HomeMy WebLinkAboutWORK ACCEPTANCE FORM HILL & SON EXCAVATING - 21-00586 - Just4Kids Pediatric Urgent CareContractor 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
Hill and son excavating
Chad Harding
City
Rexburg
State / Province / Region
Id
Postal / Zip Code
83440
Country
Usa
Update new contact information that is not already on file with the City of Rexburg
Street Address
P.O. Box 886
Address Line 2
erin@hillandsonexcavating.com 2084584401
Plumbing Pwc-c11840 6/30/2022 8,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00586 Just 4 kids
1218 bond ave rexburg 83440
Acceptance
Sign 10/29/2021