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HomeMy WebLinkAbout3939 CENTURY DR - SPECIAL INSPECTIONS - 3/16/2021 City of Community Development & Neighborhood Services Fort 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 w�x& Permit No. 4 ao Company Name il� City of Ft Collins Lic# t�17 Replacement of Sewer line. approx. ft. (100 ft. maximum) Replacement of Water line approx. (100 ft. maximum) Add Replace gas line approx. V eft. (50 ft. maximum) Materials used: G Tested at 66 Lbs. for minutes Installer Name (print) !/C Installer Signature /�22� Date Z /G/