HomeMy WebLinkAbout3858 CENTURY DR - SPECIAL INSPECTIONS - 1/8/2018City of Community Development & Neighborhood Services
Fort Collins 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
/ -`I Phone: 970 221 6760 FAX: 970 224 6134
Field Verification Form
Job Site C.
Company Name a She rn acre-@
Replacement of Sewer line
Replacement of Water line
Add Replace gas line
Materials used:
Installer
Installer
N
Tested at 3 0 Lbs.
Permit No. /& 1250()0 t
City of Ft Collins Lie#
approx. ft. (100 ft. maximum)
approx. ft. (100 ft. maximum)
approx. ft. ( 50 ft. maximum)
for _ minutes
Date