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925 PINE ST 2016-01-01 MF Import
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925 PINE ST 2016-01-01 MF Import
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Last modified
5/18/2017 1:28:19 PM
Creation date
2/24/2017 3:51:36 PM
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Template:
Address Document
Street Name
PINE ST
Street Number
925
Imported From Microfiche
Yes
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• ' � <br />� <br />• • . ' CITYOFEVEREIT �.�?__ F�"��� ,r.��_�e: %BO4 <br />, x�,,, r:�� �-r-F <br />4EPARTMENT OF PUBLIC WORKS G- ��_�?-- �; <br />UTILITIES DIVISION W � Na �� U� <br />Acct No. �07 �` � <br />UTILITY WORK ORDER <br />Date: � -' � � [f WATER <br />❑ SEWER <br />❑ STORM <br />y'a.� �� � <br />� Location: <br />a <br />�O{ <br />� SERVICE <br />❑ MAIN <br />❑ PUMP STATION <br />❑ TREATMENT <br />❑ RESERVOIR <br />❑ VALVE <br />O MAN HOLE <br />❑ CATCH BASIN <br />❑ DITCH <br />� <br />Complainl Na <br />❑ MAINTENANCE <br />❑ OPERATION <br />O REPAIR <br />O CONSTRUCTION <br />/! <br />, . ' - � '-. -- ._i;f��7_�m <br />ESTIMATED <br />Labor (hours) . <br />Material (cost) . <br />Equipment (cost) : <br />ACTUAL <br />Labor (hours) . <br />Material (cost) . <br />I Equipment (cost) : <br />SCHEDULING RE�UESTED <br />USE CHARGE ACCOUNT NUMBER BEIOW FOR LA80R TIME SLIPS. ITEMIZE <br />LABOR, E�UIPMENT, AND MATERIALS ON REVERSE SIDE. <br />Completion (Date): / � �s b � Cost:S <br />Charge Account Numbar: <br />Address: <br />Charge Cost To (Name): - <br />Invoice No.:— Amount:5 <br />+•■ <br />
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