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C08T E8TIM71TE BHEET <br />Receipt � <br />Coat of Work Order <br />S <br />Cost of Service Order $ <br />Requested By: / �ti � <br />Property owner (name) <br />Charqa Cost to (name if different than owner) <br />Addresa <br />Inetallation Location <br />_ City <br />'�i �//�-G <br />Installation type/description/size/etc. <br />/. <br />lr1 %�.Z• .t� ; ,. � f ,. �t y .,, <br />PUBLIC WORKS DEPARTMENT <br />UTILITIES DIVISION <br />2300 CEDAR STREET <br />EVERETT, WASHINGTON 98201 <br />(206) 259-8800 <br />Date Paid <br />Work Order � <br />service order # <br />Date of Request �6 �8 <br />zip <br />O� � �/h�2 <br />� � � i�.¢/! �..�D -"� �•� <br />/-.�i� 7`- / w_ s 7`,s //A7`ie .. <br />The followinq estimate is based upon the Utilities Division providing <br />all labor, equipment, materials, restoration, and final hook-up. A <br />double check valve assembly for temporary service is available from the <br />City�s Permit Counter by requestinq a Hydrant Use Permit with an <br />additional depoeit. <br />Whenever the estimated cost is not sufficient to cover the total expense <br />for labor, material, equipment rental and administrative costs, the <br />deficit shall be charqed to the property for which such installation was <br />made and the owner thereof, and provided further, that any excess <br />payment shall be returned to the person applyinq for the installation. <br />ituis�d Cost Estioat�: <br />Laboi & Overhead _� 3 7 � <br />Material !� 3 i 3 <br />Equipment Rental % �{ � <br />Surface Restoration �Oo <br />service order Cost <br />Total '� <br />i� <br />Prepared by �r �_ �` <br />��`� <br />i <br />Tim Tyler <br />Don Weitkamp <br />Larry Crawford <br />Tom Thetford <br />Clair Olivers <br />Revised 3/15/88 <br />