HomeMy WebLinkAbout1707 BARNWOOD DR - SPECIAL INSPECTIONS - 5/24/2021~F~tt°CoU1ns ,, ~ Community Development & Neighborhood Services 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 / 1v 7 & r 11 w(}?c/ Permit No. g :;J;o t 2f'/U Company Name ltwlhr:az {jz/ocae/r:2 t/wn6//J(/ i ~ City of Ft Collins Lie# /n p, 5 21 __ .Replacement of Sewer line approx. ____ ft. (100 ft. maximum) 'X Replacement of Water line approx. ____ ft. ( 100 ft. maximum) __ Ad·d·· .--R~pl.;;6: line appmx. ____ ft. ( 50 ft. maximum) Materials used: <::J--;;f.; -C-9:)qOL:C: Tested at to-Fa Lbs. for ____ minutes Installer Name (print) /~ v ).!) /d~t£ J~ Installer Signature ~ -; ? I..__ ...,::--... Date ,r;/4 LJ J ;;_/ J ... ~ ... / c:;unerr \ Ve /2 p'"U t,;c-RJ