Laserfiche WebLink
f� , j�`7ii; �•i;�. <br />. ��.. ..�-,.,�,,y ; . . . ., <br />CIT1l' OF EVERETT ��� <br />DEPARTMEMT OF PUSLIC WORK�1�yrt`�_ J�. <br />�" 1,1 <br />UTILITIES DIVI810N n W.O. Na . <br />�� <br />H_ 4�6t <br />;,� i,.�i i i �' <br />�-r.J v�-v Acct Na <br />�} 7-�$ - `,— ( <br />; t ���' Comp�eint Na� <br />l <br />11TIUTY WO�3K ORDER <br />Date: �"'—' � WATER <br />❑ 3EWER • <br />❑ STORM <br />LX SERVICE <br />❑ MAIN <br />O PUMP STATION <br />❑ TREATMENT <br />❑ RESERVOIR <br />❑ VALVE <br />❑ MAN HOLE <br />❑ CATCH BASIN <br />O .DITCH <br />,� MAINTE'VANCE <br />❑ pPERATION <br />❑ REPAIR <br />O CONSTRUCTION <br />LOCatbrc �Y�-�yL ^ <br />w.a InsWctioni;: Ip�.f�Fu� jL�� SGPLI� <br />�� <br />ESTIMATED <br />Labor (hou►s) • <br />Meterial (cost) . <br />Equipn;ent(cosq : <br />Labor(hour� . <br />Materiel (cost) . <br />Equipment (Cost) : <br />SCHEDULING REQUESTED <br />USE CHARGE ACCOUNT NUMBFSR BELOW FOR LABOR TIME SLIPS. ITEMIZE <br />LA80R, EQUIPMENT, AND MATfcR1ALS ON REVERSE SIDE. �� ., \ � <br />Completion (Date): � �F�' � h Cost:$ _��— - <br />�� - <br />Cherpe Account Nu�— Charge Cost To (Name): <br />Address: "�—Z�p' <br />Invoice No.: <br />Amount:$ Date: <br />