HomeMy WebLinkAbout460 MARIPOSA CT - SPECIAL INSPECTIONS - 2/19/2021 FCity of Community Development & Neighborhood Services
ort Collins 281 N College Ave; P.O. Box 580; Fort Collins., CO 80522-0580
Phone: 970 2216760 FAX: 970 224 6134
Field Verification Form
Job Site Permit No.
Company Name-2�--ig-e�-- - `/fop City of Ft Collins Lic# ,,00?p
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. QO ft. ( 50 ft. maximum)
Materials used: .2
Tested at Lbs. for minutes
Installer Name (print) -G C � —a
01
Installer Signature Date
C.0 .