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CITY OF EVERETT PUBLIC WORKS DEPARTMENT <br />WORK ORDER APPLICATION W.O. #: - 80 <br />Date Initiated: <br />Initiated by: �)�, BrOOrEt: <br />88/S <br />Project Title: CGSCg&: f7C/4AIS PZ47' <br />Description of Project (Location, who, what, when, why): <br />C"Uc,,nfy 1OL47` Se'rvc,:l 6I Cl-IX LcJq%r .1 C-1 ,&AteN <br />ai s« <br />Rferenc: <br />CrTyp4ejof�Project­ <br />❑ Operating ❑Grant <br />: ❑ Capital ❑ Emergency <br />❑ State <br />Funding: ❑ Federal <br />❑ Local <br />s <br />t --- <br />S <br />Estimated <br />Project Cost: <br />Estimated <br />I Completion Date: <br />Chargeable to: ❑ Utilities ❑ Engineering ❑ Streets <br />❑ Other <br />Manager's Approval <br />Signature: <br />Date: <br />_ <br />FOR FINANCE USE ONLY <br />Job Cost Number(s): <br />I Casswcrks Number(s): <br />' I <br />I <br />Verified JC it for Duplication ❑ IC Entered by: <br />I Date: <br />Comments: <br />Finance Marager's <br />Signature: <br />Date: <br />n„—r,piol P lP%1h NRkoRMP I., ✓y:.—I <br />