Loading...
HomeMy WebLinkAbout820 E LAUREL ST - SPECIAL INSPECTIONS - 4/15/2021f=iCitY,of ~tCoU1ns ' 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 ,,, "' "3 ZD ~ fu;~ ~ "~"'' 6 2-t D 2'-/ 5 3 Company Name H-c9h 6 fu,= c~tj CltyofFtColllnslic# MP l 6 _ Replacement of Sewer line approx. ___ ft. (1 OD ft. maximum) _ReplacementofWaterline approx. _ ft. (100ft. maximum) ~ Add __ Replace gas line ~rox. . Mat~a~d~ (A)~ Cle'&v16 ' b1t~02 t~l\2]V1ti 6iJ);l sntrJVlqS:31;\JlivJ (J . , I Tested at _______ Lbs. for Installer Name (print) 1ba d 1)6 l VBIAX' Installer Signature ·:f6_,J1 k\.,r~ Date L{-/S-2/