HomeMy WebLinkAboutWORK ACCEPTANCE FORM GENERAL DYNAMICS - 19-00715 - 1145 S 2nd E - AT&T Cell TowerContractor Work Acceptance Form
Business Name:*
Contact Name:*
Mailing Address
Email:*Phone:*
Mobile:
Discipline:*License #:*Expiration Date:*Value of Work:
Permit Number:*
Project Name:*
Project Address:*
By signing, I acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature Date
Contractor/Subcontractor
General Dynamics Information Technology
Mike Denney
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
michael.denney2@gdit.com 801-230-3215
Building RCE-41098 1/15/2021 $
Permit Information
Please enter in the following format: 00-00000
19-00715 Rexburg Hill
1145 South 2nd East, Rexburg, ID 83440
Acceptance
Sign 1/15/2020