HomeMy WebLinkAbout912 FOSSIL CREEK DR - SPECIAL INSPECTIONS - 5/3/2013MAY-08-2013(WED) 10;12
P. 001 /001
of
Fort Collins
Community Development & Neighborhood Services
281 N'College Ave; P.O. Box $80; Fort Collins, CO a0522.O580
Phone: 970 2216760, FAX: 970 224 6134
/� _( Field Verification Form
Job Site �l /Z �9 1 1) Ce C4� - 0/? • Permit No
Company Name.2l�- Lrcl !A /i ,^'C• �f%%r , � "'City of Ft Collins Uc# %
Replacement of Sewer line approx ft. (100 ft. maximum)
>Placement of Water line , approx. ft. (100 ft. maximum)
Add Replace gas line approx. 4_ ft. (50 ft. maximum)
Materials used: _ ACk-
Tested at 6�0 Lbs. for minutes
Installer Name (print)
I nsfaller
Date S� "3- 2t713