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<br /> i I _ k ,3 � "CITY JF EVE,RETT 4 '. . . -
<br /> i i �� j ` ` DEPARTMENTOFAUBLICWORKS ��`` � 5�
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<br /> ^ UTILITIES DIVISION . > > = ` �
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<br /> Complaini No �`�� '
<br /> UTILITY WORK ORDER . , :,,;,.k ,��p/���� � .7-
<br /> Date: S �G " b y �S WATER ❑ SERVICE � MAINTENANCE :� � '
<br /> ❑ SEWER ❑ MAIN . ❑ OPERATION
<br /> ❑ STORM ❑ PUMP STATION ❑ REPAIR
<br /> ❑ TREATMENT ❑ CONSTRUCTION
<br /> ❑ RESERVOIR
<br /> ❑ VALVE
<br /> ❑ MAN HOLE
<br /> ❑ CATCH BASIN
<br /> ❑ DITCFi
<br /> Location: V �� ����r�� l�J.�1 ��/� �
<br /> W.O. Instructions: ��E� � // �r��° �"/'� �� �/� 3// �r'�
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<br /> ESTIMATED ACTUAL
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<br /> Material (cost) . Material (cost)
<br /> Equipment (cost) :. Equipment (cost) : '
<br /> • � . -_ _
<br /> SCHEDULING REQUESTED -
<br /> USE CHARGE ACCOUNT NUMBER BEIOW FOR LABOR TIfNE SLIPS:'ITEMIZE ';, ' "
<br /> LABOR, EQUIPMENT, AND MATEflIALS ON REVERSE SIDE..�: . .
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<br /> Completicn (Date) J �� � cost:$ � �
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