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•..,�....i '.r:..,.. ,� � .� , , . . .. .... .. . . . ;�. � . ..ec. t'-�...__ �. <br /> � <br /> CITY OF EVERETT <br /> "" ` '=�'" DEPARTMENTOFPUBLICWORKS ��- �Q7� <br /> , - ; � <br /> :..� ,,:--. - . <br /> � � - UTIUTIES DIVlSION � _ <br /> r. . �. . W.O. No. <br /> � <br /> ; 4 �_. _ _ -. . -/1/� �ST/A/E� Acct No. �7S :1� 9 . <br /> �. . , —n. . . _ ' . . . . � - �� . <br /> Complaint No. <br /> UTILITY�WORK ORDER <br /> Date: �-� I� Sy � WATER � SERVICE 1'� MAINTENANCE' <br /> ❑ SEWER ❑ MAIr?' ❑ OPERATION <br /> " ❑ STGRM ❑ PUMP STATION � REPAIR i <br /> - - ,:.. <br /> , ❑ T9EATMENT ❑ CONSTRUCTION <br /> . � � ❑ RESERVOIR I <br /> � ❑ VALVE <br /> O MAN HOLE <br /> O CATCH BASIN <br /> - f� DITCH <br /> r <br /> Location: �.3 I � D�L G AA1 AO DR -- <br /> W.O. Instructions: � EPLf�GE /J'/�7Y,rP BaK K��'7'N co�c�P� BeX�it�i'7{f <br /> _ F�►-�- STEIGI LI D �� .Pt►I SE 2 �� <br /> ESTIMATED ACTUAL <br /> Labor(hours) . Labor(hours) . <br /> Material (cost) . Material (cost) . <br /> ; Equipment (cost) : Equipment (cost) : � <br /> , .: ... _.. . <br /> , _. . n .:,. . :. _ _.. . . <br /> -`.`'- •SC;IEDULING �REQUESTED � ' <br /> �rr�::....•;:...`. } _..: . , . . <br /> .:" ,�'.','i _ . . . . <br /> - ::,,y;,.USE.CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE <br /> � •;• LABOR EQUIP�1ENT, AND MATERIALS ON REVERSE SIDE. <br /> ,� k ..... .�,* , - <br /> � �"4.�.+'�r~ y <br /> , Co qlehon (Date) ��'� Cost:$ , <br /> -'•��. GhaigerA�ccount Number. ' Charge Cost To(Name):' ' <br /> � '�.�. '•1nV`��� 4 .. �� .. � . .. � . .1i . '? � .. . . <br /> �I11�1 ^a Y • <br /> � Qd'dress .r �� '. .t' Zip:. _ . <br /> ', - . . . ••. .- <br /> :._ <br /> x ;s. 'r.'�.,:`... ._ � ' Amount:$ Date: <br /> - `�In4oice No.; <br /> - J . <br /> ��BS � <br />