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y ' CITYOFEVERETT ; ' 7385 <br /> � DF PARTMENT OF PUBLIC WORKS <br /> UTILITIES DIVISIO � 19-z�� J <br /> �a`S� W.O. No. <br /> �,c Acct Na /-7 '; �� `� <br /> �� �,Nc Complsint No. <br /> UTILITY WORK ORDER <br /> O�te: � �� > >� (� WATER � SERVICE ❑ MAINTENANCE <br /> ❑ SEWER U MAIN ❑ QPERATiON <br /> ❑ STORM O PUMP STATION � REPAIR <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> j ❑ RESERVOIR <br /> � <br /> + ❑ VAWE <br /> I ❑ MAN HGLE <br /> ❑ CATCH BASIN <br /> ❑ DITCH <br /> ' l.ocat�on: _2 30$ 6 �il'� ✓F <br /> � <br /> i <br /> W.O. Inatructions: n��'�'Ir' w�'r� S�l��-1!ti- _ <br /> I <br /> i <br /> i <br /> � — <br /> j <br /> � <br /> � <br /> ESTIMATED ACTUAL <br /> � labor (hours) . _ Labor(hours) . <br /> Meterial(cost) . Material (cost► . <br /> Equipment(cost) : Equipment(coat) : <br /> SCHEDULING REQUESTED <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR IABOR TIME SLIPS�TEMIZE <br /> LABOR, EQUIPMENT, AND MATERIALS ON REVERSE SIDE. _,_� ;�\ "� <br /> � Completion(Date►: �- '�' �'� Cost:$ <br /> ' Charge Account Number. Charge Cost To(Name): — <br /> Address: Z'p� <br /> j Invoice No.:_ Amount:5 Date: <br /> � <br /> ��e <br />