50/50 Cost Share Petition

Property Sidewalk, Drive Approach, Carriage/Yard Walk, and Curb Replacement

We the undersigned, property-owner(s), do hereby petition the City of Fort Wayne Board of Public Works for neighborhood capital improvement(s) indicated below. (NOTE: Property-owners within the project’s limits will pay 50% of the cost of the improvements on their property only; the City will pay 50% of these costs). By signing this petition, the signatory affirms that the Property Owner(s) would like to participate in the 50/50 Program. Confirmation of how much work is needed and cost associated with it will be established on future letter prior to ANY work starting. The signature affirms the work being asked is only associated with the property/parcel they own. Petition is only valid if property owner(s) listed on deed sign.

Please check one or more of the following you are interested in fixing:

Sidewalk

Drive Approach / Sidewalk through drive (not including curb at street)

Curb / Driveway Curb

Carriage / Yard walk (this is the concrete between the sidewalk & curb)

Tree Removal -100% City Cost-(only to be removed if checked and causing sidewalk damage)

Please describe/note about the needs for improvement(s)

Contact Information & Property Address for 50/50 Work

Petition Contact Person – Name

Street Address

Zip Code

Best Contact Phone Number

Signatures: Petition must be signed by all property owners listed on deed. Please return to have an estimate/price associated to the petition. The City of Fort Wayne will contact you with any questions prior the final letter being sent for work to begin. Please list mailing address of home owner(s).

Legal Name of Property Owner

Mailing Address:

Zip Code:

Legal Name of Property Owner:

Mailing Address:

Zip Code:

Legal Name of Property Owner:

Mailing Address:

Zip Code:

Date:

By checking this box, I certify that I am the property owner and I give permission to the City of Fort Wayne to make an estimate on changes to the property.

Human Test