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- - i.:,-- :<<.y __ .�_ <br /> d CITY OF EVERETT �-_-- . � � 2 � 9 <br /> -� :, ��::,c.��;-N° <br /> _�H DEPARTMENT OF PUBLIC WORKS � -.,,���.�--� <br /> �- �,� <br /> -;.`� � UTILITIES DIVISION W O. No. <br /> A�S - , 1 .� -�- -- <br /> �= G 71 <br /> a N N Accl No. /� � - <br /> y z� Complainl No. —----- <br /> �-t n <br /> � H� UTILITY WORK OE?DER <br /> ;-3 �["' Date: � � WATER ❑ SERVICE Cl MAINTENANCE <br /> ia o� � _ SEWER �. 64AIN ❑ OPERATION <br /> H t7 <br /> C ❑ STORM ❑ PUMp STATION ❑ REPAIR <br /> � �O ❑ TREATN,ENT �1 CONSTRUCTION <br /> c�� cC� <br />+ ��" z y3 i� I�ESERVOIR <br /> 9 ��!T1 <br /> t" H y ❑ VALVE <br /> g �'H ❑ MANHOLE <br /> p t7 N <br /> � �r, ❑ CATCH BASIN <br /> y0� �j� � iJ DITCH ^ <br /> /.�f� r �� <br /> j_`'�y\1 _ - - - <br /> - --- --- -- <br /> Location:,`� .;,r � - - .y� / <br /> -- <br /> - <br /> Q��B �y "!' �}' �,f'/�'/pL.-.._�2T/1_y�C _1'�1Q1 - <br /> W.O. Insiruc�ions: .—/.—/"-�- --- �-t'- �� <br /> �au 74' _-- __.. . <br /> � �. <br /> TC� <br /> '-__._- —�}.� <br /> ry�.. ..�1 �—�--- ( �1 L �r , . <br /> yyy y� 6� <br /> .. .� . f},��__'��1--' l NT�L`� <br /> - �, �,D ,� � � � <br /> 9C - e - _ . _ <br /> � —�N.o�-- - - <br /> ---- - <br /> � g,! �Iwp� 5 .TT,� i�2$=9 . ---- — _ <br /> ,,,,. ------- <br /> ESTIM�TED ACTUAL <br /> Labor(hours) <br /> ' � � Labor (hours) ----- ' ---- — — <br /> Matenal (cosq --- --- <br /> Malerial (cost) <br /> � � E d Equipment (cost) : —.---� -. -- Equipment (cost� : — -- <br /> � �--_ <br /> SCHEDULIi�IG REQUESTED <br /> USB�CH EQUEPMENOTUAND MATERIALS ON ROEVERSEOSIDE-. E SLIPS. ITEMIZE <br /> ComPletion (Date): —_-- ---- <br /> Cost:S --- _ __- <br /> Charoe Account Number:_ _Charge Cosl To(Name): - - - <br /> --7.in:--_-- - <br /> Address: . -- _ _ ---- <br /> _D&te: _ . <br /> � _ ._. _AmounCS.. _-_ .. . _- --__ _.- -- ._. . <br /> :nvoire Nc.'.-----�- - - . <br /> vos <br />