrpatching. All other areas shall b es. . First Inspection and Form Made By: Date: Park Department Review Required 0 YES 0 NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL CONTRACT ESSMENT OCONTRDAT CT NO: CODE G — Other SIDEWALK REPAIR SURVEY FORM �1.TY OF WAT�'RLOO I(6A PROPERTY ADDRESS 4 /7/k PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND 1-0— L' AREA NEEDING REPAIR vi�zuiz L - length of repair needed Type of defect rSee reverse side for Defect Codes A—F) See below for Defect Cods C) ' ADDRESS. f I T, (\ I F e•i WATERSHUTOFF �S�� I N ❑ Zee � BROKEN ❑ MISSING 0 of f z ga __-- Property Unit ' it e"7. norm Y / . 6 - ,. 0 - PI'R KA �' / .LOCATIO 0 OTHER OF SIDEWALK FRONT YARD 0 SIDE YARD - Mali OF SIDEWALK 0 4 FEET 0 5 FEET (� 5.3 FEET 0 OTHER OF SIDEWALK 4 INCHES 0 5 INCHES \ Elk 6 INCHES 5 '® r - ' ✓ AREA TO BE REPAIRED 3 sq.ft. 4 in. sq.ft. 5 In. sq.ft. 6 in. COOS F — PATCHES YES 0 NO Jj 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: M6 ,3S .5/Z5 0 .._ Oats: Pork Deportment Review Required 0 YES ©NO i PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other • i. J SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS I t,t" PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1''' L' AREA NEEDING REPAIR UliwiizwA s< length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 515 WATER SHUTOFF VISIBLE ❑ • . rite BROKEN 0 • MISSING 0 Property Line _A — )i r L} �.• LOCATION OF SIDEWALK Ii FRONT YARD 0 SIDE YARD 0 OTHER wad OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET 0 OTHER 5' ' DEPTH OF SIDEWALK ill 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO SE REPAIRED ■q•tt. 4 in. ■q.1t. 5 in. ■q.H. 6 in. CODE F. — PATCHES YES ❑ NO RI NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an - may bn repaired by patching. Ali other areas • shall be repaired by reconstruction of full squares. ;3,� -{� Date: " j4.1 `/D first Inspection and Form Made Ely:__ i Park Department Review Required ❑ YES M 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 . (Joo B IocK) Qv; n cy PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I-4- L' AREA NEEDING REPAIR VZ/ZZZ�ii f L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) 91 ADDRESS. I - VIAC "W i WATER SHUTOFF i 1 VISIBLE ❑ SE BROKEN ❑ MISSING 0 Property Une L W-1C >) tithGi 1=10 OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER 202111 OF SIDEWALK 0 4 FEET ta 5 FEET ❑ 5.3 FEET ❑ OTHER DLEIH OF SIDEWALK ( 4 INCHES ❑ 5 INCHES 0 6 INCHES 508+DI AREA TO BE REPAIRED •q.ft. 4 in. ■q.et. 5 in. ■q.ft. 6 in. CODE F - PATCHES YES ❑ NO T". NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may ba repaired by patching. Ali other areas shall be repaired by reconstruction of full squares.� First Inspection and Form Made By:, L</ Dale: � _�o t Park Department Review Required (] YES 19 NO PERMIT ISSUED NO, DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: • CODE G - Other. 1 • • c • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS . (f ao @lock! Q ui ytcy 19L3 _:;Li _1 _0(*v . z4,, PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I+— L' —*-f1 AREA NEEDING REPAIR VIIlIlllllit E. - length of repair needed Type of defect See reverse side for Defect Codes A—F) See below for Defect Code C) r LA ADDRESS. I " h; 1 I WATER SHUTOFF VISIBLE [] S.a2 BROKEN 0 uissuNc ❑ Property Line �,LEAN WALK =CABO OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER MB OF SIDEWALK ❑ 4 FEET 0 5 FEET ❑ 5.3 FEET 0 OTHER. DEPTH OF SIDEWALK g 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED .. . aq.ft. 4 in. ■q.ft. 5 in. -q.ft. 6 in. CODE F — PATCHES YES 0 NO 1 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an - may be repaired by patching. All other areas . shalt be repaired by reconstruction of full squares. First Inspection and Farm Mods By: _ _ fir Date: �?1 I • Park Department Review Required 0 YES trNO 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 OS au:I IN 1 5 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND k- E' AREA NEEDING REPAIR L : length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Cods C) ' ADDRESS. .1- = - I I WATER SHUTOFF VISIBLE 0 BROKEN ❑ . MISSING 0 L. Property line — vet�"� - LOCATION OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER ------- 111Id OF SIDEWALK CI 4 FEET p 5 FEET 0 5.3 FEET 0 OTHER - 4 INCHESEl INCHES DEPm OF SIDEWALK 0 � 5 INCHES c2s ✓ `° .q.tt. 6 in. - AREA TO BE REPAIRED . _sq.11. 4 in. .- ■q•ft. 5 In. CODE F - PATCHES YES 0 NO `A NO. OF SQUARES WITH PATCHES._._------ NOTE. Areas marked with an -r may be repaired by patching. All other ursas shall bs repaired by reconstructlan of full squares. 2 U-�( First Inspection and: Form. Mad. 8y:___ L� Date: `J i Park Department Review Required 0 YES OK3 NO PERMIT ISSUED NO, DATE: INSPECTION DATE: i IF UNCOMPLETED. SPECIAL CONTRACT COMP ETIONNT DA CONTRACT NO- —� CODE G - Other- _ i 1 i 1 I i i SIDEWALK REPAIR SURVEY FORM ' CITY OF WATERLOO. IOWA PROPERTY ADDRESS 1 • O_A)Am•1 l -f. . • PARCEL CODE CONTROL NUMBER CERT. NUMBER , LEGEND L' AREA NEEDING REPAIR viiriizowl L . length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ---)1E ADDRESS. j 9` I ( WATER SHUTOFF W518LE ❑ \ . SAE BROKEN 0 MISSING 0 .._ ���c� Property Line ^ ,y _ (C:5)/ 1\ . . OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER _ OF SIDEWALK 0 4 FEET 5 FEET 0 5.3 FEET 0 OTHER DEEM OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES V AREA TO BE REPAIRED q, q.ft. 4 in. ■q.ft. 5 In. ■q.ft. 6 in. �. CODE F — PATCHES YES 0 NO NO, OF SQUARES WITH PATCHES NOTE. Arias marked with an -F" may be repaired by patching. All other urea. shall be repaired by reconstruction of full squares. 