Laserfiche WebLink
� <br />�, <br />< <br />a <br />ves <br />GIIYOFEVERETT ,, 7821 <br />DEPARTMENT OF PUBLIC WORKS <br />UTILITIES DIVISION yy,0. No. <br />4/39 �c�°=-�D� -`ekv�CE �='-C.EACY Co`uu <br />� 3E—Z9— ,S AcctNo. (.�5�-1��/ <br />Complaint No. <br />UTILITY WORK ORDER <br />Date: J' � ��X � WATER <br />❑ SEWER <br />0 STORM <br />39.30. lt/Et/�o� !I✓E <br />Location: <br />W.O.Instr� <br />� SERVICE <br />❑ MAIN <br />❑ PUMP STATION <br />O TREATMENT <br />❑ RESEFVOIR <br />❑ VALVE <br />❑ MAN HOLE ' <br />❑ CATCH BASIN <br />❑ DITCH <br />�MAINTENANCE <br />0 OPERATION <br />❑ REPAIR , <br />� CONSTRUCTION <br />ESTIMATED <br />Labor (hours) . <br />Material (cost) . <br />Equipmen: (cosq : <br />SCHF.OULING REQUESTED <br />ACTUAL <br />Labor (hours) . <br />Material (cost) . <br />Equipment (cost) : <br />USE CHARGE ACCOUNT NUMB�R BEL04V FOR LABOR TIME SL�PS. ITE� <br />LABON, EQUIPMENT, AND MATERIALS ON REVERSE SIDE. __�_ <br />Comp�etion (oate): _�9'GZ-PJ23 Cost:3 <br />Charge Account Number. <br />Address: <br />harqe Cost To (Name): <br />Invoice No.: Amount:S Date: <br />