HomeMy WebLinkAbout419 MAPLETON CT - SPECIAL INSPECTIONS - 6/5/20106al
City of Fort Collins
Job Site
Fort Collins Building & Zoning Department
281 N College Ave PO Box 580 Fort Collins CO 80522-0580
Voice 970 2216760 FAX 970 224 6134
Field Verification Form
Permit No
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Company Name �2 ct K1PIb4 M PLO City of Ft Collins Lic # I , b (E;7
Replacement of Sewer Line approx ft (100 ft maximum)
Replacement of Water Line approx ft (100 ft maximum)
-X_ Add _ Replace Gas Line approx a r'/ /eft ( 50 ft maximum)
Materials used , v..,94j, 1,tv-d -z /u cP_Ca e- D rr- --
Tested at Ibs
Installer Name (print)
Installer Signature
for 15 minutes
VIA
Date