3(� (�{% Date: -J 3 --i 0 First Inspection and Form Made By:,___ --Iv Park Department Review Required Ie YES El NO 1 PERMIT ISSUED NO. ._._ DATE: INSPECTION DATE: J., IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: i CODE G — Other i It I , y,- SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 33? A)( i J sr ✓ g913 _a` _ L57. 067 ✓ Z67/' PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I..— L' _.. .I AREA.NEEDING REPAIR fll/7/777/7A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) . ADDRESS: � T 3 <t I `T N t ,--i li , Property Line WATER SHUTOFF t' VISIBLE ❑ 41 D .22 BROKEN ❑ ... MISSING 0 LOCATION OF SIDEWALK ❑ FRONT YARD 1A2 SIDE YARD 0 OTHER WIDTH OF SIDEWALK 0 4 FEET 5 FEET 0 5.3 FEET 0 OTHER _ f DEPTH OF.SIDEWALK IS1 4 INCHES ❑ 5 INCHES 0 6 INCHES 335 j' AREA TO BE REPAIRED bsq.ft. 4 in. sq.ft. 5 in. 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 fulls; .free. • First Inspection and Form Made By: • Date: 3 -`ZS 70 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 . 4 dg } PARCEL CODE CONTROL NUMBER CERT. NUMBER . LEGEND t"' L' AREA NEEDING REPAIR of '71/ZT A _ I - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. L 0 I ' WATER SHUTOFF VISIBLE 0 \ • sib BROKEN 0 MISSING ❑ • Property tine 0,1 C_ aN t,UALK LOCATION OF SIDEWALK V_ FRONT YARD 0 SIDE YARD 0 OTHER Q OF SIDEWALK 0 4 FEET 5 FEET 0 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES 01 AREA TO BE REPAIRED __sq.It. 4 in. ■q.tt. 5 in. WI. 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 e uores. /� first Inspection and Form Made By:� Dale: - Park Department Review Required 0 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 QF WATERLOO, IOWA PROPERTY ADDRESS iq 1.:ti-4j.-1,53. -068 ✓ '6,(® PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND t' AREA NEEDING REPAIR vriiii/ZZA , L au length of repair needed A Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code C) ---)tE ADDRESS. 4-1 1 5v. ' + WATER SHUTOFF sae ❑ mm BROKEN 0 . MISSING 0 _A- Property Line A '" S OF SIDEWALK ti FRONT YARD 0 SIDE YARD 0 OTHER NUM OF SIDEWALK ❑ 4 FEET 0 5 FEET 15.3 FEET 0 OTHER ` OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES C�✓ . AREA TO BE REPAIRED -' .q.ft. 4 in. ■q.11. 5 in. ■q.ft. 6 in. "- • CODE F - PATCHES YES ❑ NO a NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an -r may be repaired by patching. AU other areas shall be repaired by reconstruction of full squares. • First Inspection and Form Made By: 1 Date: 3 a5-to Pork Department Review Required GI YES 0 NO r 1 PERMIT ISSUED NO. DATE: INSPECTION DATE: ' IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' _ CONTRACT COMPLETION DATE: i CODE G - Other I I I I . i • t E SIDEWALK REPAIR SURVEY FORM , IIYOFtial F PROPER ADDRESS . `` ` 0J3 ✓ ✓ (4-7 CERT. NUMBER .1.L3— L CODE CONTROL NUMBER PARCEL CODE • LEGEND AREA NEEDING REPAIR L gm length of repair needed Type of defect See reverie side for Defect Codes A—F) (See below for Defect Cods C) 1 + 4 ( ADDRESS. _._._- ----- I '1 WATER SHUTOF F WStBIE ❑ ,,I 1 .. . I___________--_--_ ______0_\•. �- N TOKEN B MlsslNc z Prop4rty Ling -�._____ _-.-------' _________________ S{J _________--___________________.__________ . ,,,\..1 - „,.... OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER-- CI S.3 FEET 0 OTHER � OF SIDEWALK 0 4 FEET -- 5 FEET OF SIDEWALK ON 4 INCHES 0 5 INCHES 0 6 INCHES — gam a5Q I t!. 6 M. .sq.it. 4 in. sq.ft. 5 in. ---aq AREA TO BE REPAIRED CODE F - PATCHES YES 0 NO 0 NO. OF SQUARES WITH PATCHES___---- NOTE. Areas marked with an -r may bn repaired by pa• tching. All other areas reconstruction of full squares. "J shall be repaired by i Data: ... ) First Inspection and Form Mad* 6y:..._-_.-= Park Department Review Required YES PERMIT ISSUED NO.__--.__ DATE:._...___---INSPECTION DATE; i IF UNCOMPLETED. CONTRACT SCOMPLETION DATESSMENT ECT NO' 1 CODE G Other ----. I \I . 1 , i SIDEWALK REPAIR SURVEY FORM -CfTY OF WATERLn2 town PROPERTY ADDRESS 33 .3, 6( # PARCEL CODE • CONTROL NUMB`— --- x--- '� CERT. NUMBER LEGEND • AREA.NEEDING REPAIR L. ~ '— L = length of repair needed Type of defect See reverse side for Defect Codes A—F)(See . .. , below for Defect Code G) r �� • 4E. __ajL__ ADDRESS: l U N I i _______I .. • • _ ----- Property Line WATER SHUTOFF 1----j VISIBLE ❑ SAE BROKEN ❑ _`,-5xt.i� MISSING ❑ LoGAIl4t1 OF SIDEWALK ❑ FRONT YARD . • � SIDE YARD 0 OTHER • Iti OF SIDEWALK 0 4 FEET gr 5 FEET • 0 5.3 FEET 0 OTHER — .D.EP.111 OF.SIDEWALK 4 IN • 0( ❑ 5 INCHES 6 INCHES AREA TO BE 'REPAIRED • 5J©'C✓CHES 0 sq.ft. 4 In. aq.f#. 5 in. sq,ft. 6 in. CODE F — PATCHES YES 0 NO ( NO. OF SQUARES WITH PATCHES NOTE: Areas marked with an "F" maybe repaired by patching. All other areas shalt be repaired' by reconstruction of full squares. " 15— • First Inspection and Form Made By; /I I `.�. Date: 0— �0, Park Department Review Required YES 0 NO -,r -PERMIT ISSUED N0: DATE:________INSPECTION DATE • IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: • CODE G — Other SIDEWALK REPAIR SURVEY FORM • r( F W T • .5PROPERN ADDRESS CODE O Z CERT. NUMBER Q� -� -���` CONTROL NUMBER yL PARCEI, LEGEND 222222Z622 \ AREA NEEDING REPAIR L os length of repair needs Type of defect (See below fortde for Defect Defect C)CodesA-F) (See * /SO ADDRESS. ' WATER SHUTOFF 1 ZgcK bar- msieu. ❑ — N BROKEN ❑ IAt551NC ❑ vtf props'rtY Une _ _ j FRONT YARD SIDE YARD ❑ �jfFt£R ._._---- �r••�,z1oN O f SIDEWALK ❑ Si FEET 0 OTHER...r--- [� 4 FEET ❑ 5 FEET DIMS .� OF SIDEWALK T\ 0 5 INCHES ❑ 6 INCHES4 INCHES OF SIDEWALK '^q In. J AREA TOq.it. 6 in. F y.tl. 4 in. sq°tt. 5 —:--'s REPAIRED ( NO Of SQUARES WITH PATCHES -' BE YES 0 NO C CODE _ PATCHES patching. �i other urea* f" may bn repaired by P with an liquors'. '7i✓ -D NOTE. Areas be marked by reconstruction of full sq Date:shall ""�L 4-11 -/� _.