HomeMy WebLinkAbout2211 S COLLEGE AVE - 200 - SPECIAL INSPECTIONS - 7/12/2021City of ~tCollif!: 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 ~).CD Field Verification Form Job Site '.Pe lea d,d\\ S, Co\\e..q R AvQ, 6\-t Col!\\~~rmitNo. pJ,f Ol~e>~ Company Name E:>reo,\.Z tb{'c\Jqb Resa, A,cce. M{J'--~~l~7§o~JLic# rt,P--9LPt _ Replacement of Sewer line approx. ___ ft. (100 ft. maximum) _ Replacement of Water line approx. ft. (100 ft. maximum) V Add Replace gas line approx. 5 a ':-.. ,ft. ( 50 ft. maximum) Materials-u-sed: -, -, ,-. ;;,.. k,~~f f '' b\,,.. c/L pr\?< I .,,/,/ 6 /acif 12 ip? 1 3 -i-e,<:: S / J 9 O 05 Tested at _ ....... /_O ____ Lbs. for / .5 minutes 3 \.A"": cvrl { • Installer Name (print) Mt' ~ h. Qf, I s _ I Lr! Jz r'f e lnstallerSignature ~ ~ 7