HomeMy WebLinkAbout1667 KIRKWOOD DR - SPECIAL INSPECTIONS - 7/6/2021City of /fyrt Collins ~ 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 //4tz 7 &c.Ku ,i,Qod, ..f)r., Permit No .. J3 .,210 4100 Company Name 1/or{hem t'b/or&/o /JJum6, oq ~ i],,-d.-ir, City of Ft Collins Lie# m P-51,tf __ Replacement of Sewer line ,.)5:,..._ Replacement of Water line · __ Add __ Replace gas line approx. ___ ft. {100 ft maximum) approx. (2 0 ft. (100 ft. maximum) approx. ___ ft. ( 50 ft maximum) . ( \ l Materials used: 2/4 ~(_. LD~ V\ 9). f/z::'i>I,' Tested at L0er\:--t --=t}--1--1.bs. for 2± Installer Name (print) w✓, i-\WQ ,C.I Cl,\il,1,--, Installer Signature /.f!!; . ¢;., ~ +¥vUYy minutes Date '-:t-/ ~ }J {\ ~ ... J.... . .......... -........ . -·-, { JC6ej-;rJ6' ~