HomeMy WebLinkAbout1344 Armsley Ct - Special Inspections/Gas - Log, Line, Pipe - 08/21/2013Fort Collins Building & Zoning Dept.
!!�r_ 281 N. College Ave. • P.O. Box 580 • Fort Collins, CO 80522-0580
cicv of Fort s Voice: 970-221-6760 • FAX: 970-224-6134
Field Verification Form
Job Site I3gq *hMm 4 G- ' E� N111)6 )Permit No. 9 /,7Q �// 97
Company Name �8+4 hk f City of Ft. Collins Lic. #
Replacement of Sewer line approx. ft. (100 ft. maximum)
-'eplacement of Waterline approx. ft. (100 ft. maximum)
V Add Replace gas line approx. ;20 ft. ( 50 ft. maximum)
Materials used: Tz' --rQL Dope,
Tested at Ps' lbs.
Installer Name (print) �\ U
Installer Signature
for 'Zminutes
Date n91:21—/