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+ <br />.`.� r <br />r• C(f"''^'1R4"T f7f=lUrVl <br />CITY OF EVERETT <br />! ...:...� <br />t <br />....:..� — DEPARTMENTOFPUBLIC WORKS _ _._.__ t` _,.9000 <br />UTILITIES DIVISION <br />W.O. No. <br />Acct No. Z073 -119 <br />i' <br />Complaint No. <br />UTILITY WORK ORDER <br />E <br />Date: I��WATER <br />❑ SERVICE <br />200'MAINTENANCC <br />1 <br />❑ SEWER <br />eMAIN <br />❑ OPERATION <br />CJ STORM <br />❑ PUMPSTATION. --❑;; <br />REPAIF. <br />❑ TREATMENT <br />❑ CONSTRUCTION <br />I <br />❑ RESERVCIR <br />❑ VALVE <br />❑ MAN HOLE <br />❑ CATCH BASIN <br />❑ DITCH <br />y <br />Location: � 0SC &,f J4NrY <br />/ <br />"iVe- <br />W.O. Instructions: F/ X S C �P{y//r/%� /�J �O /I C',PQ <br />/ Z, / c%P / UG /k- <br />our-e Co" cr /tea/iJ <br />ESTIMATED <br />ACTUAL <br />Labor (hours) 7_ _— Labor (hours) <br />Material (cost) Material (cost) _ <br />Equipment (cost) uipment (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): <br />Charge Account Number: <br />Address: <br />Invoice No.: — <br />; ies _ <br />CoStS <br />Charge Cost To (Name): <br />mount: <br />_Date: <br />