|
'w�. � r• • :� � � ...,..,.;�.. .. � � . .. . . .
<br /> '�r'K� �. ��. +tw-c��mi ' � � `t`�C. n� �-�:ti �:CITYOFEVERETT ,'.. � , ,.� ���c... .. �8,`i�y�y�y„{,:.
<br /> .r. �'.!` �. . K.�. � � ...�-�. fi,d�`l. � .
<br /> , c ;�. ..
<br /> •,DEPARTMENTOFPUBIIC .WORKS � $���
<br /> ' � , • . . :T,.��" ,� �
<br /> • � � '�'��� -�4-+:•' UTILITIES DIVISION . .;'...�a. � { ��,.ir�*� r ���
<br /> ,
<br /> . , „ .
<br /> '• ti . ,:
<br /> �,.� � W O No '
<br /> , � . , •. �i ' , / t , . , , ,
<br /> , ` :�.�; ` ' � .. .' ` ���, l Acct No f-� ?> ��y� �
<br /> .• . . 1 f.. . /�.� � � [ ' .' � Y
<br /> . . . .1; . .' . . � ./ � . �,. . .
<br /> UTILITY WORK ORDER ' Complaini No
<br /> Date: �/- G� -� �`� ��' WATER SERVICE ❑ MAINTENANCE
<br /> t'--1�'—,'. � �
<br /> O SEWER ❑ MAIN ' ❑ OPERATION • .
<br /> ; 0 STORM ❑ PUMP STATION � REPAIR
<br /> ❑ TREATMENT ❑ CONSTRUCTION:.':; ' .
<br /> ❑ RESERVOIR '
<br /> ❑ VALVE
<br /> ❑ MAN HOLE
<br /> ❑ CATCH BASIN
<br /> _.1%�<_:-/' ' ❑ DITCH
<br /> .,li�Ci�
<br /> Locatiom �'
<br /> . ,
<br /> ,
<br /> W.O. Instructions:
<br /> ESTIMATED ACTUAL
<br /> Labor(hours) . Labor(hours) . ��
<br /> Material (cost) . Material (cost) .
<br /> Equipment (cost) : Equipment (cost) :
<br /> SCHEDULING RE�UESTED . � � � ' . ` , :
<br /> USE CHARGE ACCOUNT NUMBER BELOW FON LABOR TIME SUFS. ITEMIZE'�`-' . ' ` �'� `
<br /> ,, -.
<br /> LABOR, EQUIPMENT, AWD MATERIALS ON REVERSE SIDE. �
<br /> . ,, i r ,` ;.• �,,;' `
<br /> � 'Completion (Date): , �—�� �� Cost.3 ' ,:. ti:..
<br /> t .":: ",�...:. . . .���.:✓I . �._ . ... ( .:_ . '��n �:."S a rti;: t t � � ,`��.(+��S¢�i r�t; �` '
<br /> � � ... � \ r..c� � r� y ��f ! \F'�,r'v 1 +A� ��.ti \�!'.
<br /> Charge Account Number - Charge Cost To(Name, > �-.
<br /> � C . . . �� � .� � .ral.��.� ♦ � ...w yt f i ,.^.Y�'.Lw �. ' .. .ti ,� �o.�.:t ;, 'Yx`e i .+'., .; j4 Y.Ayh,�J' •',
<br /> . `r� _ � h Y�i j}4 ��p�iy•�"-
<br /> ' Address. . .r Zip, _•.�. __
<br /> Invoice No.: . Amount:5 Date: . '
<br />
|