HomeMy WebLinkAbout4676 SHETLAND LN - SPECIAL INSPECTIONS - 3/2/2021Cityof
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Job Site LI "1 t l.o
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
Fuv loll\V\S (0 o0S 24 Permit No. /32 /0JSbb
. ( u & r ,;lCf("' t)lC..f 'r-lv City of Ft Collins Lie# (YtP-S7 ,j
_ Replacement of Sewer line approx. ___ ft . (100 ft. maximum)
_ Replacement of Water line approx. ___ ft. (100 ft . maximum)
_L Add __ Re place gas line approx. 3 c; ft . ( 50 ft . maximum)
Materials used: cssr ;1ex112te ha.ffM"M Jt{j Pl/21/ttJ=
Tested at_ /S J bs . for ('_:S minutes
Installer Name (print) 7Jr€"[<..._
Date 03 -02 · 202/