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HomeMy WebLinkAboutNEEL'S HEATING INTERNET ACCESS.TIF02/05. 07:22 '046632578 PEELS HEATING 8 A/C Par,E 01, CATAWBA COUNTY BUILDING SERVICES PO. WXW9 PERIYM N W,NC 266ct Rv Numner 1818) W-Neo NeMw O FM NYIMH(8201 as 8141 gOM'C w OMn Phom Wmex (82B) W4 M09 Contractor Information for Internet Access papplicaot bottle muldple licenses, a separate application must be submitted for cash liwnes. ALL FIELDS MUST BE COMPLETED OR THEAPPUCATIOH WILL BE MECTED Company name as hated an state license: r✓eels�R /P.. License holdors name as l isted an State License L er rev 1 (It different from Company Name) (First Noma) (M) (Last Nams) License Number WWO Licerse Expiration Date: j3-31- Melrose: r 6 , � 2 Mmfav'11 n)C aYIIS E -mail address: ��LAAeeI3111� rv. (E -mail addresses will be used for notifr-alion) Telephone; 70V-Ip(a3 -aJ.�4 Fax Number. Mobile Call. OalO Nome(s) of any other Qualifier listed on the license: Name(s) of any other person that re authodcad to sign for a pmnit wah Catawba County: slgnmurectappm /. //_ Y= —� `- bate: o - S %O By sgning this applicator, you a intain t seaxlty of the Inyin name and password. password sawdrywal he the full resppnsibllity of Me applicant. The Issuance of a fop-In and owwwo d will allow a person to schedule Inspecdpm for am projects they arc listed an the a contractor. Your Leer name and temporary password with be sets to the emaH address you provided shwa 2111 warmNlnn on ddstorm tavern", This furor can be melted to ow address or either M the fax numbers IIMed above. r✓mocs