HomeMy WebLinkAbout823 E ELIZABETH ST - SPECIAL INSPECTIONS - 1/13/2021Community Development & Neighborhood Services 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580 Phone: 970 221 6760 FAX: 970 224 6134 fneM! Veirofocatioll1l form Job Site 623 E. f \ \ :zO b-e.,,TI\-, Permit No.32D\ '6le 3 q Company Name bM-Co\.evw:\o €\M(h,~~ ~ , City of Ft Collins Lie# \IV\. P -C:Si" °t x ~ 2. ~ o\-'\..>-of-l~ ~ Replacement of Sewer line approx. ___ ft. (100 ft. maximum) __ Replacement of Water fine approx. ___ ft. (100 ft. maximum) __ Add __ Replace gas line Materials used: 4 \\ S~✓ approx. ___ ft. ( 50 ft. maximum) \~ \\-b?c Tested at ______ Lbs. for ___ minutes lnstalle, Name (print)~~~ Installer Signature ;1-z 7 Date_\\-+-/ \;S=-r--/2_D_;___'2j.:.:.___ ) /