HomeMy WebLinkAboutWORK ACCEPTANCE FORM FOR IDAHO TOWER CONSTRUCTION - 22-00152 - 1145 S 2nd E - T-Mobile Cell Tower Anchor ProjectContractor 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
Idaho Tower Construction Company
Dwayne Ernest Robinson
City
Hailey
State / Province / Region
ID
Postal / Zip Code
83333
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
400 S Main St Unit 201
Address Line 2
dwayne@idahotowerconstruction.com 12086157433
Building RCE-43 8/22/2022 $
Permit Information
Please enter in the following format: 00-00000
22-00152 T-Mobile Anchor Project
1145 S 2nd E
Acceptance
Sign 3/17/2022