HomeMy WebLinkAbout6038 MEDLAR PL - SPECIAL INSPECTIONS - 7/27/2021 FCityof Community Development & Neighborhood Services
ort Collins 281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
Phone: 970.221 6760 FAX: 970 224 6134
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Field Verification Form
Job Site DCJ ( Permit No.
Company Name City of Ft Collins Lic# 0-0
Replacement of Sewer line approx. ft. (100 ft. maximum)
Replacement of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. 37 1 ft. (50 ft. maximum)
Materials used: nn
Tested at � Lb for d0 minutes
Installer Name rint Ivy
Installer Signatu e Date �� ��