Laserfiche WebLink
CITY OF EVERETT �,,y • � � ; <br />DEPARTMENT OF PUBUC WORKS ������r�'I Q. • <br />UTILITIES DIVISION �J� �- � ��U-S <br />�� W.O. No. _ <br />. �� �� <br />� AccL No. /�• %> - i / j <br />�(�� ���[j� Complaint No. <br />UT:LITY WORK ORD�R <br />Date: .:'�-__�---.-�— i;�'4VATER <br />C SE\VER <br />❑ STORM <br />Location: <br />W.O. instri <br />F�SERVICE <br />❑ MAIN <br />�' PUMP STATION <br />TREATMENT <br />� I�ESERVOIR <br />G VALVE <br />C: MAN HOLE <br />❑ CATCH BASIN <br />❑ DITCH <br />❑ MAINTENANCE <br />❑ uPERATION <br />G]�REPAIR <br />❑ CONSTRUCTION <br />ESTIMATED <br />Labor (hours) . <br />Material (cost) . <br />Equipment (cosq : <br />ACTUAL ,;( iL <br />Labor (hours) <br />Material (cost) <br />Equipment (cos.) <br />SCHEDULING f�EQUEST[D <br />USE CHARGE ACCOUNT NU�v1BER BELOW FOR LABOR TIME SLIPS. IT[�'v11Z[ <br />LAC30R, EQUIPM[NT, AND R4ATERIALS ON R[VERSE SID�. <br />Cornpletion (Date): /!%_'-6'�_.p7 -------Cost:S.----____ _ --------- <br />Charge Account Number: <br />Address: -------- <br />Invoice No.:_._ _ <br />� <br />Ch�r9e Cost To (Name): <br />Amount:S <br />� <br />e: <br />