HomeMy WebLinkAbout224 WOOD ST - SPECIAL INSPECTIONS - 9/4/2013City of I I . Community Development & Neighborhood Services
Fort Collins 281 N College Ave; 0522-050
Phone 97082021 6 60oIlIFAX• 9708
780 224 6134
Field Verification Form
Job Site 22� AJeoo S7- -, Fr. eau1NS Permit No.
Company Nameg'reICA City of Ft Collins Lic# / P 25V
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
X Add Replace gas line approx. 30 ft. ( 50 ft. maximum)
Materials used: C557— 4,5trrcrc PP6
Tested at /0 Lbs. for 30 minutes
Installer N
Installer S
Date �13