HomeMy WebLinkAboutWORK ACCEPTANCE FORM LKE & SONS AG LLC - 23-00056 - Rexburg Quality Inn - ElectricalContractor 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
LKE & Sons Ag LLC
Laramie Eckman
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
lkeandsonsag@gmail.com 208-351-3890
Electrical 041993 8/31/2023 2,500.00$
Permit Information
Please enter in the following format: 00-00000
23-00056 Quality Inn
885 W Main St
Acceptance
Sign 2/8/2023