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Home My WebLink About2602 Timberline Rd - Special Inspections/Field Verification - 04/14/2011i City of Fort Collins Job Site 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 '(�00Pv/\S b Permit No.�©V�b Company Name -i PtUnbf' 1 4- q6A41n4 City of Ft. Collins Lic. # /0 C? � Replacement of Sewer Line placement of Water Line Add eplace Gas Line Materials used: l %1 A: approx. ft. approx. ft. approx. 4oft. n..-d ---7 -- (100 ft. maximum) (100 ft. maximum) ( 50 ft. maximum) /X 4-e� / W Tested at 100 lbs. for minutes Installer Name (prir Installer Signature