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Receipt � <br />X <br />Contact Person <br />�l PUBttcWoaxsDer,�Fr�fE�7 <br />UtiliHes Division, 3200 Cedar Strcet <br />E•vcrettlVA 93'_'01 <br />�}25-bi SS00 <br />Cost of 4Vork Order <br />Cost of Servim Order <br />300.00 <br />�1121d-oU� <br />Date Paid <br />Work Order# <br />Service Order # <br />Telephone � <br />Reyucstedi3y GordooWitcher DateoERequest 7/24H2 <br />Property Owncr (name) State of Washington pept of Gnr Adm Div of Eng 8� Arch Services <br />Charge Cost to (name if difEerent than owner) <br />Address PO Box 41012 Ciry Olympia Zip _ 98504 <br />Insfallation LocaHon 930 N Broadwa , Index Hall <br />installation rype/descripGon/sve/etc. _ Replace meter on contraetor installed DCDA. _ <br />� The following esHmate is based upon the UtiliHes Division providing all labor, equipment, <br />materials, mstoration, and final hook-up. <br />Please notify the Ci� of Lverett Utilities Division 10 workine �s in advance of required installation <br />date to �llow for scheduling and parts vrocurement <br />W'henever the estimafed cost is not sufficient lo cover the total ex�ense for IaHor, material, equipment rental and <br />administrative costs, tfie deEicit shall be chuged to Hie properry for which such installation was made and the <br />owncr thercof, and provided furtheq that any excess payment shall bc retnrned to the person applying for the <br />installation. <br />*Deposit must be paid prior to ardering parts or schednling wack. <br />WATER ME7tR5 3"AND LARGER 1�iAYHAVE A SIX TO 10 LVEL-K LEAD TlitilF_. <br />hlatcrial <br />Labor and Benefits <br />C-yuipment Rental <br />Tax <br />245.00 <br />35.00 <br />15.00 _ <br />5.00 <br />cc: Bldg. Pemtit Center <br />htark Sadler <br />Kirk Brooks <br />Gordon Witdier <br />Matt WelUorn <br />Mi�.e Ward <br />Randy :'.11en <br />TOTAL 300.00 <br />Preparcd by: � C �', Datc C-stimare Prepar:d 8/1112 <br />;1�ceptcd by: w Representing G. !�(��" <br />I STI�I:\TG GOOD FOR 6 D10NTHS <br />ti. :Comm�•n cicn:al�Co,i cnC�01^_`. <br />lofl <br />