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, <br /> City of Everett Work Activity <br /> Work Order Information <br /> *Service Request# 00171695 _ � w0#Assigned - �d��-���"2_ _ _ <br /> Date Issued <br /> Issued By _ _ <br /> *Initials *Full name <br /> Fund 12� � I ' Program $4� Function 1�$ Activity 611 <br /> *Job Cost No. -�� -� *Project No. � <br /> Title Sidewalk Replacement <br /> *Rel. Work ONder 20050387 <br /> Problem Information <br /> Address Pre-direction Street Street Type Post-direction <br /> 5020 � Do�wood � �� Dr ' _ <br /> XCI�, Everett <br /> *If not "Everett"spec�which City <br /> Structure/Equipment Information <br /> Struct/Equip Type Problem _ � <br /> Struct/Equip Na - -- Sub Problem � <br /> Structure/Equipment type when applicable <br /> *Feet _. _ � *Description _ <br /> *Comments Bill to : Robert Cracchiolo <br /> 5020 Dogwood D Evt Wa 98203 <br /> Concrete : .75 cu.yds (a� $98.50 per.yd = $73.87 <br /> Bold Type=Mandatory fields to be populated <br /> *Italic = Optional fields <br />