HomeMy WebLinkAbout2403 TREESTEAD RD - SPECIAL INSPECTIONS - 2/2/2021F:Cityof ~tCoUins ------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 ol'::\c:5 ~"' e &sen h ~ Penn it No. ?::, ?,.,;;;,',:=,"1 \ '::, Company Name~1;,,, r:»-"""~ \J Qo \)\l • , ,, CJ, W .../ \ City of Ft Collins Lie# \\ -~3':::, __ Replacement of Sewer line __ Replacement of Water line ~Add __ Replace gas line approx. ____ ft. (100 ft. maximum) approx. ____ ft. (100 ft. maximum) ' approx. 2-L-ft. ( 50 ft. maximum) Materials used: ______________________________________ _ Tested at ( 7 PS" j ' . Lbs. for /S: minutes Installer Name (print) \'J»g)(:\. ~~ C•;,<::-, ' ' \: \ > ,' I Installer Signature X,.,_ :~, ·•·.,'--IA;"~---· -• I '-. ' ) Date 2 -2-~ L 1