HomeMy WebLinkAbout609 Stoneham Ct - Special Inspections/Field Verification - 06/22/2020City, of Community Development & Neighborhood Services
Fort Collins 281 N College Ave; P.O. Box.580; Fort Collins, CO 80522-0580
Phone: 970 2216760 FAX: 970 224 6134
Field Verification Form
Job Site 609 STOwE-MAnn CY 132005g85
Permit No.
Company Name G 0n12A L ES f I —Um KIM & City of Ft Collins Lic# W- 50 3
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
:Z(6�)Replace gas line approx. 7.S ft. (50 ft. maximum)
Materials used: POLYLTHYLENE 6Ai PSFE 3/t, "
Tested at 15 Lbs. for 30 minutes
Installer Name (print)
Installer
6 E OuTNON &5
Date JUKE ZZr►d c 0000