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� CITY :iF EVERETT <br /> DEPARTMENT OF PUBLIC WOHKS ��'-- �q 6 � <br /> UTILITIES DI'JISION <br /> �� Z� '���— � W.O. No. <br /> {,D.r= ; — �/�a Acct. No. _l,7 5 1` � <br /> r <br /> v D � �-�''� �'�' j Complaint No. <br /> UTILITY WORK ORDER <br /> Date: S �7-!�� �P� WATER ��SERVICE ❑ MAINTENANCE <br /> ❑ SEWER � A•IAIN ❑ OPERATION <br /> ❑ STORM ❑ PUMP STATION tPS REPAIR <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ RESERVOIR <br /> ❑ VALVE <br /> ❑ MAN HOLE <br /> ❑ CATCH BA31N <br /> ❑ DITCH <br /> ��,-����R�� � <br /> Location: �5�4F � '1 <br /> W.O. Instructions: �r �"� �' � /-Lr- - <br /> �� li <br /> � � <br /> i <br /> '/,7�j�, <br /> ESTIMATEU ACTUAL <br /> ILabor(hours) . Labor(hours) . <br /> Material (cost) . Material (cost) . <br /> Equipment (cost) : Equipment (cost) : <br /> SCHEDULING REQUESTED <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE • <br /> LABOR, EQUIPMENT, AND MATERIALS ON REVERSE SIDE. ,:. , <br /> Completion (Date) s��B / -' Cost:� <br /> +, <br /> <�� Charge Account Number: =• Charge Cost To(Name): `'� Y <br /> ., _ , :. ., .: . . <br /> . ,... <br /> . _ _ . � <br /> � Address. ' . . Zip. - <br /> � Invoice No.: Amount:S Date: <br />