HomeMy WebLinkAbout4676 Shetland Ln - Special Inspections/Field Verification - 03/04/2021FCityof Community Development & Neighborhood Services
ort Collins 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
Phone: 970 2216760 FAX: 970 224 613
Field Verification Form
Job Site q bTu ShtilmdLK, 60 C0111vis t0 Us2q Permit No. 621015 6 (a
Company Name ( f M t" 500(GEc ldci City of Ft Collins Lic# iNn �S
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
X Add Replace gas line approx. 31� ft. (50 ft. maximum)
Materials used: L J
Tested at
Installer Name (print)
Installer Sianature
"a,
for Z=11c-�minutes
Date __DJ- 02 - 2oz1