9211 34TH DR SE 2018-01-02 MF Import

CITY OF EVERETT PUBLIC WORKS DEPARTMENT WORK ORDER APPLICATION W.O. Date Initiated: �✓C —� 3 Initiated by: h B/OO cS Ext: Project Title: CGS C4 cld &J XJ IDZQ 7'� o Description of Project (Location, who, what, when, why): Cvunfy lQe<7' SCrve( 6� C,,-fx 100Xer *he✓ , IeAjev ai s,h-51e Cross Refer .ice: ❑ Operating ❑ Grant Type of Project: ❑ Capital ❑ Emergency ❑ State $ Funding: ❑ Federal $ ❑ Local $ Estimated A Project Cost: Estimated Completion Date: Chargeable to: ❑ Utilities ❑ Engineering ❑ Streets ❑ Other Manager's Approval Signature: Date: FOR FINANCE USE ONLY Job Cost Number(s): I Casswcrks Number(s): I I Verified JC # for Duplication ❑ I JC Entered by: Date: Comments: Finance Manager's Signature: Date: 5 •i mnmunsisr¢aIFUR.'I5:'AHRURUFR du: 1W-:41k1