Laserfiche WebLink
CITY OF EVERETT <br /> Z�2.� � ;�:: L 14 5 <br /> DEPARTMENT OF PUBLIC WORKS <br /> � <br /> UTIUTIES DIVISION I <br /> W.O. No. i <br /> �/) C/ `� � � + I; <br /> Acct. No. (' �� � � <br /> No Po�r���� ��39 C�zzaoouokoA � 'i <br /> omplaint No. <br /> UTILITY WORK ORDER <br /> Date: S� 6d 'NATER � SERVICE � MAINTENANCE <br /> ❑ SEWER ❑ MAIN ❑ OPERATION <br /> ❑ STOfiM ❑ PUMP STATION ❑ REPAIR <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ RESERVOIR <br /> G VALVE <br /> Ci MAN HOLE <br /> ❑ CATCH BASIN <br /> f� DITCH �D <br /> / / �/ o� .S', e L ti�P <br /> Location: ._ � � <br /> W.O. Instructions:�'� �) �q ce ��U�G'N �e/C.� !>O � - <br /> � _ _ .r-- <br /> ESTIMATED ACTUAL <br /> Labor(hours) . Labor(hours) . <br /> Material (cost) . Material (cost) . _ <br /> Equipment (cost) : Equipment (cost) : <br /> SCHEDULING REQUESTED <br /> - `. <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TI LIP . ITE IZ� <br /> LABOR, E�UIPMENT, AND MATERIALS ON REVERSE SI��U �,�..,a� <br /> \� <br /> Completion (Date�: Cost:$ ` <br /> Charge Account Number. Charge Cost To(Name):_ <br /> Zip: <br /> Address <br /> Invoice No.: <br /> AmounLS Date: <br />