Loading...
HomeMy WebLinkAbout443 W SWALLOW RD - SPECIAL INSPECTIONS - 3/15/2021Ci ty of ~tColli~ 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 ~ ~a l~W f2d~CD&>52.4:i Permit No. Bk: /0 t:11.eS Company Name_ J-t a re u;;;; ~1'~ f ~ ~ •:ia City of Ft Collins Lie# MP-1 -5 _ 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) =ui.ftt.~J.!fd 2 ws3 c l-ec>nact • SD e, f i pe & s\5Wng ) Jn C '2-t~ C ~ Tested at · Lbs. for ___ minutes ()vq. '- Installer Name (print) :11-Jad Tu l Vc:9ux;' Installer Signature __ ,7L~L---'-'1_t'-c=-·/4'-"C:~'--=.S. _ _,d,~,....-,~~-~-=---Date_-=3_-_,s=--_2_,_I __