HomeMy WebLinkAbout2820 GARRETT DR - SPECIAL INSPECTIONS - 3/16/2021Cityof
ktColli!!:
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 $JO !Ja-«of{ fk✓ Permit No.
Company Name fuh 15 &t)wt!y J.ervt&6
I
City of Ft Collins Lie# / ~()()// fe >
__ Replacement of Sewer line
--~placement of Water line
__ Add __ Replace gas line
approx. ___ ft. (100 ft. maximum)
approx.~ ft. (100 ft . maximum)
approx. 0 -( 50 ft. maximum)
Materials used: ---le,_-/,=--·=--~-'--i6r----.e.-,vt'F-~_,_--· "'-------------------------
1
Tested at ____ &_() __ Lbs . for J() minutes
Installer Name (print) _ _.@'---'-'t,_h-'---=G"--'-~-u_cA_· ______ _
Installer Signature ___ ~_-_C-G-=_/L-e__· _______ _