\i first Inspection and Form Made By;--- ❑N0 0 YES Pork Deportment Review Required 'l INSPECTION DATE:NO -- DATf:-------� PERMIT ISSUED ASSESSMENT IF UNCOMPLETED. TR0TECT NO.CONA COMPLETION DATE: CODE G - Othar. 1I i 1 SIDEWALK REPAIR SURVEY FORM NOE WAT W w PROPERTY ADDRESSe 1 — PARCEL CODE CONTROL NUMBER Z i CERT. NUMBER LEGEND L' AREA NEEDING REPAIR I " length of repair needed Type of defect Seee revelow eriefor D efec side fort DefectCodeC)Codes A-F) Se b I --1(-- ADDRESS. , / I i. ' SHUTOFF N ❑ BROKEN Q > MISSING ❑ yo i 1 — ---�operly tine Si I 7-,- ,. . ..... OF SIDEWALK ~! FRONT YARD 0 SIDE YARD .�tQlti OF SIDEWALK 0 OTHER ❑ 4 FEET 0 5 FEET zejli5.3 FEET 0 OTHER OF SIDEWALK 0 4 INCHES 05 INCHES fzi G INCHES _ AREA TO BE REPAIRED 2/,7 CODE F - p q•ft. 4 in. _ sq•ft, 5 in. s PATCHES YES 0 NO y q.ti. 6E in. '- °` NO. O!' SQUARES WITH PATCHES� NOR. Areas marked with an 'p" may repairedbn _, shall be repaired by reconstuction of full squares. patching. All other areca First Inspection and Form M I S q rites. Made By:__ D6 Pork Department Review Required -- Cole; -- _Z�� - �� 0 YE5 `NO i PERMIT T-�` ISSUED NO.________ • DATE:_______ INSPECTION - IF UNCOMPLETED. SPECIAL CONTRACTSSESSMENT COMPLETION CONTACT NO CODE G - Other. r - I I I SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA (loo Bloc ) PROPERTY ADDRESS c ore Si-. • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND Vli,f1'ff A r� G� AREA NEEDING REPAIR CV L .s length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods G) ' ADDRESS. I ' WATER SHUTOFF vfsie1.E ❑ BROKEN 0 MISSING ❑ Se — — Properly line Iccx&6 _• IDCATION OF SIDEWALK -21 FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK ❑ 4 FEET ❑ 5 FEET CI 5.3 FEET 0 OTHER DEEM OF SIDEWALK t•Y 4 INCHES ❑ 5 INCHES 0 6 INCHES Z( 5,O .q.ti. 5 in- ■q•f . 6 in. AREA TO BE REPAIRED q•tt. 4 in. . CODE F — PATCHES YES ❑ NO 0 NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. AA other urea* shall be repaired by reconstruction of full squares. Z3 I Ll First Inspection and Form Made Ely:_MK.5 & Date: 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 • • g SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA — (/oo 01ac,K) PROPERTY ADDRESS Sy cawto rL S-I-. - 2!1 —z3—. -17—L_..i Z 74' PARCEL CODE CONTROL NUMBER CERT. NUMBER ' LEGEND k— L. —•1 \\1*— AREA NEEDING REPAIR TIZZ/ .I.,w �� L - length of repair needed �`e Type of defect See reverse side for Defect Codes A—F) See below for Defect Cod* C) k, ADDRESS. VCk CO.ni- i WATER SHUTOFF \ VISIBLE Q BROKEN ❑ MISSING 0 i _ Property Line — c VcaMar-e Sr *A j=COM OF SIDEWALK 54 FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK 0 4 FEET 0 5 FEET let 5.3 FEET 0 OTHER - — DEPTH OF SIDEWALK DIN 4 INCHES Q 5 INCHES 0 6 INCHES AREA TO BE REPAIRED2279r REO sq.ft. 4 in. •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 - may bn repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Mode By:_� �5 D C.L.7 Date: 3 25"1 b Pork Department Review Required 10, YES 0 NO L PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT N0• L CONTRACT COMPLETION DATE: CODE G — Other' i 1 L 1 ' i 1 ,. 1 ; L SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS i iS CGtv►'t0re_ _5-, g_c.1 3 23_ 1479_ 00 / PARCEL CODE L (e�� CONTROL NUMBER CERT. NUMBER LEGEND ke--. L- AREA.NEEDING REPAIR Cllll/L/t//A L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) u (See below for Defect Code G)>lc CZ ADDRESS: I d j N J t c Lit 11ti�z ce.stev— pcs,4,,,,,, L„, 53 Property Line ��� T WATER SHUTOFF VISIBLE ❑ CAP BROKEN\ HL90 CI ((km A r e SA. . MiSSIN3 ❑ LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET 0 5 FEET • L� 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK 0 4 INCHES ❑ 5 INCHES , 6 INCHES AREA TO BE REPAIRED sq.ft. 4 in. sq.ft. 5 in. zE1 I sq.ft.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 of full squares. First Inspection and Form Made By: �S . .bC; Date: 3 - Z3"-lt7 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 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 00-2-i2 ii cc r"e; $P S /313 _ z3_ Li% i_ 001 x/ Z7/p • PARCEL CODE CONTROL NUMBER i tQ: CERT. NUMBER LEGEND L' -0-I • _ AREA.NEEDING REPAIR t//I///I///A L = length of repair needed A Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) >lc ADDRESS: ‘0' h , \D.3r Property Line ^ S,° M WATER SHUTOFF S'1� VISIBLE ❑ �b1 CAP / . \ r BROKEN ❑ MISSING 0 ,1 Ca.^OTt Si-• LOCATION OF SIDEWALK ❑ FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF.SIDEWALK ❑ 4 FEET Dils 5 FEET a 5.3 FEET 0 OTHER _ DEPTH OF SIDEWALK ❑ 4 INCHES ❑ 5 INCHES X 6 INCHES AREA TO BE REPAIRED sq.ft. 4- in, sq.ft. 5 in. leg,-7 sq.ft. 6 in. CODE F - PATCHES YES 0 NO 54 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 ,) Cs Date: Zi-i—I0 •Park Department Review Required ❑ YES NO -PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL CONTRACT ASSESSMENT CONTRACT NO: CODE G - Other SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA o� 1 PROPERTY ADDRESS 30a <S4 ca Al G r&- Si—, ` Zci ' 13 :yg i_ ObZ � Z77 PARCEL CODE CONTROL NUMBER CERT. NUMBER ti�l 1-4,, , � r I L D a LEGEND L' -� c-1 `1Jci AREA.NEEDING REPAIR V77l////77A 7143 1_' L = length of repair needed �� Type of defect RIG i i.k (See reverse side for Defect Codes A—F) � (See below for Defect Code G) AP>K3C � �'� ADDRESS: + d DOS occ e- I e \ ‘1) 6.° Property Line . M WATER SHUTOFF VISIBLE ❑ /el \ CAP " 1-11 BROKEN ❑ MISSING D 3rd .5.-z LOCATION OF SIDEWALK ,- FRONT YARD EKSIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 0 5.3 FEET 1:8-....OTHER DEPTH OF SIDEWALK ig 4 INCHES 0 5 INCHES I 6 INCHES _, AREA TO BE REPAIRED 3` i.'