HomeMy WebLinkAbout5801 Colby St - Special Inspections/Field Verification - 02/15/2017Cltyof, Community Development & Neighborhood Services
. 281 N College Ave; P.O. Box 580; Fort Collins, CO S0522-05SO
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Phone: 970 221 6760 FAX: 970 224 6134
Field Verification Form
Job Site 01 W liT�( (7k
Company Name Mr. Rooter Plumbing/GDL Industries
x Replacement of Sewer line
Replacement of Water line
_ Add Replace gas line
Permit No. V 1 (00 S 5 W
City of Ft Collins Lic#
approx. 3_ ft. (100 ft. maximum)
approx. ft. (100 ft. maximum)
approx. ft. ( 50 ft. maximum)
Materials used: SDR 40; 3/4-in. mountain granite; dual -sweep cleanouts
Tested at
Installer Name (print) Jason Willis
Lbs. for minutes
MP 844
Installer Signature Date
Cityof Community Development & Neighborhood Services
0 Collins 281 N College Ave; P.O. Box 560; Fort Collins, CO 80522-0580.
Phone: 970 2216760 FAX: 970 224 6134
Job Site
Company Name
Replacement of Sewer line
_ Replacement of Water line
_ Add Replace gas line
Materials used:
Verification
Permit No.
City of Ft Collins Lic#
approx. ft. (100 ft. maximum)
approx. R (100 ft. maximum)
ap ( 60 ft. maximum)
Tested at Lbs/ for minutes
Installer Name (print)
Installer Signature /. - Date