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CITY OF EVERETT PUBLIC WORKS DEPARThtENT <br />WORK ORDER APPLICATION W.O. #:� / gL� <br />�Cate initiated: � � cJ —v ;j � initiated by: �ti ,� Bj��p�S _ I Ext: ���5 <br />I Project Title: CGSC4c�� {/c�s/,iS /�« �` <br />�I <br />� Cescription o( Project (Loca[ion, who, wha[, when, .vhy): <br />C'vcinfy PL4t .Sc-i�ve� G� C��-fy �'nf4.� a��e✓ feNe�^ <br />' �/ S,.,St� ��,,, fy �� ts <br />Uoss Reference: <br />------- ❑ State <br />❑ Operating ❑ Gran[ I pi�ndir <br />. Type of Projed: I 9� ❑ Fr�eral <br />❑ Caprtal ❑ Emergency <br />❑ LOCaI <br />Estimated /(�� I Estimatea <br />! ProJed Cost: '"� _ I Completion Date:_ _ <br />C'iargeable to: ❑ Utilities ❑ Engineering ❑ Streets <br />htanager's Approval <br />��gnature: _ <br />FOR RNANCE USE ONLY <br />Job Cost Numher(s): I Czsswcrks Number(s): <br />❑ Other <br />Date: <br />._�rfied )C +s for Duplicaticn ❑ <br />rnments: <br />,:,�, :e Manager's <br />r' .:IP: <br />�� JC Entered by: <br />' Date: <br />= �te: <br />