HomeMy WebLinkAbout942 DRIFTWOOD DR - SPECIAL INSPECTIONS - 12/20/2019Fgg��CitryofM Community Development & Neighborhood Services
o! t Collins 281 N College Ave; P.O: Box 580; Fort Collins, CO 80522-0580
u Phone: 970 2216760 FAX: 970 224 6134
Field Verification Form
Job Site
5
Company Name 0�5 k ro F-j' (G ?I etCC 5ugPt So
Permit No. 13/9 c-f9
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. S ft. ( 50 ft. maximum)
Materials used: S I/-z," black E/-on
Tested at (U Lbs. for minutes
Installer Name (print) J (✓ fD a A k%jec ,-o—
Installer Signature
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Date