.'3 sq.ft. 4 in. sq.ft. 5 in. 911© sq,ft. 6 in. CODE F — PATCHES YES ❑ NO CA, 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 First Inspection and Form Made By: � °D Date: 3T 2 L'7 - 10 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 2- 0 PROPERTY ADDRESS 30a S ca 441 a re_ -- 3 q 13 —Z —WTI _ooz v -1'1 - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR W//U/l7JX L = length of repair needed Type of defect lS t_ (See reverse side for Defect Codes A—F) (See below for Defect Code G) ' ADDRESS. I U .1* c cc I WATER SHUTOFF VISIBLE [] Lae BROKEN 0 MISSING 2i ���,0 Property Linn E Is+ } � LOCATION OF SIDEWALK El FRONT YARD 0 SIDE YARD El OTHER WIDTH OF SIDEWALK 4 FEET (g. 5 FEET 0 5.3 FEET bit.OTHER —.....—. DEPTH OF SIDEWALK 54 4 INCHES C...� 5 INCHES 0 6 INCHES AREA TO BE REPAIRED L1'2•'fq.tt. 4 ;n. 5 in. q.ft. 6 in. CODE F — PATCHES YES 0 NO l* 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: - R S g.) . Date: 3 211`10 Park Department Review Required D YES 9 NO PERMIT ISSUED NO. .,.,_ DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO- CONTRACT COMPLETION DATE: CODE G — Other: _—_ SIDEWALK REPAIR SURVEY FORM oP 5 CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3oc (6 t,`,10re 3+ • ,Eui3 -z - 1-i® � Z77 -_ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-0-- L' --+� AREA NEEDING REPAIR vitiilillllt 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 p o c f i Ct P WATER SHUTOFF VISIBLE ❑ • BROKE'd L`3 4.7 j MISSING ❑ Property Line nen FPFPc. \q:1-1- sy ca,rvtc 'e s+� LOCATION OF SIDEWALK ID FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF' SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET OTHER _ DEPTH OF SIDEWALK ( 4 INCHES 0 5 INCHES Di 6 INCHES 'i3o,0 ✓ 7 / AREA TO BE REPAIRED —sq.ft. 4 in. — _aq.ft. 5 in. 33; _legit. 6 in. E _ '/.t I 1-- CODE F — PATCHES YES ❑ NO [_j Na 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. First Inspection and Form Made By: _R. Dale: � -2 y-I0 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 400 bik '5yA /0 --57", 0y i. -z.-,6E- off t/ Z7.e' ,... PARCEL CODE NTROL NUMBER CERT. NUMBER (ZCo& LEGEND ti AREA.NEEDING REPAIR V///»///A )4. Y L = length of repair needed n � Type of defect �T — (See reverse side for Defect Codes A—F) (See below for Defect Code G) ,K ADDRESS: \ J Property Une WATER SHUTOFF VISIBLE ❑ , DCAP i BROKEN ❑ MISSING ❑ r A mote_ Si-, LOCATION OF SIDEWALK ❑ FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET ❑ 5 FEET • ❑ 5.3 FEET jgr OTHER _ DEPTH OF SIDEWALK .r 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE 'REPAIRED 'uZ' ,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: lb .h& Date: 3 — Z-.5-- / Park Department Review Required 0 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, IOWA PROPERTY ADDRESS f S. _ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I..-- L' _-404 AREA.NEEDING REPAIR V7Il//////�1 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) _ -0- X Z.' \ ADDRESS: I ,C' 5 u " � :T S s>,/ ,, /1., j „ '. V Prope Line J. 74 f WATER SHUTOFF VISIBLE ❑ r1----)2L J CAP 41 y5'� VI BROKEN El �''Y��1 - . 3" ' Si- MISSING CI LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD [] OTHER WIDTH OF SIDEWALK El 4 FEET El 5 FEET El 5.3 FEET 50 OTHER DEPTH OF SIDEWALK [ ]- 4 INCHES 0 5 INCHES 0 6 INCHES ® VP\"--/ AREA TO BE REPAIRED IEb q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. 77'O VaczcT 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- . — & Date: 3--Z t -10 •Park Department Review Required E] YES NO PERMIT ISSUED NO: DATE: INSPECTION DATE: IF UNCOMPLETED: SPECIAL ASSESSMENT CONTRACT NO: CONTRACT COMPLETION DATE: . CODE G — Other 3c,nA 5Qc.‘ Urr• ' Vrzvt-1- SIDEWALK REPAIR SURVEY FORM _ CITY OF WATERLOO. IOWA PROPERTY ADDRESS . cae2 /21/< .5 j% lieb _ _q i3—c".C—_Lc i—co3 ✓ iigtO PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR WZAVUZZA — L mg length of repair needed A Type of defect (See reverse side for Defect Codes A-F)(See below for Defect Cods C) - ADDRESS. I I I WATER SHUTOFF - vIs�LE ❑ _ \ . - ° see -�8�- BROKEN ❑ MISSING ❑ Property Line i A LOCATION OF SIDEWALK Eg. FRONT YARD 0 SIDE YARD 0 OTHER, ISM OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET .0 oTHER DEMI OF SIDEWALK 0 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 32-.-=-sq•1t. 4 in. •q.It. 5 in. sq,ft. 6 in. T CODE F - PATCHES YES 0 NO 6 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. • First Inspection and Form Made By: _ 12_5 -b _ Dote; ) 23 M; Pork Department Review Required 0 YES ER NO PERMIT ISSUED NO. DATE:, INSPECTION DATE: • 1• IF UNCOMPLETED. PECIALCONTRACAT ES ASSESSMENT CONTR CONTRACT NO' CODE G - Other 1 1 I I . i SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 5a9 b`k )/4-0,Q,e - i 9 3-z. -1 © F - 23 ✓ ��� PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-+-- L' -►4 AREA NEEDING REPAIR VIZ/W11,a L a. length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cods C) ADDRESS. ' I I WATER SHUTOFF crr VISIBLE 0 BROKEN 0 t f�' MISSING 0 Property Line ill/41 LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD 0 OTHER MOB OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET )7 OTHER DEEM OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED `q L q.H. 4 in. •q.tt. 5 in. •q.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: wg S Date: _ 3 Z 3~ l b Pork Deportment Review Required ❑ YES 1,1 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO' CONTRACT COMPLETION DATE: CODE C — Other. SIDEWALK REPAIR SURVEY FORM OtTY OF WATERLOO, IOWA PROPERTY ADDRESS SQQ vyicre_ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND U AREA NEEDING REPAIR V7/Z',WZ4 L = length of repair needed c . Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) y ADDRESS: '50 01 -S I �� 4' Qara M7r��5 5-' Property Line WATER SHUTOFF VISIBLE ❑ CAP BROKEN ❑ • MISSING ❑ • LOCATION OF SIDEWALK ❑ FRONT YARD CA SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FLEA ❑ 5.3 FEET gl OTHER — DEPTH OF SIDEWALK 14 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 7Z I 0 cq.