HomeMy WebLinkAbout612 PARLIAMENT CT - SPECIAL INSPECTIONS - 2/27/2017Cl Of
F6N Collins
Community Development & Neighborhood Services
281 N College Ave; P.O. Box s8o; Fort Collins, CO 80522-0s80
. Phone: 970 2216760 FAX: 00 224 6134
Field Verification Form i G
Job Site Z � �/ Permit No. o C) D , D
Company Name r
City of Ft Collins Lie#
Replacement of. Sewer line approx. ft (100 ft. maximum)
_ Replacement of Water line
Add Replace gas line
Materials used:
Tested at Lbs.
Installer Name (print)
Installer
approx. ft. (100 It. maximum)
approx. 70 ft (Soft. ma)imum)
for _4Wminutes
Date c a