|
....�'%)I� ��� .. . . �.. .r�� �.... .. .. .:. .-.. ._
<br />� � `�:3�wlSNtb .'���1'...� ..�.�.4���.. �1`..�.vN{'��i�iJ.: N :�bi�}•(.y.l�ybJMtYT��'•If.'1r�1.:t.:,���.d�:'.
<br />�, r r..' , . . .. ' ::CITY OF EVERETf;: ,, , r ,
<br />��-'�� . �.DEPARTMENT OF PUBLIC WORKS ; t'�-�; � � S � �
<br />';
<br />UTIL{TlES DIVISION . "' � : '
<br />.. , . ,,.
<br />; W O No.'
<br />/ //
<br />� ..�- ,� KiQ�xl3 Z�-~�. . . Acct No.; �(� `� i ,
<br />.. l fl S � C z�1 zs: �f :' � ' : . C`\'� FBoaE �Z�n� � ``
<br />. .. C ��p�� �0 0-� ... . � .
<br />UTILITYWORKORDER i�'JeTv� Rcp/�<<^��,���0��-�2aA'. ::"� ,
<br />Date:.'S�`Z'� `' � s � WATER ❑ SERVICE' - � MAINTENANCE <'
<br />❑ SEWER ❑ MAIN - ❑ OPERATION -
<br />❑ STORM ❑ PUMP STHTION ❑ REPAIR
<br />❑ TREATMENT ❑ CONSTRUCTION =' . ..
<br />❑ RESERVOIR
<br />❑ VALVE .- . , .
<br />❑ MAN HOLE
<br />❑ CATCH BASW
<br />❑ DITCH
<br />Location: %e�0� /IO��C� �riida',����7`Ave,cN K � �-Z$- �
<br />W.O. ir,structions: /'`'�07 ��@��rf€'1/��d_��f�l��`� C; i3-��-�-1
<br />q��� , � � �/��Sd�j�.T� � �'3 -Zfi-�
<br />/
<br />/�o�B „ � � (�% 13 _ZX-'-�
<br />�i yB 4� " � � �'�ii��h�%c � � 3 - zs- �+
<br />,., . _
<br />/A,3/� �, i� /�Yay,�� .lE zSF-z�-�
<br />���� � ve�%r�enl[�ay X (3=.z�-�/ .' _ _
<br />.. . . � `L�OS- . � .. . � . � ..�^�S�1A .
<br />� uT F11S(o . . . � . � � .
<br />�.:�.� �. .. .. . . . . . . _ . . . . . . ..
<br />. . � , -METEP� . .. . . . . . _ .
<br />R�PLrtcE�
<br />_ , .
<br />; _: �-2Z-�9 _ ,
<br />ESTIMATED ACTUAL '
<br />Labor(hou�s) Labor(hours) .
<br />Maierial.(co��t) . ; _Material (cost) . .
<br />Equipment (oost) :; _ Equipment (cost) _:
<br />,. _ .
<br />' SCHEDULIiJG REQUESTED ' ' ' ' '
<br />. �:'
<br />USE CHARGE ACCOUNT NUMBER BELOW f'OR LABO TIME SLIPS. ITEMI E`
<br />LABOR EQUIPMENT, AND MATERIALS ON REVERSE� �� "
<br />S •Ws���° ,
<br />=.. �i t�.. � .a ' � �, _: :�� .1
<br />Completion„(Dafe), Cost$ ` ~
<br />, , �, . � . ,. ;,r
<br />.:��� n 4'Y' ..r ... , _:; �.. .._' . . ,.
<br />. . . � � . .: -.;,, ' s. . �. ';_ �... j' ! a � 1
<br />..° Cliarge Account Number, 'Charge Cost To (Name)
<br />.._�E . ,.:�_:, .. _,. r .� �. _�.�� .�, ..�y, — cx
<br />Addres{s ' _ - - Zip.f— --- ' _
<br />Invoice No.: _AmountcS Date:
<br />
|