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: R.5 D G Date: j- Z3 fD — Park Department Review Required ❑ YES al 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 c PROPERTY ADDRESS ccurvvo PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - L' -•-I AREA.NEEDING REPAIR rll/////lll�i L = length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Defect Code G) k>i< ADDRESS: SO f3iuc4'_s [did • I 4.1 Property Line `° - WATER SHUTOFF VISIBLE ❑ Y /I 2CRP ,ei BROKEN ❑ MISSING ❑ v-Clevl et r- S T e LOCATION OF SIDEWALK El FRONT YARD ❑ SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET ❑ 5 FEET ❑ 5.3 FEET El OTHER DEPTH OF SIDEWALK ❑ 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. /Z,Cd�OaOH- 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: 5. DC Date: 1 2 3` 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 V Q v 14 op SIDEWALK REPAIR SURVEY FORM crTY OF WATERLOO, IOWA PROPERTY ADDRESS 0 , ,SC CrA v t c1 re- 5+ �� ki 13 — 1 - 010 ✓ M35 PARCEL CODE CONTROL NUMBER CERT. NUMBER 2 LEGEND L' -1.-1 - - AREA.NEEDING REPAIR V/////////A L = length of repair needed ,. Type of defect _ (See reverse side for Defect Codes A-F) (See below for Defect Code G) , ok" ADDRESS: \, 3 c 12•P itt<l< fBl x' FA'® �;Zg,\ VS-CA. a t \ .2.0' *-1'6 k e,:\ '1'`o' \z DI t�a ;sue y & f t1e, � roperty Line /e5 .P t+^ "ln1'4";4,0 3 A WATER SHUTOFF 1------) VISIBLE ❑ N CAP _ .r BROKEN ❑ MISSING 0 E. , Pckc & Ave LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD 0 OTHER WIDTH OF SIDEWALK El 4 FEET 0 5 FEET 0 5.3 FEET 121 OTHER_ DEPTH OF SIDEWALK ►1 4 INCHES 0 5 INCHES ❑ 6 INCHES Jc ucF Tcf' _ AREA TO BE REPAIRED 2N2 y 5 Sq.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. tog• ✓V'c:�v l 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 ( Date: 2.3 IC) -" 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 V at t it Tof ref air SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS Z.2 Mk 72oMP J Av -• 3cr1 3 23= 'i3- 0L3 ✓ i3,1- PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-.4— L' --•-I • AREA.NEEDING REPAIR V7/777/W./A L = length of repair needed A Type of defect (See reverse side for Defect Codes A—F) See below for Defect Code G) 3 \'► /\Ce .re,. ADDRESS: I A>l< . o �; 1 0_,,Vl T I i—O 1 s 1 0 5.1 i a i Property L r WATER SHUTOFF VISIBLE El '.1 D CRP BROKEN ❑ Ave.., MISSING CI -I A • LOCATION OF SIDEWALK ❑ FRONT YARD M. SIDE YARD ❑ OTHER WIDTH OF SIDEWALK El 4 FEET ❑ 5 FEET N, 5.3 FEET ❑ OTHER _ DEPTH OF SIDEWALK IX 4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED Sy•I sq.ft. 4 in. sq.ft. 5 in. sq.ft. 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. First Inspection and Form Made By: R..4) D Cr Date: 3 Z Li ~)(2 Park Department Review Required 121 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 21L( 7ha►,tpSan Ave., • — get 13 -?3- J- 9-013 ,85 PARCEL CODE CONTROL NUMBER CERT. NUMBER • LEGEND L. AREA NEEDING REPAIR Wizzezi la - L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. .1 1 4 I ( WATER SHUTOFF \ nsIuLE ❑ SAE BROKEN 0 • MISSING 0 Property Line 5. A • - `T" moSa,0 8yP LOCATION OF SIDEWALK V. FRONT YARD 0 SIDE YARD 0 OTHER J OF SIDEWALK 0 6 FEET 0 5 FEET 18 5.3 FEET 0 OTHER--- DEPTH OF SIDEWALK EI 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED 2—•-- •q•ft. 4 in. . ■q.ft. 5 in. aq.fl. 6 in. CODE F - PATCHES YES 0 NO 2.1 NO. OF SQUARES WITH PATCHES • NOTE. Areas marked with an -r may bn repaired by patching. Ali other areas - nA shall be repaired by reconstruction of full squares. ` Eire inspection and Form Made Ely: Date: y-9- Ili Pork Department Review Required ❑ YES fig NO ! PERMIT ISSUED NO, DATE:, INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO CONTRACT COMPLETION DATE: + • CODE G - Other. i I 1 1 I 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA 3oo .BIock PROPERTY ADDRESS %h o M ►s6n Ave PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND �- L' -•- C`e-c'A .. f e5 AREA NEEDING REPAIR i///I/44I77A rig" I - length of repair needed Type of defect (See reverse side for Defect Codes A-F) 7 L� (See below for Defect Cods C) ADDRESS. I I �`a c(1.1� I WATER SHUTOFF . 1 VISIBLE ❑ SAE BROKEN 0 MISSING ❑ 301 ..L'. Property l.i d T hc°M3Scir p1 re. LOCATION OF SIDEWALK ❑. FRONT YARD 0 SIDE YARD 0 snub OF SIDEWALK ❑ 4 FEET ❑ 5 FEET 5.3 FEET 0 OTHER DEPTH OF SIDEWALK Er 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED 159' q ft. 4 in. sq.ft. 5 in. ■q.fs. 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: .S 1) 6, Dale: 3`"2 -'b • Pork 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. ,3 i Ll -1,G'"? c r\ Nve PARCEL CODE CONTROL NUMBER CERT. NUMBER — � `, � �� 4-- . LEGEND AREA NEEDING REPAIR VZIWZlMw L - lay L es length of repair needed 11 f Type of defect C-{"`� (See reverse side for Defect Codes A—F) (See below for Defect Code C) ?1(-- ADDRESS. 319 ' _ I WATER SHUTOFF VISIBLE ❑ • — \ ' me BROKEN ❑ MISSING ❑ -rP rt y line ` — v 0 / e3 • - IN yWe. Avg . OH OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER jtAMI OF SIDEWALK 0 4 FEET 0 5 FEET } 5.3 FEET 0 OTHER DEPTH OF SIDEWALK I 4 INCHES 0 5 INCHES 0 6 INCHES 0AREA TO BE REPAIRED 15-!-q.ft. 4 in. ■q.ft. 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 bs repaired by reconstruction of full squares. 