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. CITY OF EVERETT <br /> DEPARTMENT OF PUBIIC WORKS `• �`-' � � 52 <br /> UTILITIES DIVISION <br /> W.O. No. _ <br /> Acct. No. S: � S �) y <br /> UTILITY WORK ORDER Complaint No. <br /> Dste: �" !�J �� � WATER 1f�SERVICE � MAINTENANCE i <br /> ❑ SEWER O MAIN ❑ OPERATION <br /> ❑ STORM ❑ PUMP STATION ❑ REPAIR <br /> O TREATMENT ❑ CONSTRUCl'ION <br /> ❑ RESERVOIR � ���._� r��� <br /> ❑ VALVE ��'PL � � <br /> ❑ MAN HOLE �� � E <br /> onrt <br /> ❑ CATCH BASIN <br /> O DITCH <br /> Location: _�z $ � � 1�il K I'+? /1�-� <br /> W.O. Instructions: G�L��G� / r� jh T� �•%�� <br /> 1 <br /> _ .n�a�'—� g �� � — <br /> G- � <br /> --- , - <br /> ESTIMATED ACTUAL <br /> Labor(hours) . _ Labor(hours) . _ <br /> Materlal (cosq . Material (cosq . _ <br /> Equipment (cost) : �______ Equipment (cosq : ___ _ <br /> SCHEDULING REQUESTED <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIh1E SLIP�. ITEMIZE <br /> LABOR, FOUIPMENT, AND MATERIALS ON REVERSE SIDE. <br /> Completion �Date): 2'13" q� Cosk$ _ _ <br /> Charge Account Number. Charge Cost To (Name): <br /> Address: _ _Zip: <br /> R� <br /> Invoice No.: Amount:$ Date: � <br /> i;es <br /> � <br /> i <br />