HomeMy WebLinkAboutWORK ACCEPTANCE FORM MITCH HARRIS CONSTRUCTION LLC - 23-00426 - Chocolate Plunge (Dippin Bar) - RemodelContractor 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
Mitch Harris Construction LLC
Mitch Harris
City
St. Anthony
State / Province / Region
ID
Postal / Zip Code
83445
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
P.o. box 56
Address Line 2
330 n. 2600 e.
mharriscon@gmail.com 2083136893
Building RCE31854 5/19/2024 $
Permit Information
Please enter in the following format: 00-00000
23-00426 Dippen Bar
155 w. main #3 Rexburg Idaho 83440
Acceptance
Sign 7/11/2023