Loading...
HomeMy WebLinkAbout1006 W MOUNTAIN AVE - SPECIAL INSPECTIONS - 11/12/2020. ' ~orfCoUins ~ Community Development &. r\feighborhood Services 281 N College Ave; P.O Box 580; Fort Collins, CO 805~-0S80 Phone: 970 221 6760 FAX: 970 224 6134 f aeld Verofocation Form Job Site ___ / O,tJ£z_!JJ./Jl}~r!:3 hd' __ Company Name ¾cfti«n {/.af;?r&f.o /J!df'l'M,IU) ;.t)/tt.,//J Permit No.-~ :l;o.35i:;Q __ City of Ft Collins lie# /)')/J.-5-79· ' ..){_ Replacement of Sewer line ___ Replacement of Wat~ line ·!\o approx l C fl. t100 ft. ma)(irnum) approx. _____ ft (10C ft. m,:1ximurn) ___ Add ...... ___ Rap!ace gas line approx. _ -~-___ ff { 50 ft. ;paxtf'Tlum) Malenals used~ u CZE.~ x.,l.;'-t.,_th,_~--l1---~---£~,-LiJ~ lt'-t-='~•-''~---------Testcd a! ______ lbs for 1Tiinutes lnstalier Name \Print) \Zg:;\\-.l!;'~-litv) ~ 'fL V\)..t.1,-... Installer SigMture __ L~ {/~~----Date ... J::/~ ~2 CJ 1 .. ______ _