HomeMy WebLinkAbout2525 Tulane Dr - Special Inspections/Field Verification - 08/24/2020CommunitV Development &.Neighborhood Services
.281 N d6ilege, Ave; P.O. BqX'.580,"' i Fort CORInS. d6 - 60522-058D.
67760 : 976 224 6134
OftIC o. Ph6ne: FAX
Field Verification Form
7V(- -5z 0 0 Z- 1 (0 1
Permit t4q.:..
Job Site
City ofF,�.t.-Collins . Llc# /q P— (I Tl�
Compan9.Narne
kdo6U6idnt of Sewer line approx. ft. (100 ft. maximurh)
.R6616c4fne , rit of Water line approx._ I (100 ft. maximum)
—.Add ..." -'.Replace gas line approx._ ft.. ( 50 ft. maximum)
Materials used:
Tested at Lbs. for minutes
Installer
Installer
Name (print)
Signature Date