HomeMy WebLinkAbout2107 Barnwood Ct - Special Inspections/Field Verification - 08/24/2012•�- Cityof Community Development & Neighborhood Services
F6r't Collins 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
Phone: 970 221 6760 FAX: 970 224 6134
Field Verification Form
Job Site C9 l 0 7 QJ'��k,��0j " '6 Permit No.
L 10067,;Sl
Company Name/�'(,%l�,Ttd'(;/C/U 6n , 1/y6ifn4rld City of Ft Collins Lic# s�Z
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. b (ill ft. (100 ft. maximum)
Add Replace gas line approx. ft. ( 50 ft. maximum)
Materials used:
Tested at Lbs. for minutes
Installer Name (print) ��
%� Installer Signature lam.- Date C