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s v � <br /> .�S <br /> I• <br /> i- <br /> � <br /> a <br /> � <br /> i� <br /> Y <br /> , ' CITY OF EVERETT ti <br /> DEPARTMENT OF PUBLIC WORKS �'-- � 6 `''r-% <br /> e� <br /> UTILITIES DIVISION � <br /> W.O. No. �� <br /> r' �r� -��') - .� Acct. No. (, 7� ) ��/ <br /> UTILITY V!�ORK ORDER Complaint No. — I <br /> Date: � zt� ���/ � WATER � SER'JICE O MAINTENANCE , � <br /> ❑ SEWER ❑ MAIN ❑ OPERATION <br /> ❑ STORM ❑ PUMP STP.TION �� REPAIR <br /> t <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ R�SERVOIR <br /> 1� i' <br /> ❑ VAL'JE ��!� -ns'nN6 <br /> ❑ MAN HOLE '' <br /> ❑ CATCH BASIN <br /> O DiTCH <br /> '_ccation: _��� � �''�� � S� — <br /> W.O. Instructions: G_.�t��� �7� �"� f����G�P <br /> ESTIMATED ACTUAL �c-S <br /> Labor (hours) . Labor(hours) . <br /> Material (cost) . Material (cost) . _ <br /> Equipment (cost) : Equipment (cost) : <br /> SCHEDULING REQUESTED <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE <br /> LABOR, EQUIPMENT, AND MATERIALS ON REVERSE SIDE. . ' <br /> Completion (Date): _Cost:� <br /> Charge Account Number. Charge Cost To (Name):_ <br /> Address: Zip;. <br /> Invoice No.: _ Amount:$ Date: <br /> ,5 <br />