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C08T EBTIMl1TE 88EET <br />Receipt A <br />Coat of Work Order <br />S <br />Coat of Service Order $ <br />Requested By: �iYl'l � <br />Proparty Owner (name) <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 ii <br />Service Order # <br />Date of Request d - �6�� <br />Charqe Cost to (name if dilfarent than owner) <br />1►ddress <br />Installation Location /o �i <br />City <br />Installation type/descri�tion/size/etc <br />�- � ��a- � n <br />zip <br />� <br />l K 57`�� / 3 0� -F <br />o.- � — � ' ` �e,�,�,�v. <br />The followinq estimate is based upon the Utilities Division providing <br />all labor, equipment, materials, restoratlon, and final hook-up. A <br />doubla check valve assembly for temporary service is available from the <br />City's Parmit Counter by requesting 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 />delicit shall be charqed to the property for which such installation was <br />sade 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 Estiaat�: <br />Labor & Overhead <br />Material <br />Equipment Rental <br />Surface Restoration <br />Service Order Cost <br />Total J / <br />Prepared by LJ�,��l . C�c/Q�L�X <br />cc: Tim Tyler <br />Don weitkamp <br />Larry Crawford <br />Tom Thetford <br />Clair Olivers <br />�'� �°g� <br />� , <br />�L �� \ Revised 3/15/88 <br />� � <br />� �,� 4� �\ <br />, <br />���'` ,�QV c.��`� . <br />�� � <br />� <br />