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�� �� . , . . . .. . <br /> • CITY OF EVERETT <br /> ^ DEPARTMENT OF PUBUC WORKS S . : u �: 2Q <br /> UTILITIES DIVISION <br /> ,^ ..� ` cl —� W.O. No. <br /> K � � _ ., <br /> ` �l JT�D— �/�-• ao�c No. �7 S - l09 <br /> ;�lo � �-� `'�''�- Complaint No. _ <br /> a <br /> UTILITY WORK ORDER <br /> • Date: ��� ❑ WATER ,J� SERVICE ❑ iVIAINTENANCE <br /> � SEWER ❑ MAIN O OPERATION <br /> ❑ STORM � PUMP STATION —B— REPAIR <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ RESERVOIR ' <br /> , ❑ VALVE <br /> � MAN HOLE <br /> ❑ CATCH BASIN <br /> ❑ DITCH <br /> � Location: ��/S Ll�O�,av�P J ��/� <br /> W.O. Instructions: <br /> �7 . <br /> m�n�,a.!' /�D�ii�� .(l�in n /liu.,/a,l- � (��• ��r�i <br /> �Saulc.J- G,�ul �, � n-mk �O �.J PC/Ci ,(�! o ��uJo-,� �///i <br /> �• (s�'n M�G�t�,Jl !7'� GL��Ov� l �rar+'�0�M� Q6- �'L�Q¢s N � O-N,.�?"!"� L/ r� <br /> _ /�f^!lir��D I�t�t 2 l�// � �(1�/ � � <br /> ,. <br /> i ESTIMATED ACTUAL <br /> Labor(hours) . Labor(hours) . <br /> Material (cost) . Material (cost) . <br /> Equipment (cost; : Equipment (cost) : <br /> SCHEDULING REOUESTEO <br /> USE CHARGE ACCOUNT NUMBER BEIOW FOR IABOR TIME SLIPS. ITEMIZE <br /> LABOR, EQUIPMENT, AND MATERIALS ON REVERS[ SIDE. <br /> Completion (Date): Cost:S <br /> Charge Account Number. Charge Cost To (Name): ' <br /> Address Zip:. <br /> Invoice No.: Amount:S Date: <br />