HomeMy WebLinkAboutWORK ACCEPTANCE FORM COLT BLASER LLC - 22-00262 - 7N Apartments - Bldg 3 - 4 PlexContractor 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
Colt blaser llc
Colt blaser
City
Saint Anthony
State / Province / Region
Id
Postal / Zip Code
83445
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
6787 north 4000 west
Address Line 2
cblaser23@gmail.com 2082013010
Building RCE-50299 2/8/2023 210,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00263 7N apartments
676 Carlow street Rexburg id 83440
Acceptance
Sign 6/20/2022