HomeMy WebLinkAbout4306 HUMMINGBIRD DR - SPECIAL INSPECTIONS - 12/22/2015City. of Community Development & Neighborhood Services
Fort Collinsl281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
Phone: 970 2216760 FAX: 970 224 6134
Field Verification Form
Job Site �� L \ v^^' ' ^�{` ��^ Permit No.
Company Name oNr (a�l`ri] 1} �'" �n'�1�.� City of Ft Collins Lic# 1A -13 00V
Replacement of Sewer line approx. ft (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
y_ Add Replace gas line approx. I u . S ` ft ( 50 ft. maximum)
Materials used: \" M <-- ) h3 � `4--
Tested at f. tiers
Installer Name (print)
Installer Signature
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