Your Name
(Required)
First
Last
Address of Sidewalk Repair
(Required)
Street Address
City
ZIP Code
Phone
(Required)
Email
(Required)
Property Type:
Residential
Business
Minimum Criteria for Sidewalk Reimbursement
To qualify, a sidewalk must meet at least one of the following conditions: it has a sudden grade difference between panels of 1 to 1½ inches, between 25% and 50% of the surface shows severe spalling at least one inch deep, more than half of the sidewalk is broken into multiple pieces, or the cross slope is greater than 4%.
Estimated Square Footage of Sidewalk to be Replaced:
(Required)
Estimated Total Cost of Replacement:
(Required)
Deficiency Rating (must be 5 or worse):
(Required)
Acknowledgments (Check each to confirm compliance)
(Required)
I understand that applications must be submitted and approved prior to the work being done.
I will obtain an encroachment permit prior to beginning the project.
I understand that permit fees will be waived if this application is approved.
I certify that all work will be performed in accordance with current City Engineering Standards.
I understand that the sidewalk must be inspected and approved by the City after completion before reimbursement will be issued.
I understand that reimbursement is contingent on available budgeted funds, and applications are processed on a first-come, first-served basis.
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Photo(s) of existing sidewalk condition
(Required)
Max. file size: 15 MB.
Cost estimate or contractor bid (if applicable)
Max. file size: 15 MB.
Copy of deficiency rating (provided by the City)
Max. file size: 15 MB.
I hereby apply for reimbursement under the West Jordan City Self-Maintenance Sidewalk Reimbursement Program and agree to the guidelines listed above.
Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
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