HomeMy WebLinkAboutWORK ACCEPTANCE FORM LECHTENBERG SERVICES801 - 20-00977 - Cal Ranch Interior - RemodelContractor 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
Lechtenberg Services801
Dan Lechtenberg
City
Bluffdale
State / Province / Region
Utah
Postal / Zip Code
84065
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
15663 Woodhollow Dr
Address Line 2
dan050@live.com 8019494014
8019494014
Building 4832259-5501 11/30/2021 104,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00977 Cal Ranch
530 N. 2nd E. Rexburg
Acceptance
Sign 1/22/2021