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�� .. r � .��. . . <br /> PUBLIC WORRS DEPARTMENT <br /> UTILITIES DIVISION <br /> COBT E6TIlf�TE BHEET 2300 CEOAR STREET <br /> EVERE'1T, iJASHINGTON 98201 <br /> (206) 259-8800 <br /> Receipt � �J �B Date Paid ��c�_ <br /> Cast of Work Order $ Work Order � <br /> ___g__ Cost of Service order $ 7560 Service Order ; �7g <br /> Requested By: Gordon Witcher Date of Request 7-29-88 <br /> Property Owner (name) Holidav Retirement Coro. <br /> Charge Cost to (name if different than owner) <br /> Address 2741-12th St. S.E. State Salem, oreaon 2ip 97302 <br /> Installation Location 3915 Colbv <br /> InsYallatinn type/description/size/etc. Excavate 8" main, hot tao, in- <br /> " o e c or ec c v u t sto e . <br /> C /' U <br /> �o � V`Q .S� ru,`?_Q <br /> The followinq estimate is based upon the Utilities Division providing <br /> all labor, equipment, materials, restoration, and final hook-up. A <br /> double check valve assembly for temporary service is available from the <br /> City�s Permit Counter by requestinq a Hydrant Use Permit with an <br /> additional deposit. <br /> Whenever the estimated cost is not sufficient to cover the total expense <br /> for labor, material, equipment rental and administrative costs, the <br /> deficit shall be charqed to the property for vhich such installation was <br /> made and the owner thereof, and provided further, that any excess <br /> payment shall be returned to the person applyinq for the installation. <br /> it�ais�Q Cost ssii�at�: � <br /> Labor � Overhead 3360 cc: Tim Tyler <br /> Material 3500 Don ileitkamp <br /> Equipment Rental 600 J,arry Crawforl <br /> Surface Restoration 100 Sob Chervenell <br /> Service Order Cost 7560 Clair Olivers <br /> Total 7560 <br /> Prepared by O. Don Wahl <br /> � n' � ' Revised 3/15/88 <br /> �`"�'�'� <br />