HomeMy WebLinkAbout1619 Redberry Ct - Special Inspections/Field Verification - 08/10/2010City of Community Development & Neighborhood Services
Fort 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 / 0 6 Permit No. U /Cb 39 ,-,?-
Company NameCity of Ft Collins Lic#
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. /J5- ft. (50 ft. maximum)
Materials used: CJ,37-
Tested at ! 0 Lbs! for minutes
Installer Name (print)
Installer Signature 074��--
Date
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