12z6 _10 First inspection and Form Made 8y:,..,_ R_S D& ---- Date; -{ • Park Department Review Required YES ❑NO — ! PERMIT ISSUED N0, DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: 4 CODE C — Other i . • t 1 I i 1 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS IY )L1o8 i hoMfson Ave. ✓ 67 ►3_23--Y31 — oto i/ Age PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' AREA NEEDING REPAIR 1/7/1Z/Z/ZZA L a■ length of repair needed G Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) I ADDRESS. y o 8 I I WATER SHUTOFF vistatx \ • SAE BROKEN 0 MISSING 0 S.a / 'oC, �.2 Property Line • 7-416retpSon AvP.. LOB OF SIDEWALK ❑ FRONT YARD f l SIDE YARD 0 OTHER _ mud OF SIDEWALK 0 4 FEET 0 5 FEET ® 5.3 FEET ❑ OTHER DEM OF SIDEWALK Er 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED- 2 ' 5 aq.ft. 4 in. ■q.ft. 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 Mode By: 2 S D G Dale: 3 Pork Department Review Required ❑ YES to 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 . Li 1 '_Z 71hc;v.pse.-) Ave, / - T 'l t_3— e3_ 2g— Q i ✓ Gi PARCEL CODE CONTROL NUMBER CERT. NUMBER — ' LEGEND L' - AREA NEEDING REPAIR LWI WW/A J`efLek L. length of repair needed tN Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) — ---)1 ' ADDRESS. 1/ 1 J I ( — WATER SHUTOFF \ VISIBLE ❑ Siee BROKEN 0 • MISSING ❑ Property Line r • 0 \lcywri.crx Ave. _ 1prwei= OF SIDEWALK 14FRONT YARD 0 SIDE YARD 0 OTHER DJ OF SIDEWALK. 0 4 FEET 0 5 FEET Da 5.3 FEET 0 OTHER _- DEPTH OF SIDEWALK 0 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED i O'Q 3iq.it. 4 in. •q.ft. 5 in. ■q.ft. 6 in. m • 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: . 3 D • Doil--:-1® • Pork Department Review Required [` YES 0 NO 1 PERMIT ISSUED NO. . DATE:, INSPECTION DATE: ' i IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. — CONTRACT COMPLETION DATE: 4 CODE G — Other I I 1 1 j- SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS .-`7 b/k -�� S-- . 89 /3 _23_2-8G_0_j ✓ 740 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND �-+-- L' -. AREA NEEDING REPAIR T771171W11.I L - length of repair needed Type of defect (See reverse side for Defect Codes A-F) (See below for Detect Code C) _31 `7 ADDRESS. - I PI-}L- WATER SHUTOFF tor- VISIBLE ❑ _GM BROKEN ❑ MISSING 0 • Property Line ._ JU'sCA .5-r. lid OF SIDEWALK C ERONT YARD 0 SIDE YARD ❑ OTHER jtJ OF SIDEWALK (( 4 FEET 0 5 FEET 0 5.3 FEET ❑ OTHER DEPTH OF SIDEWALK ( 4 INCHES [] 5 INCHES 0 6 INCHES AREA TO BE REPAIRED /6Uidsq.tt. 4 ;n. eq.ft. 5 in. ■ q.il. 6 in. • CODE F - PATCHES YES D NO [ J NO. OF SQUARES WITH PATCHES NOTE. Arson marked with on -r may be repaired by patching. All other urea* shall be repaired by reconstruction of full squares.'1 First Inspection and Form. Mode By: Date: AILS //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 • • • J�-- .j SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA - PROPERTY ADDRESS 3 111 _`! CA, �•t . ✓ _ g /3 _Z-3.2_.%- ©tz ✓ . 9/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' D 71 . AREA.NEEDING REPAIR 1777777777/A L = length of repair needed Type of defect I (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4 ADDRESS: 3 I 1 J \ - 3 Property Line — ,C J-e \f•f/s-C-- - �y, WATER SHUTOFFi__i j . VISIBLE ❑ P BROKEN' 0 MISSING ❑ LOCATION OF SIDEWALK ❑ FRONT YARD 121 SIDE YARD ❑ OTHER WIDTH Or SIDEWALK ® 4 FEET Q 5 FEET ❑ 5.3 FEET 0 OTHER _ DEPTH OF.SIDEWALK 4 INCHES ❑ 5 INCHES 6 INCHES AREA TO BE 'REPAIRED 7 'I q.ft. 4 in. sq.ft. 5 in. `}9�d�sq.t 6 in. CODE `F — PATCHES YES 0 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: i'••• BS Date: 3— ` tQ __ 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 f (,i 771-c46, - .577 89 + 3 —L3 _2ey_oo ✓ z,e z PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND AREA NEEDING REPAIR viiirrriira L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Cod. C) I ADDRESS. (, G Ix% WATER SHUTOFF VISIBLE 0 zee BROKEN ❑ MISSING ❑ Property tine �5 ' x 25 x 4 „ V1 r•Ac {1T LOCATION OF SIDEWALK I1A FRONT YARD 0 SIDE YARD 0 OTHER W OF SIDEWALK [ 4 FEET 0 5 FEET 0 5.3 FEET ❑ OTHER DEEM OF SIDEWALK [ 4 INCHES 0 5 INCHES {r 6 INCHES AREA TO BE REPAIRED 0, ■q.lt. 4 ;n. ■q.it. 5 in. /CJ�.U■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 area. shall be repaired by rsconstructiorutf lull squares.First Inspection and Form Made By: Date; 3 l L /C//0 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 2 b/k LJ4LAJ/7 ` - e2.t,1-a_ --ao_,/ 293 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I-•- L' AREA NEEDING REPAIR rrlitil/Zrll L — length of repair needed Type of defect A (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. / o. L rT ) ( WATER SHUTOFF _ VISIBLE 0 �, �� ��— BROKEN 0 MISSING 0 IT Property tine 2 5.1 i . _ 041/g LOCATION OF SIDEWALK 93,FRONT YARD 0 SIDE YARD 0 OTHER mad OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET V) OTHER ! QJH OF SIDEWALK 0 4 INCHES 0 5 INCHES 01„,6 INCHES AREA TO BE REPAIRED eq.ft. 4 in. ■q.it. 5 In- Z752q.f1 6 in. — CODE F — PATCHES YES 0 NO It NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may be repaired by patching. AU other areas • shall be repaired by reconstruction of full squares �o First Inspection and Form Made By: ._ 7. ��ate: �/ /5 '� Park Department Review Required ❑ YES (g NO — PERMIT ISSUED NO, DATE:. INSPECTION WATT: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO• CONTRACT COMPLETION DATE: I • • CODE G — Other. 1 1 I i i i SIDEWALK REPAIR SURVEY FORM r. CITY OF WATERLOO, IOWA // PROPERTY ADDRESS 7.09 &/k I,t lai�vcrr- fir- /oi� el/3 - z -. -pzl� Tpq PARCEL CODE CONTROL. NUMBER CERT. NUMBER LEGEND L' -+-) AREA NEEDING REPAIR vzz,z/i7JZ.t L - length of repair needs Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. I (z,riltRiva I WATER SHUTOFF viSIBLE ❑ "q=.a111 BROKEN 0 MISSING 0 140 Property Line — Immo OF SIDEWALK El FRONT YARD 0 SIDE YARD ❑ OTHER _ OF SIDEWALK ❑ 4 FEET 0 5 FEET 0 5.3 FEET El OTHER 5r jamli OF SIDEWALK ® 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED !J sq.ft. 4 in. •q.ft. 5 in. +q.ft. 6 in. CODE F — PATCHES YES ❑ NO IN; NO. OF SQUARES WITH PATCHES J NOTE. Areas marked with an -r may ba repaired by patching. All other areas shall be reoaired by reconstruction of full squares. / First Inspection and Form Made Sy: rE LC- Date: 3 V.0 /0 Q 1' 0 Park Department Review Required YES []NO 4 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- : `j [Al"t1u - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L t: —0"1 AREA NEEDING REPAIR VI/1)77/UA L .