HomeMy WebLinkAbout143 SYLVAN CT - SPECIAL INSPECTIONS - 2/5/2019City of Community Development & Neighborhood Services
Flirt Collins 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
Phone: 970 221 6760 FAX: 970 224 6134
Field Verification Form
Job Site 12 Pof+s ry t, SaueA g4-. FfCotr1,1.5 Permit No.
Company Name ///, &Ay City of Ft Collins Lie#
Replacement of Sewer line approx. 112 ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. ft. ( 50 ft. maximum)
Materials used: so e �s (2) c/ren6« %eaoS io' sntz 35-
Tested at
Lbs. for
Installer Name (print) at-m mein !?,a%/"�aS
minutes
Installer Signatures Date i12-a •/i