HomeMy WebLinkAbout5306 ELDERBERRY CT - SPECIAL INSPECTIONS - 3/24/2021City of ,5~tColl~ Comm4nity Deyetopment & Neighborhood Services 281 N ~g.3~e.;_ J?.O;, Box 580; Ftir.t C0Jlins,lc918os22-os80 P~ne: 970 2-2\ '676'0-> F¼>l-<970 224 6134 l '--{ -.;;--.,.J ~ I Field Verification Form .J .) C+-/ vc ~..:~ J-PermitNo. B2lOl0:52/£'f210I05 , -'--.,.. - I I Job Site :::::> '\Vy 1-} <..! ~f.._ .. ,\....:. ._ f2...y , Company Name A I J t:'..-,, ~.-{L --.J • c:..,...__ City of Ft Collins Lie# _____ _ __ Replacement of Sewer line 7 Replacement of Water line __ Add __ Replace gas line approx. ___ ft. (100 ft. maximum) approx. 1....J c> ft. (100 ft. maximum) approx. ___ ft. ( 50 ft. maximum) Materials used: _3_..;../_y-'----f'~-il,__· _.Y ________________________ _ Tested at _______ Lbs. for ____ minutes I Installer Name (print) \/\., \ r¼ u '4-1 i✓\ \~ t-. Yv«-::,-:._ \.ft,..._._ ( .,I l -Installer Signature J --..:>< V \___ \ Date -=-:--L I -.=:: I \ 1"~ ,,