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j .. <br /> � PUBLIC `+OrZKS DEPhnTH:1�T <br /> � U'?'ILITI£S DIVISION <br /> C ST ES:IY.:,TE SY.E�T 3200 CEDT,R STRE�T <br /> EVERETT, WASHINGTCN 95201 <br /> (206) 259-8800 <br /> Receipt r ��'7� Date ?aid T/SOU 7-//'4}` <br /> ✓ Cos� o= Work Order � 7 �'� Work Order r <br /> Cos� oP Service O:de� $ Service Orde: r P�ry�_ <br /> Con�ac� Pe.son: I� OQ �.9� ��� 7 Telephone r ��af'S76u1 <br /> Rer�uested By: �Av�- Me �C�� Date o_` Request �' ��5� <br /> .-- �_ <br /> prroe��y Owner (name) /S SU� S ��� � <br /> Ch�rge Cost to (name i� diiferent than o:+ner) ��'�_ <br /> � y 8'vTS� <br /> . Ad:�ress .3 � b - l 0 8� �� 5,�.� s�a6 /3EL�[ldtf Zip <br /> Ins.tzlla�ion Locz�ion �`�/ `C E/���9'����J���{ �`"���°'f�� ��'20� <br /> :ns�zllation ��voe/descri�tion/size/etc. • � - <br /> S � txr� �f•%/yd,er9•✓T7e f',J�s� ��2� dc <br /> [^` Tre following estima�e is bzsed uaon �ne U�ili�ies Division <br /> p=oviding ell labor, eauipnent, nat�rials, res�oration, and =ina1 <br /> hook-u5. <br /> � � ; The =ollowing estimate 15 bzsed UD071 ��1e S�reet �1V1510T1 WO'_"}: C'_'DL'D <br /> D:o�io�ng c�l labor, eauipment, mz�e=ials 'di1C� res�oration LO <br /> pro�er�y. <br /> l:henever the estim�ted cos: is not sv`:icient :o cove_ the :o:�l eanense :o: labo:, <br /> � • ' 've cos=s the de:ici� sh�ll be cha:aed �o <br /> '� nz:�.-.:al, ecciamen: ren:a_ and adm_n_s�ra:_ � . <br /> =he n=ope_cy `o= �hich such ins:z?lz:ion was mzde and �he ovne_.chereo`, znd n=ov:ded <br /> � - `ur2?ie:, tha� any excess paymen� shall be zeturned to :he pe:son �o??ying :o= :he <br /> 'insta2lztion. � <br /> Ite3ized Cost Estimate: ' <br /> Labor ��& bverhezd . _���� � cc: aldg. �e:mi� covater <br /> . . Clz±z olivers <br /> N,aterial � �7 ��i• oU Tom Thet_`ord <br /> • Don h'eitkamp <br /> £quipment Rental � 6� xirk �rooks <br /> o=don H'itcfie= <br /> Su=face Res�o�2`..lon • / qL/ o. Don S:ahl <br /> �/� �/��/77 Da Lo�+ell <br /> Totzl ��__1�f� � SOO� an H'_�chell <br /> PTepzred �b�l �— <br /> Acc.pted Renr=senting ���M�� <br /> �..�..� oEnbr9, <br /> .� — <br />