HomeMy WebLinkAboutWORK ACCEPTANCE FORM GENERAL DYNAMICS - 23-00175 - Dish Wireless Tower ModificationsContractor 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
General Dynamics
Rocky Mattison
City
Pocatello
State / Province / Region
Idaho
Postal / Zip Code
83204
Country
Bannack
Update new contact information that is not already on file with the City of Rexburg
Street Address
948 N. Harrison
Address Line 2
rocky.mattison@gdit.com 801-201-0566
801-201-0566
Building RCE-41098 1/15/2024 64,220.00$
Permit Information
Please enter in the following format: 00-00000
23-00175 Dish wireless
155 EAST 2ND NORTH REXBURG, ID 83440
Acceptance
Sign 8/15/2023