HomeMy WebLinkAbout2420 ROCK CREEK DR - SPECIAL INSPECTIONS - 4/16/2021F:;Cltyof ~tColllns ""' ~ 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 ·--7 ;f ~ct4r//d __5--~ 7 -2-/ Field Veri.fication Form //4 Job Site ;!Lf .2 0 lcoc)( Lf"<e-1( 1)c: PermitNo. h -.L..:--~-----Company Name I €.)(qs F,·rq '-'< c.e Exfrth 5, City of Ft Collins Lie# FP-)l:>qg __ Replacement of Sewer line approx. ____ ft. (100 ft. maximum) __ Replacement of Water line approx. ___ ft. (100 ft. maximum) /Add __ Replace gas line approx. ___ ft. ( 50 ft. maximum) Materials used: S:' (,551 1/i 11 , I 't 13" 1/t. 2 x 9(/ ~z'' 1 11?. 11 --Yt'' &ill Vc:tlv~ • I I Tested at / 0 Lbs. for 2C>_ _ minutes Installer Name (print) ~LL Pe cq,f.v r lnstanerSlgnature ~Lif( Date ~ L/ /l(p /zJ