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CITY OF EVERETT PUBLIC WORKS DEPARTMENT <br />WORK ORDER APPLICATION W.O. *: a U l 1 a �I C� <br />Date Initlated: /L , (7 - / / <br />Initlated by: �J , lie / o le Ext: D �� <br />Project Title : Stems• i..olll.! <br />re, e,+ <br />Description of Project (Location, who, <br />what, when, whY): 3: qve <br />Cross Reference: <br />_ — — <br />---I ❑ State $ <br />Operahnq <br />❑ Grant I <br />Funding: $ <br />g: ❑ Federal <br />T of Pro <br />Type �: ❑Upta' <br />tmergency <br />Local $ <br />Estimated <br />Estimated Completion Date: /� vr Gl <br />&ee <br />Pro)edCost: <br />- _--- -- An <br />Chargeable to: ❑ Utilities <br />❑ Engineering XStreets ❑Other <br />-- <br />Date: <br />Managers Approval / <br />/d % ?- <br />Signature: <br />FOR FINANCE USE ONLY <br />Job Cost Number(s): <br />Cassworks Number(s): <br />Date: <br />Verified JC ft for Duplication ❑ <br />JC Entered by: <br />Comments: <br />Finance Manager's <br />Date: <br />Signature: <br />\.1,m- .0104,9.b 10 ii W) <br />