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1 <br />1 <br />�1 <br />�1 <br />F <br />a <br />C08T EBTIHATE BHEET <br />Receipt # � <br />X Cost of Work Order � <br />_ Cost of Service Order <br />Contact Person <br />$ <br />PUBLIC WORKS DEPARTMENT <br />UTILITIES DIVISION <br />2300 CEDAR STREET <br />EVERETT, WASHINGTON 98201 <br />(206) 259-8800 <br />Date Paid 9-Z3_9/ <br />Work Order # <br />$ Service Order # _ <br />Telephone # <br />Requested By: (7orcton Wi7�clner Date of Request `j /9 �'i/ <br />Property owner (name) r/ti � l� G �l t/ «� <br />Charge Cost to (name if different than owner) <br />Address .S�i � � �� Gi vr�� City �✓G"t ( / Zip <br />� f . . � /l <br />�jinstallation Location !�5 :LT %7� !Z /-riryC <br />! � /� / / <br />Installation type/description/size/etc. /Ar/G l� f9rG� Tir't Gt N O�h?�tf <br />cort <br />(�(( The following estimate is based upon the Utilities Division <br />providing all labor, equipment, materials, restoration, and final <br />hook-up. <br />[ j The following estimate is based upon the Street Division work'group <br />providing all labor, equipment, materials and restoration to <br />property. <br />Whenever the eetimated coet ie not euffic:ent to cover the total expenee for labor, <br />material, equipnent rental and adminietralive coete, the deficit ehall be charged to <br />the property for which auch inet'allation was made and the owner thereof, and previded <br />further, that any exceee payment shal'� be retuined to the person applying for �the <br />installation. <br />Itemized Cost Estimate: <br />Labor & Overhead <br />MaY.erial <br />Equipment Rental <br />Surface Restoration <br />Total <br />Yrep <br />Accepted <br />6 7 �-- <br />�� /Q <br />� <br />cc: Bldg. Permit Counter <br />Clair Olivere <br />Tom Thetford <br />Don Weitkamp <br />Kirk Brooke <br />cordon witcher <br />O. Don Wahl <br />Dan Lowell <br />Stan Nitchell <br />Representing <br />a.i..a oe/ia/ai <br />v <br />