HomeMy WebLinkAboutWORK ACCEPTANCE FORM ECOCON LLC - 22-00257 - Denny's in Rexburg - 585 N - 2nd E - SignContractor 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
Ecocon LLC
Tod Peterson
City
Burley
State / Province / Region
ID
Postal / Zip Code
83318
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
105 E 400 S
Address Line 2
tod@a1booth.com 208-670-3026
Building RCE-40181 8/6/2022 11,586.00$
Permit Information
Please enter in the following format: 00-00000
22-00257 Denny's/Rexburg
585 N 2nd E
Acceptance
Sign 4/14/2022