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xService Request # <br />Date Issued <br />Issued By <br />City of Everett Work Activity <br />_- - <br />00151709� _�'i <br />. <br />�.___..�_. .� <br />Xbzitials <br />Work Order Information <br />WO# Assigned �-� �' � �`'` = P `� �� _ _� <br />*Full �zame <br />Fund 12� �' S' Program 840 Function 108 Activity 611 <br />� <br />*Job Cost No. <br />Title <br />. _ . _ ..__�. _._ ---�. <br />�2------ _ �� _ �.. ---� *Project No. � _,. .�. � <br />Sidewalk Replacement '� <br />*Rel. WoJ°k Order 20050387 Y' Y� ���� <br />Address <br />Pre-direction Street <br />-- - - . _ <br />_ _,_ <br />, 2323�__�_a__�.�.._, � Rucker I <br />x ��� � - - <br />''`If not "Everett" specify which City <br />Problem Information <br />Street Type Post-direction <br />__ - <br />Ave ' <br />Structure/Equipment Information <br />. _. .._.. _ � ._ __.. ._� ._ _ <br />Struct/Equip Type � - - ' Problem I <br />Struct/Equip No. _ _ _ ' Sub Problem <br />Structure/Equipme�zt type when applicable <br />,� _ _. . � ..� � <br />*Feet � �'� *Description _ _ _ . _ <br />*Con�ments Bill to : Rob & Kelly Hallum �, <br />2323 Rucker Ave. Everett WA. 98201 <br />�Concf•ete . S cu. yd. (a� $98.50 per c _ ._.. ' . Y <br />u. yd. $492 50:� '� <br />Bold 'I'ype =1Vlanclatory �ields to be po�sulated <br />'�`Italic = Optio»al fields <br />