Laserfiche WebLink
CITY OF EVERETT a�y�b� t J� �S � 3 <br /> DEPARTMENT OF PUBLIC WORKB :�'�� � <br /> UTILITIES DIV1810N� x �—Z $ � <br /> W.O. No. <br /> GE�Y" ,/ /g� Accl No. /,7 5 � �� <br /> � <br /> � '� r� Compialnt No. <br /> UTILITY WORK ORDER <br /> D�te: , l � � 7 � WATER C�Y SERVICE p' MAINTENANCE <br /> ❑ SEWER ❑ MAIN D OPERATION <br /> ❑ STORM ❑ PUMP STATION O REPAIR <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ RESERVOIR <br /> O VALVE <br /> ❑ MAN HOLE <br /> O CATCH BASIN <br /> ❑ DITCH �� � <br /> �� ! <br /> �ocaUon: � �1 �R�s'f GAS I NO <br /> N'.O. Inat►uctions: K� 1 1 S i ,d'�I�L <br /> ESTIMATEO ACTUAL <br /> L�bor(hour� . Lebur(hours) . <br /> M�te�ial(cost) ._ _ Matsrlal(cost) . <br /> Equipment(coeq : Equipment(cost) : <br /> � BCHEDULINd REQUESTEO — <br /> t USE CHAROE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE <br /> � LABOR, EOUIPMENT, AND MATERIALS ON REVERSE SIDE. <br /> Completion(Dete): � Coat:S <br /> iCharpe Account Number. Charge Coat To(Neme): <br /> � Address: Z�p'" <br /> Invoice No.: _Amount:3 Date: <br /> .�na <br />