• length of repair needed 4. Type of defect [ (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. ')—( -,,I+ _.`�``2 I t WATER SHUTOFF 11 L VISIBLE 0 \ . -ok BROKEN 0 MISSING 0 f _ Property Liney3_ =MB OF SIDEWALK 0 FRONT YARD 0 SIDE YARD 0 OTHER MIUj OF SIDEWALK 0 4 FEET 0 5 FEET 0 5.3 FEET 0 OTHER _--` OF SIDEWALK 'FA4CIN/CHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED ' _tq•lt. 4 in. ■q.K. 5 in. •q.ft. b in. , CODE F — PATCHES YES 0 NO NO. OF SQUARES WITH PATCHES NOTE. Areas marked with en "F' may be repaired«< by patching. All other areas shalt be repaired by reconstruction of full uaros. , j(, t-`' Data: /'-1:) I First inspection and Form Made By:_� - Park 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. -- I i ( — t SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 3 'Weld iu-i_ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND 1-+-- AREA NEEDING REPAIR II iZ1W7/a L - length of repair needed Q Type of defect /t (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. 3 I I ! WATER SHUTOFF ViS18LErite ❑ BROKEN ❑ MISSING 0 Property Line _ 5_o lJtir't i,<x."\-- 1OCATIO 1 OF SIDEWALK V FRONT YARD 0 SIDE YARD 0 OTHER OF SIDEWALK ❑ 4 FEET 0 5 FEET t 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES AREA TO BE REPAIRED J6'5 eq.ft. 4 in. eq.tt. 5 in. ■q.tl. 6 in. CODE F — PATCHES YES [] NO igt 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 t First Inspection and Form Made By:— Date: ��`' �` Pork Department Review Required 0 YES )M NO PERMIT ISSUED NO. DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT No CONTRACT COMPLETION DATE: CODE G — Other' II, • SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO IOWA PROPERTY ADDRESS 9 I S UrA1 tAtAl $4 • PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L' - _. AREA.NEEDING REPAIR V777/7//77A L = length of repair needed r Type of defect p , 1 ' See reverse side for Defect Codes A—F) See below for Defect Code G) ,0 > 4( ADDRESS: I 1 S \ rW . ‘‘.2, ...._ Ai' (property Line, — V l/ `+/ ////// f (/ 1i� f WATER SHUTOFF / \ \(1.° 1 3.5 D(/1/i'% ' i/`i/!�E VISIBLE ❑ CAP f % 5.j a ,rt "` BROKEN ❑ MISSING ❑ LI Mt. LOCATION OF SIDEWALK 34 FRONT YARD 0 SIDE YARD I 1 OTHER _... .."____AS) Ail _ WIDTH OF'SIDEWALK CI4 FEET CI5 FEET •V 5.3 FEET IP OTHER 51 1 DEPTH OF SIDEWALK 0. 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED ' k�`�. q.ft. 4 in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO fA 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_Nuares. , First Inspection and Form Made By: /lam. ,_1 Date: - o '1© 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 1S 2h ��� 5� . PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND h+- L` -.4 AREA NEEDING REPAIR vfV.Z/ZZW,e1 L - length of repair needed Type of defect r` (See reverse side for Defect Codes A—F) (See below for Defect Cods C) 41(-- ADDRESS. 115 I ( WATER SHUTOFF VISIBLE ❑ • .G6E BROKEN 0 MISSING ❑ Property Line 1 f17ll C"//1 '1 5,vJ \"3--Z.\Ds\-v/ • I - LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER f OF SIDEWALK 0 4 FEET O 5 FEET ❑ 5.3 FEET ❑ OTHER • DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES _J/ s/ AREA TO BE REPAIRED _sq.it. 4 In. ■q.ft. 5 In. =q.ft. 6 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 squares. first Inspection and Form Made By: i i� w Dale: `1 O Pork Department Review Required YES 0 NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO —i CONTRACT COMPLETION DATE: CODE G — Other —I r- • •• SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS /3 0 6)e-i5-i-e-1/" 3+ , i'i ) 3 _a_Y_ to7_ ©u5 .4, PARCEL CODE ' CONTROL NUMBER CERT. NUMBER LEGEND kw— L' - • AREA.NEEDING REPAIR VI/7ZJ7J/TA L = length of repair needed A _. Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) ADDRESS: /3 0 ems --� k \ _ Property Line _ WATER SHUTOFF VISIBLE ❑ CAP — 4. BROKEN ❑ MISSING 0 E. St-. LOCATION OF SIDEWALK FRONT YARD 0 SIDE YARD 0 OTHER WIDTH OF-SIDEWALK 0 4 FEET ff 5 FEET • 0 5.3 FEET ❑ OTHER — DEPTH OF.SIDEWALK gr4 INCHES ❑ 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED if3A,0 q.ft. 4in. sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO K 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: Date: ,3_ v7`i-,6 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 . 303 t 1. 3 41....to a = 300 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND - LI -0-1 AREA NEEDING REPAIR DW4441A444 L N.. length of repair needed A Type of defect (See reverse side for Defect Codes A-F) (Sea below for Defect Code G) ADDRESS. ,3°:2-5 viWAsiaTELEE3 WATER SHUTOFF rite BROKEN 0 MISSING 0 Properthne P7/4 L., -- U'Jvijtt - — LOCATION OF SIDEWALK It FRONT YARD 0 SIDE YARD 0 OTHER ICIMI OF SIDEWALK El 4 FEET 5 FEET El 5.3 FEET 0 OTHER DEPTH OF SIDEWALK 1.tl, 4 INCHES 0 5 INCHES 0 6 INCHES Sq,O AREA TO BE REPAIRED --sq.lt. 4 in. eqit. 5 in. q.ft. 6 in. • CODE F - PATCHES YES 0 NO-El_ NU. OF SQUARES WITH PATCHES NOTE. Areas marked with an -r may bn repaired by patching. All other areas ! shall be repaired by reconstruction at full squares. First Inspection and Form Made By: LI/ Dale: -tO Park Department Review Required 14 YES 0 NO PERMIT ISSUED NO, DATE: INSPECTION DATE: • IF UNCOMPLETED. SPECIAL. ASSESSMENT CONTRACT NO- - . CONTRACT COMPLETION DATE: CODE G - Other • •. . . • • a SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO, IOWA PROPERTY ADDRESS 30Li \ J'„iivi Il L%° 13—9`I— 0y-001 ✓ ' 30/ PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND f"'" L' AREA NEEDING REPAIR VfflfffflfA _ I a length of repair needed A Type of defect (See reverie side for Defect Codes A-F) (See below for Defect Code G) ADDRESS. I I WATER SHUTOFF VISIBLE ❑ \ . rdtiE _.. BROKEN 0 MISSING ❑ i Pro{rty Lin* _.. a 5.0 s CO ‘J& A 4,t-11 CA-. LOCATION OF SIDEWALK tP FRONT YARD 0 SIDE YARD 0 OTHER Rignj OF SIDEWALK 0 4 FEET IP 5 FEET 0 5.3 FEET 0 OTHER - DEPTH OF SIDEWALK 4 INCHES 0 5 INCHES 0 6 INCHES lC °'I AREA TO BE REPAIRED 5�7. zq.It. 4 in. ■q.ft. 5 in. sq.ft. 6 in. CODE F - PATCHES YES 0 NO `/ .. 