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City of Blackfoot PLANNING & ZONING DEPT 157 N Broadway Blackfoot, Idaho 83221 Phone [PHONE REDACTED] Fax [PHONE REDACTED] www.cityofblackfoot.org City of Blackfoot SIDEWALK REPAIR/REPLACE GRANT APPLICATION Owner Applicant Name: Mailing Address: Phone Number(s): Email Address: Project Location Address: Project Description: Size of Project: square feet Estimated Cost: Attach Copies of Sidewalk Bid(s): (If project is over $1,800.00, two bids are required.) Certification: By signing this application, I certify that, 1) I am the legal owner of the property where the proposed sidewalk repair project will take place, 2) that all information on this application and accompanying material is true and accurate to the best of my knowledge. If awarded a grant, I agree to comply with all the the rules and conditions set forth in the application packet and on the permit forms. Signature: Date: Applications are available online at and may be emailed to [EMAIL REDACTED]; or by mail to City of Blackfoot, Planning & Zoning Permits, 157 N. Broadway St., Blackfoot, ID 83221. City of Blackfoot cityofblackfoot.org Project Approved By Date Forms Final Attach Copies of Tree Removal Bid(s): Tree Removal Required: Yes No (If project is over $1,800.00, two bids are required.) Date Date FOR OFFICE USE ONLY REIMBURSEMENT REQUEST APPROVAL Mayor Date P & Z Administrator Date P.O. # 10-49-750 REQUIRED INSPECTIONS SIGN SIGN SIGN ---PAGE BREAK---