HomeMy WebLinkAbout601 STRACHAN DR - SPECIAL INSPECTIONS - 1/12/2011City of Community Development & Neighborhood Services
Fort Collins 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
Phone: 970 221 6760 FAX: 970 224 6134
Field Verification Form
Job Site /l�(J) Y-.0 iPermit No.��0yCi`
Company Name W�67'!L" ACG— 4JO City of Ft Collins Lic# / ✓ t�l��J
Replacement of Sewer line approx. ft. (100 ft. maximum)/6 f�l�
acement of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. ft. (50 ft. maximum)
Materials used:
Tested at 00) Lbs. for � 0 minutes
Installer Name (
Installer Signatu
Date Z'/ z '2,61l