HomeMy WebLinkAbout743 LARKBUNTING DR - SPECIAL INSPECTIONS - 7/6/2021Fort Collins ~ Community Development & Neighborhood Services 281 N College Ave; P.O. Box 580; Fort Collins, CO 8052-2-0580 Phone: 970 221 6760 FAX: 970 224 6134 Field Verification Form Job Site 713 Mckbrmh /JCj Company Name 11.b:lbero !k!loC/uia /Jium/aio9 ~ _})172_,-,,7 Permit No. /:) ,2,;o, 12 4 9 City of Ft Collins Uc# Jn/J-,"i, 79 __ Replacement of Sewer line approx. ____ ft. (100 ft. maximum) L Replacement of Water line approx. {Q :5 ft. ( 100 ft. maximum) __ Add __ Replace gas line approx. ____ ft. ( 50 ft. maximum) Materials used: ··3111' K-· ~ ~ Tested at -~~-Jct ~ .,\it'\ he Los. for u p~1,1\'"'L,, 21 Installer Name (print) Rs.c\n~ '¢:L-1\f\o'Cl\~Y) ~l,~ 111n1utes ~ Installer Signature_~//~--=...,,....--;....._----Date }/L; f2c~ \ I I -Toth/ da_rOI? ~