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� <br />, <br />► <br />1 <br />i <br />; <br />i <br />� <br />I <br />;'�C06T EBTI!(71TE BHEET <br />'�; <br />Receipt # <br />Cost of Work Order $ <br />Cost of Service Order $ <br />Requeated By: ��!'�l %� <br />Property Owner (name) <br />Charqe Cost to (name if different than owner) <br />1lddress <br />InBtallation Location <br />City <br />T f T i_ T I <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 b' %(c -� <br />_ 2ip <br />i• <br />/ /L v <br />Installation type/description/size/etc. 3 S`o� � R• �- �'(% � <br />v/� /��'%17� <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 deposit. <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 charged 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 applying for the installation. <br />itqis�d Cost Esti�at�s <br />Labor & Overhead 3_3 70. <br />Material 7� <br />Equipment Rental ]�i� <br />Surface Restoration (c o <br />Service order Cost <br />Total <br />Prepared by __ �,Cy c-.J c/!� ,� ' G <br />\J� <br />. �(, <br />�` <br />Tim Tyler <br />Don Weitkamp <br />Larry Crawford <br />Tom Thetford <br />Clair olivers <br />Revised 3/15/88 <br />� <br />� <br />I <br />; <br />� <br />