HomeMy WebLinkAbout2908 SPACIOUS SKIES DR - SPECIAL INSPECTIONS - 4/29/2021City of k t Colli!!:>
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
Job Site
Field Verification Form
C 9 0 i Sf D C j O 0:) 5K-,) 65 '() fl,) v1:S Permit No . ..:..B_Z-'-ID,.:c_:;.~_;,_\ ..;;...lo\o __ _
Company Name (<'._ ~rY'l ~ f U,..\(1/\ ()' \ I\ G [!'IC · City of Ft Collins Lie# Y 2?;, ',?7
__ Replacement of Sewer line
__ Replacement of Water line
_2-Add __ Replace g~ine
approx. ___ ft . (100 ft. maximum)
approx. ___ ft. (100 ft. maximum)
approx. 2.,S-ft. ( 50 ft. maximum)
Materials used: G .a -5> 7j-y E,
( A1 •1..; Tested at IO f oi Lbs . for ---=--'--"--'---
Installer Name (print) ~{0\ 0 l'.Y\ '{:x{)0/:51\
Installe r Signature k ---J----·,
I
_..;.../'5_-__ minutes
..