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CITY OF EVERE7T PUBLIC WORKS DEPARTMENT <br /> WORK ORDER APPLICATION W.O. #: a G I 1:� �-1 O� <br /> Date Initiated: 6. ��,�� Inittated by: M��/,� �,���� E�ct: g$� <br /> ProjectTitle : S;��i I�C �Le nl�.�¢ �•�,�4—/1 � �1G (,JG''3Y�'�v.e /��c. <br /> r �= <br /> Description of ProjeR(Location,who,what,when, why): ���G ��M���- �"� <br /> p�P��.e S',dec..�Gi�� � � {'r,.g �� P��P���� <br /> Cross Reference: <br /> ❑ state ; <br /> �Operating ❑Grant <br /> Type of Project: Funding: � Federal $ <br /> ❑Capital ❑ Emergency <br /> �Local S <br /> Estima[ed Estimated Completion Date: <br /> Project Cost: O�c c � � <br /> Chargeable to: ❑ Utilitie� ❑ Engineering �Streets ❑ Other <br /> hlanager's Approval �' �--' Date: <br /> Signature: / ,�� ��' G —l7—�( <br /> FOR FINANCE USE ONLY <br /> Job Cost Number(s): Cassworks Number(s): <br /> ��� '�- o _ o�— �� <br /> Verified]C # for DupUcation ❑ ]C Entered by: Date: <br /> Comments: <br /> Finance hlanager's Date: <br /> Signature: <br /> y�vi,�--..nJumilFt'R.A1CrNUASOkIR�0.d:, r`�:+'�0 <br />