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SNOHOMISH COUNTY PUBLIC WORKS DEPARTMENT <br /> { ENGINEERING SERVICES—BRIDGE GROUP <br /> w 3000 Rockefeller, M/S 607 <br /> Everett, WA 98201 <br /> PUBLIC WORKS BRIDGE INSPECTION SERVICES WORK ORDER <br /> Agency/Jurisdiction: <br /> Submitted By: Date Submitted: <br /> Contact Info: Requested Completion Date: <br /> Authorized By: Position/Title: <br /> (Signature from Agency/Jurisdiction for approval to proceed per Estimated Cost Below) <br /> Date Approved: <br /> WORK TO BE PERFORMED (Description)(Attach Additional Pages If Needed) <br /> Once completed please email to: Contact.PWBridge(a�snoco.orq <br /> For Completion by Snohomish County Engineering Services Division <br /> County's Estimated Cost For Services: <br /> County Reimbursable Service Number: RR <br /> County Work Order Number: (progressive number assigned by order of request) <br /> Approved By: <br /> Bridge Group Supervisor: Date: <br /> ES Director: Date: <br /> Date of Completion: By: <br /> 79 <br /> C-3 <br />