Laserfiche WebLink
CITY OF EVERETT <br />DEPARTMENT OF FUBLIC WORKS <br />UTILITY WORK aRDER <br />Oate: 12-z- �7 yJ WATER <br />❑ SEWER <br />❑ STORM <br />Location: <br />UTILITIES DIVISIO� I �� <br />V <br />�v. <br />'� � <br />i t � �''�� <br />/',.t � � <br />d SEFiVIC��❑ <br />❑ MAIN ❑ <br />❑ F'UMP STATION �7 <br />❑ TREATMENT ❑ <br />❑ RESERVOIR <br />❑ VALVE <br />❑ MAN HOLE <br />❑ CATCH SASIN <br />❑ DITCH <br />�, t ;� _ � - -- <br />W.O. No. <br />Acct No. �� S-I I q <br />Complaint No. <br />MAINTENANCE <br />OPERATION <br />REPAIR <br />CONSTRUCTION <br />• . . d, 2[�: : w�� s i fr <br />� i ii ! • / <br />��Pkc�r� ��v. Ma�'.er Jµ�...,n-�' <br />alua�ir�+�. IVc�',��t� c.ctt'k�`^2'+� � <br />EST�MATED <br />Labor (hours) . <br />Material (cost) . <br />Equipment (cost) : <br />SCHEDULING RE�UESTED <br />i,CTUAL <br />Labor (hoursl <br />Material �cost) <br />Equipment (cost) <br />USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE <br />LABOR, EQUIPMENT, AND MATERIALS ON REVERSE SIDE. , ,., <br />Completion (Dalej: �"1 Z� Z' �L/ Cost:S <br />Charge Account Number: <br />Address: <br />Invoice <br />ves <br />Charge Cost To (Name): <br />Amount:S <br />Gi� <br />ate: <br />