HomeMy WebLinkAbout423 FRANKLIN AVE - SPECIAL INSPECTIONS - 3/5/2014City of Community Development & Neighborhood Services
Flirt Collins 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
i1`' Phone: 970 221 6760 FAX: 970 224 6134
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Field Verification Form
Job Site. U3 Fif hAkOl Permit No. 2 ` I z+DD U g z�
Company Name ANRR City of Ft Collins Lic#
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. ::t�T ft. ( 50 ft. maximum)
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Materials used: —3�� G
Tested at jo Lbs. for � minutes
Installer Name (print),`�!�/
Installer Signature Gc��
Date 3-5-
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