HomeMy WebLinkAboutWORK ORDER - 04-00225 - Vision Communications - Tenant FinishACC# RT# PHONE WORK ORDER
NAME_. + a n 2 � U / 1 QQQEFFECTIVE DATE DATE
MAILING ADDRESS
SERVICEADDRESS 505A)
OWNER 'I
�40 U\
ADDRESS _L to
+�56 '&,p �' L. PHONE 301-VC-Oypy NO.OFPEOPLE
4ti nn'N
EMPLOYER OR RELATIVECorr\
tLATIVE
SS#
❑ IN
❑ ON
OUT
❑ OFF
VACANT
READ
❑ RE -READ
❑ CHECK LEAK
❑ WTR.SWR ONLY
❑ GR CONT. #
❑ RENTING
❑ BUYING
SELLING
❑ OWNER
❑ BL CONT #
DEPOSIT AMOUNT I �t�xM C&"
DATE PAID IN
REFUND DATE
AMT. REFUNDED
AMT. APP. BILL
METER SIZE GR RT# BIN SIZENOM T W T F S
LOCATION . OF BINS ❑ ❑ ❑ ❑
COMPLETED BY El El
ISSUED BY
❑ COMPUTER FILE
APPLICATION FOR REXBURG CITY SERVICE
NAME - 'rSroN 9tV6R V,u we6 L.C.
ADDRESS 115 E. (ow S. AM�ca-tJ F„R ,Ler 84003
PLUMBER_ Ac-rlort t- EtoA i _
PROPERTY OWNER_ lyTow Rwe2 V1UhC E Z_c
WATER SERVICE: Type_ tixts-nNG Size Z/, VAMNG
Water Connect...... = In City ✓ Out of City
Water Met
or .......
S
Meter Box .........
f
Ring 8 Lid........,
f
Curb Stop .........j
Setter ..............
i
Sewer Connect .....
_
TOTAL ............
t—
Storm Drains — $ f�ysnNt�
APPROVED BY