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CITY OF EVERETT PUBLIC WORKS DEPARTMENT <br />WORK ORDER APPLICATION W.O. _ 31 SD <br />Date Initiated: _7�C —� 3 <br />Initiated by: ti A Bj^OD�S <br />I $8�s <br />ProjectTitle: CGseack -g/s PK474 <br />— <br />_ <br />Description of Project (Location, who, what, when, v.-hy): <br />Cvuaf)/ ,ol.«t SCrveo 6/, Ci•ty Gcl�%r an� fc'nt�" <br />�'i/ ,s,n'rCt �4N�ify Lnfs <br />Cross Reference: _ <br />State $ <br />❑ Ope,ating ❑ Grant <br />Funding: ❑ Federal <br />Type of Project: i <br />❑ Capital ❑ Emergency s <br />❑ Loral <br />Estimated `` // <br />Project Cost: Al <br />Estimated <br />Completion Date: <br />— <br />Chargeable to: ❑ Utilities ❑ Engineering ❑ Streets ❑ Other <br />Manager's Approval <br />Signature: <br />FOR FINANCE USE ONLY <br />Date: <br />— <br />Job Cost Number(s): <br />I Casswcrks Number(s): <br />Verified JC # for Duplication ❑ JC Entered by: I Date: <br />Comments: <br />Finance Manager's i <br />Signature: <br />Date: <br />5 I .Vr x%Is 41`A011I1-Re 0*, -� <br />