HomeMy WebLinkAbout1326 Sunflower Dr - Special Inspections/Field Verification - 06/20/2005City of Fort Collins
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 13 -2 L, Permit No. 3 -
Company NameAASste- C14A City of Ft. Collins Lic. # �t - ILIq(0
Replacement of Sewer Line
Replacement of Water Line
approx.
ft. 0 00 ft. maximum)
ft. 0 00 ft. maximum)
Add _ Replace Gas Line approx. f� ft. ( 50 ft. maximum)
Materials used: �e jL P6, P F(.e„� b ae--, t,,oe
approx.
Tested at `p lbs. for 15, minutes
Installer Name (print) S'1�kje�63t(ctAk
Installer Signature � � �-YZ , Date a