HomeMy WebLinkAbout2007 SHEFFIELD CT - SPECIAL INSPECTIONS - 7/26/2021City of
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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
JobSite 2/J07 5tfeEf!€LD Gr Permit No. r:>2/6 3/70
City of Ft Collins Lie# Af(?... l-/ Company Name A {_,t,6-,v f.;f/ilvl c£
Jt.._ Replacement of Sewer line approx.
__ Replacement of Water line approx.
--Add __ Replace gas line approx.
Materials used: 4" fill-l/" Wll..6 f/V
to.
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ft. (100 ft. maximum)
ft. (100 ft. maximum)
ft. ( 50 ft. maximum)
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Tested at Lbs. for ___ minutes
Installer Name (print) _4-Jt(i.::.µ'f.'-"k£"""-~&/-<-V<..,_/"-"'M~c::.-==----
lnstaller Signature._""'~__,""""'""~""-"=-"""~"-"-""'""""'="'----
• ~/ Date---'7_,_/2'--"'t,-'-/2_ZCJ_z_,_( __
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