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:_„_1 J> _ Date: Park Department Review Required "(y; YES 0 NO i PERMIT ISSUED NO. M DATE:, ,INSPECTION DATE: • IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: I CODE G - Other° i1 — f i j-- i I-- { L. SIDEWALK REPAIR SURVEY FORM CITY QF WATERLOO, IOWA PROPERTY ADDRESS t -`i ��- $` L3 _O-Lf_ / ©? oci v 3®Z PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND ke-- L' --0-1 • AREA.NEEDING REPAIR f'll////////il L = length of repair needed Type of defect 1 (See reverse side for Defect Codes A—F) (See below for Defect Code G) 4‹ ADDRESS: 0 Propt r Line Yl}�/ WATER SHLTOFF (1 f 41 D VISIBLE ❑ CAP BROKEN 0 &U:iv\c.1 MISSING ❑ • • LOCATION OF SIDEWALK 0 FRONT YARD SIDE YARD ❑ OTHER WIDTH OF SIDEWALK 0 4 FEET t .'5 FEET 0 5.3 FEET 0 OTHEP _ DEPTH OF SIDEWALK ((( 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED IA �1,. 1 eq.ft. 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 be repaired by patching. All other areas shall be repaired by reconstruction of full squares. First Inspection and Form Made By: 1.E L ' Date: -3 9Y /0 Park Department Review Required yl 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 3 4 ,D 2 l/1dt i k C�-4---, • - PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND t0` E` AREA NEEDING REPAIR vWi ijf»A _ L .• length of repair needed A Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. ?33 I I WATER SHUTOFF VISIBLE ❑ \ BROKEN 0 MISSING ❑ kL) i _ _ Property tine — _ 0 c.,-t-\---4 _ t Jteidkt 1 (+ . jaCaligi OF SIDEWALK 0 FRONT YARD 0 SIDE YARD ❑ OTHER j OF SIDEWALK 0 4 FEET ( 5 FEET 0 5.3 FEET 0 OTHER --- _ TH DEP OF SIDEWALK 4 INCHES ❑ 5 INCHES 0 6 INCHES AREA TO BE REPAIRED sq.it. 4 in. ■q.ft. 5 in. ■q.ft. 6 in. CODE F — PATCHES YES 0 NO E 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_>t7 • First Inspection and Farm Made 8y: ._.� .._ Date: Park Department Review Required YES CI NO • PERMIT ISSUED NO. _ DATE:. INSPECTION DATE: IF UNCOMPLETED. SPECIAL CONTRACT COMPLETION SESSMENT DATE: CONTRACT NO ' I CODE G — Other `— 1 i . i SIDEWALK REPAIR SURVEY FORM Y OF WATERLOO IOWA PROPERTY ADDRESS O`-t . I dffi,it ei I + PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L, --4 .1 AREA.NEEDING REPAIR —YT2JTrrrrrrr-- L = length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code G) \, d ADDRESS: C' "L`` I I ..... '''.::c...\ N A _ Property Line ; r _ i f ij /// WATER SHUTOFF Ic:3' VISIBLE ❑ 1' f v ,A.., f I-et 1Ct e i C f. MISSING El Q ATiO OF SIDEWALK 03, FRONT YARD 0 SIDE YARD ❑ OTHER WIDTH OF SIDEWALK ❑ 4 FEET 5 FEET 0 5.3 FEET 0 on-ER _ DIEM OF SIDEWALK q 4 INCHES ❑ 5 INCHES -�7 ❑ 6 INCHES AREA TO BE REPAIRED' 7,6/ sq.ft. 4 in, sq.ft. 5 in. sq.ft. 6 in. CODE F — PATCHES YES ❑ NO 1521 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 full squares. First Inspection and Form Made By:�'� i c Date: J1—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 - - / of 2 SIDEWALK REPAIR SURVEY FORM CITY OF WATERLOO. IOWA PROPERTY ADDRESS 1-13 1 wehae I I ct. e_4 13 -2 y--i o 2-o.Q. 3 O 5 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND L, AREA NEEDING REPAIR E .• length of repair needed /� Type of defect !� (See reverse side for Defect Codes A—F) (See below for Defect Code C) A 3 � _i� /�\— ADDRESS. _ VIS BiE ® rocky need \ . BROKEN 0 MISSING 0 y9 Property Line --L In)@ ndiI Ca• OF SIDEWALK ❑. FRONT YARD 0 SIDE YARD 0 OTHER - -- lattli OF SIDEWALK CI 4 FEET 0 5 FEET ❑ 5.3 FEET tEl OTHER 14"g DEEM OF SIDEWALK -❑ 4 INCHES 0 5 INCHES 0 6 INCHES 2?5.5fl. a i�. AREA TO BE REPAIRED eq.H. 4 in. •q.ft. 5in. q CODE F — PATCHES YES 0 NO f0 NO. OF SQUARES WITH PATCHES_---- NOTE. Areas marked with an -r may bn repaired by patching. All other areas — NQ shall be repaired by reconstruction of full ■quaes. y_ _'O Fi 1f Inspection and Form Mode 8y: Dale; • Pork Department Review Required YES ❑NO PERMIT ISSUED NO.__...... DATE: ---INSPECTION DATE: IF UNCOMPLETED. CONTRACT tAL ASSESSMENT COMPtETIONODATECT NO CODE q - Other ------------------------- • i . - SIDEWALK REPAIR SURVEY FORM 2 c'c 2 CITY OF WATERLOO, IOWA PROPERTY ADDRESS 4,31 (AJeAdel1 c±. (o rl Neweji aag3 -2y- roz—�a®j 305 PARCEL CODE CONTROL NUMBER CERT. NUMBER LEGEND I-.-- L' —-1 AREA NEEDING REPAIR V7/WWZZz7r2 L - length of repair needed Type of defect (See reverse side for Defect Codes A—F) (See below for Defect Code C) ADDRESS. y 3 J I I I ` WATER SHUTOFF \\` VISIBLE• ❑ LJr b SAP ‘t (;) BROKEN 0 6-�` MISSING ❑ • `C.>�, Property Una NO.I' Rear- yard LOCATION OF SIDEWALK ❑ FRONT YARD ❑ SIDE YARD X OTHER On /UeV-I WIDTH OF SIDEWALK ❑ 4 FEET ❑ S FEET 0 5.3 FEET tSt OTHER 7.11. DEPTH OF SIDEWALK V! 4 INCHES 0 5 INCHES ❑ 6 INCHES AREA TO BE REPAIRED .2'! 1 sq.ft. 4 ;n. _—_ _sq.ft. 5 in. ■q.ft. 6 in CODE F — PATCHES YES 0 NO NO.NO. OF SQUARES WITH PATCHES NOTE. Areas marked with an -F" may be repaired by patching. All other areas 64 shall be repaired by reconstruction of full squares. Sifir Inspection and Form Made By: . Doe: Park Department Review Required ❑ YES El NO PERMIT ISSUED NO. DATE: INSPECTION DATE: IF UNCOMPLETED. SPECIAL ASSESSMENT CONTRACT NO. CONTRACT COMPLETION DATE: CODE G — Other