HomeMy WebLinkAbout4771 FORELOCK DR - SPECIAL INSPECTIONS - 8/13/2018City Of I $'+''I�a'r `"Com'munity Development &Neighborhood Services
Flirt Collins 281 N!Gollege Ave; P.O. Box 580; Fort Collins, : 9 80522-0580
6134
%,e`�"- Phone: i970 221.6760 FAX: 970 224 6134
Field Verification Form
Job Siteac/l �rrt
Company Name
Permit No.
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. V,:5' ft. ( 50 ft. maximum)
Materials used: 3/� "GSS''
Tested at /y Lbs. for 36 minutes
Installer Name (print) o
Installer Signature Date _