HomeMy WebLinkAbout223 E PLUM ST - SPECIAL INSPECTIONS - 3/25/2021~°Cotl1ns ~ 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 JobSite ZZ(3 {. horn C)+. f;'rJ: G,1:/1\5 Permit No. Bl IOI q JS CompanyName ~<l,, £,ae. P;ee AA6) City of Ft Collins Lie# /Z,DW· fl}{.) uG "'$6 _J(_ Replacement of Sewer line approx. / 0 ft. (100 ft. maximum) IO 5 ' ;311,s-+ ro T Ctl(7 _ Replacement of Water line approx. ___ ft. (100 ft. maximum) _Add __ Replace gas line approx. ___ ft. ( 50 ft. maximum) Materials used: :5 D fl 3S,, 5q,ue~;zee 1 5 -h-'"o"":z bt:.vt<.. ~r.,. W5, f( rfJ /7 £ / 7 Tested at __ ..,.-= ____ Lbs. for Installer Name (print) \ lf/If, d: _1/j-J. v, d< e l, Installer Signature ~5-4': ,.. ____ minutes Date 3 · l 5 -lV 2:-l