HomeMy WebLinkAbout4238 STONERIDGE DR - SPECIAL INSPECTIONS - 3/25/2021hCityof ~tCollins ..______ 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 ✓ Job Site ~ 3/JJt~~, 0: Permit No. fJ :Ji6 )O:J:<;: Company Name f)lr:t.,,,!:S 01u6 ,£,,c1c;,.,:t5 _ Replacement of Sewer line ~eplacement of Water line __ Add __ Replace gas line Materials used: Pu 61-~.) I I Tested at /,£{) Lbs. approx. approx. approx. for Installer Name (print) nu &cA 1 Installer Signature ~ ~ ~ c;J-c) City of Ft Collins Lie# -11P56 ft. (100 ft. maximum) ft. (100 ft. maximum) ,ft. ( 50 ft. maximum) minutes Date 1/J~~/