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� COST TESHEET <br />Receipt M <br />Puwk woric. nep.rheaie <br />Utpida DirWon, 3200 Ccd�r Street <br />Ererett, W�le�on 98201 <br />(12� 2S7•!!00 <br />Date Paid <br />X Cost of Woric Otder l64.00 Work Order N <br />Cost of Service Order Service Order M <br />Contut Person Bob K�tMrlln Telephone N (4Z6) 739-7a61 <br />Requested By Oo►don WItCMr Date of Request Y-22-Ye <br />Property Owner (name) Tnmmd-Crow <br />Charge Cost to (name if differcnt than owner) <br />Addrcss 4014 lk Wn. Blvd Ciry Kivkl�nd Zip 9�033 <br />lnstallation Location 7th 8 8►uskrud N.E. com�r <br />Installation type/deuription/size%tc. R�IoCat� �xlstln0 hydrant Mhind tM sidwvdk. <br />� The following estimate ia baud upon the Utilities Division providing all labor, equipment, mnterials, <br />mstoration, end final hook-up. <br />❑ 'IT�e following estimate is baud upon the Strcet Division work group providing all labor, equipment, materials <br />and rostoration to property. <br />Whene�er t6e pdm�ted eoat � eot wflleimt to rnver the total ezpeme tor labor, m�terW, eqolpmest renW �ed <br />�dminbintive emb, t6e dcfkil �11 be cAar�ed W 16e propertr tar w6k6 acb Imtall�tloe wn m�de �nd the oweer <br />16ereot, �od provided fWrtl�er, lh�t �ny e:cw p�rmmt �hall be retn�ned to the P��� �PPM�i for the Imtdl�floa. <br />•Deposit muat be patd p�ior W orderina parfs or echeduling work. <br />Labor & Benefits <br />Meteriel <br />Equipment Rentul <br />Surfuce Restorution <br />TOTAL <br />Prcparcd by: <br />Accepted by: <br />cosr�cYo�.ni�wMq.�uvn�� <br />432.00 <br />260.00 <br />172.00 <br />'586�.00 <br />Date Est. <br />cc: BIdQ. Permit Center <br />Clrir Oliven <br />Tom Thetfad <br />Kirk Brook� <br />Gordon Witcher <br />Dan Lowell <br />Smn Mitchell <br />Paul McKa <br />Gerty Crum <br />Alan Locke <br />Preparcd: � Reprcunting: <br />