HomeMy WebLinkAboutReimbursable Work Request - Public WorksGRANT COUNTY
REQUEST TO THE COUNTY ROAD DEPARTMENT
FOR REIMBURSABLE WORK
To The County Engineer:
Pursuant to terms of an agreement between the County and
ONO*
ktame of Requesting Agency)
adopted and approved on the undersigned hereby requests the
County to perform the work listed below at a time and in a manner convenient to the County. The
undersigned further requests that the work be completed no later than 110 zo Z0711)�
and hereby guarantees reimbursement to the County for all work done up to a maximum ofs-A-3,
Work to be Completed:
L4 M0*!;ft;z 006,
DATED:
SIGNATURE
Also
cy Representaltvq•,
A
TITLE 4-n
To The Board of County Commissioners.
-
DATE
I have examined the above request and made the Ball Ing recdations:
Approved
ElDenied -county Road Tn-g`jn6er/Director of PublicWorks
Action of the Board of County Commissioners. DATE
The Engineer's recommendation is hereby approved.
The Engineer's recommendations is disapproved or modified as follows:
I est:
0 /1
CJerk of the fop
Recommended for use with Section 2
of Foran: CRAB #101 and WAC 136-32-030
BOARD OF COUNTY COMMISSIONERS OF
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IGTON