HomeMy WebLinkAbout2113 Creekwood Ct - Special Inspections/Field Verification - 01/29/2008( Z
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City of Fort Collins
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Fort Collins Building & Zoning Department
281 N. College Ave. • P.O. Box 580 • Fort Collins, CO 80522-0580
Voice: 970-221-6760 • FAX: 970-224-6134
Field Verification Form
Job Site 1,1l 3 1-t Permit No
i S 4
Company Name Rf'tPr"Acc- Svppl� City of Ft. Collins Lic. # i W
_ Replacement of Sewer Line approx. ft. (100 ft. maximum)
_ Replacement of Water Line approx. ft. (100 ft. maximum)
Add _Replace Gas Line approx. y ft. ( 50 ft. maximum)
Materials used: 41" 04-4sf?t'e- � I Rik jrov
Tested at
Installer Name (print)
lbs. for 60
St*-vtiA/ TLA 4v tr
minutes
Installer Signature -11w^'h ! jv�/ Date t— M-08