HomeMy WebLinkAbout738 Campfire Dr - Special Inspections/Field Verification - 12/12/2019k
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City, of Community Development & Neighborhood Services
F6r't Collins 281 N College Ave; P.O. Box.580; Fort Collins, CO 80522-0580
I Phone: 970 221 6760 FAX: 970 224 6134
Field Verification` Form Job Site ti �rmn�'; l e 1%��_ Permit No. "� kn �I (o-� '� "-s
Company Name ,1 rt"/-?0 e ..City of Ft Collins Lie# �RC�J _ �g C90�C1(o
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Replacement of Sewer line approx. G/. $ ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. ft. ( 50 ft. maximum)
Material used: .,�r2n�iLy. p �
Tested at Lbs. for minutes
Installer Name (print) �G50>7 Jri'S
Installer Signatur Date