HomeMy WebLinkAbout6314 GRASS CT - SPECIAL INSPECTIONS - 6/1/2021City of kt Colli[!: 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 Permit No. B2.-I O 2-r11 City of Ft Collins Lie# fi?,/J.-529 __ Replacement of Sewer line __ Replacement of Water line _j(_ Add __ Replace gas line approx. ___ ft. (100 ft. maximum) approx. ___ ft. (100 ft. maximum) approx. 2 5" ft. ( 50 ft. maximum) Materials used: s1e-~.1 f'f F Tested at f) Lbs. for 11 7 '72 . 1 lnstalle, Name (prin ~/"! W= Installer Signature__.._____:______..,.q,..-=-~,,,_,,_·_==------:: __________ _ _"3_·o ___ minutes Date _k_,---'-1 h-_~J __ _ J