HomeMy WebLinkAbout1624 Scarborough Dr - Special Inspections/Field Verification - 01/19/2015SEP-04-2007-TUE 12:40 PM P.001/001
*^ Fort Collins Building & Zoning Department .
281 N. C:oUege Ave. - P.O, Box 580 a Fort Collins, CO 80522-0580
Voice:970-221-6760 • FAX- 970-224-6134
Field Verification Form
Job Site
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Permit No. 3 14 I 7-9 Z ! '
Company Name
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City of Ft. Collins Lic. # .�
_ Replacement of Sewer Line approx. i4. ,.(1t30 ft. maximum)
_ Replacement of Water Line . approx. ft. (100 ft, maximum)
X Add _ Red lace Gas Line approx, C50 ft. (50 ft. maximum)
Materials used: riJ - eg-E- 0-- GCST ne(� Iinr..
Tested at I D llbs.
Installer Nprpe (print) i ��1�' )
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Installer Sgnature f
for D minutes
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