HomeMy WebLinkAbout1943 Massachusetts St - Special Inspections/Field Verification - 07/31/2017City,of
I Community Development & Neighborhood Services
FOI t Collins 281 N College Ave, P O Box 580, Fort Collins, CO 80522-0580
-`— Phone, 970 221 6760 FAX 970 224 6134
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Field f Verification Form
Job Site �C1 3 1 \�gs C V 5e�1S }��� Permit No
Company Name N 646ew 69 _-p6m6�� !e 0 City of Ft Collins Lic#
Replacement of Sewer line approx ft (100 ft maximum)
Replacement of Water line approx 56 ft (100 ft maximum)
Add Replace gas line approx ft (50 ft maximum)
Materials used
Tested at Lbs for minutes
Installer Name lnnntl
Installer
Date 40
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