HomeMy WebLinkAboutWORK ACCEPTANCE FORM LEGACY TELECOMMINICATIONS LLC - 21-00584 - 1802 N 7th E - T-Mobile 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Legacy Telecommunications LLC.
Brian
City
Nampa
State / Province / Region
ID
Postal / Zip Code
83687
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
2024 N. Elder St. 83687
Address Line 2
brian@legacytowers.com 2087032183
Building RCE-19785 12/19/2021 18,341.00$
Permit Information
Please enter in the following format: 00-00000
21-00584 SL02446A
1802 North 7th East Sugar City ID. 83440
Acceptance
Sign 9/14/2021