Laserfiche WebLink
' � CITY OF EVERETT <br /> DEPARTMENT OF PUBLIC WORKS • , � ti OO� <br /> UTILITIES DIVISION <br /> W.O. No. <br /> Acct No. �-7 � ��y <br /> Complaint No. <br /> UTILITY WORK ORDER <br /> Date: � �- � 3� �� �� WATER � SERVICE � MAINTENANCE <br /> ❑ SEWER C MAIN ❑ OPERATION <br /> O STORM O PUMP STATION ❑ REPAIR <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ RESERVOIR �os7E� <br /> ❑ VALVE No PREV, <br /> 'i-iJrnMS— � <br /> ❑ MAN HOLE r � _ � g-5 No Eu�y9Re4q I <br /> 3 i <br /> � CATCH BASIN <br /> ❑ DITCH SNcoRaEGT ADOR£SS <br /> 4 <br /> location: b� O'��A�l G O�, <br /> L� 1 <br /> W.O. Instructions: KI L V E XIST1 A� 3�'t / SE.QY��' <br /> ESTIMATED ACTUAL /\ <br /> Labor(hours) . Labor(hours) . • <br /> Materiai (cost) . Material(cost► . <br /> Equipment (cost) : Equipment(cost) : <br /> SCHEDULING REQUESTEO <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE <br /> LABOR, EQUIPMENT, AND MATERIALS ON REVERSE SIDE. <br /> Completion (Date): ����� �✓a Cost:$— <br /> Charge Account Number: Charge Cost To(Name►: <br /> Address: Z�p� <br /> Invoice No.: Amount:$ Date: <br /> �na <br />