HomeMy WebLinkAbout905 W Mountain Ave - Special Inspections/Field Verification - 03/28/2007City of Fort Collins
Fort Collins Building & Zoning Dept.
281 N. College Ave. • P.O. Box 580 • Fort Collins, CO 80522-0580
Voice: 970-221-6760 • FAX: 970-224-6134 �I
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Field Vercation Form
Job Site 41,a-,,-- Permit No.
0 �7 0 18<-0- 1
Company Name c� City of Ft. Collins Lic. # /t'?i'. yi
Replacement of Sewer line approx. '0 ' ` ft. (100 ft. maximum)
Replacement of Waterline approx. ft. (100 ft. maximum)
Add Replace gas line approx. ft. ( 50 ft. maximum)
Materials used: 5,0 �e
Tested at
lbs. for
minutes
Installer Name (print)
Installer Sign a _ s — Date 3—��—�7