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HomeMy WebLinkAbout2236 Dover Dr - Special Inspections/Field Verification - 05/26/2010FCity of Community Development & Neighborhood Services ort 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 Z Z 3 6 D D J ur Permit No. 15 k ric 32 © 3 Company Name BPS C-cctrvn (( 1�%tiw,(o.�SepUq,� City of Ft Collins Lic# _ M26 7 'T Replacement of Sewer line approx. ft. (100 ft. maximum) Replacement of Water line approx. ft. (100 ft. maximum) ✓ Add Replace gas line approx. 2 a ' ft. ( 50 ft. maximum) Materials used: 13(4 <( i r4,n + GSST P r p+ rv�, Tested at to Lbs. for 60 minutes Installer Name (print) 4.1?A . (mot-v-r6 U1 Installer Signature 4-1, 6eC-W Date --V26 to