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
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Name of Requesting Agency) �� .��� � , �� . ��7�
adopted and approved on 2-0 2-:3 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 , 3/,5,4 20-�->,�
and hereby guarantees reimbursement to the County for all work done up to a maximum of $
Work to be Completed:
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SIGNATURE
TITLE
To The Board of County Commissioners:
"-(Agency Representative)
DATE 7 * I q < 20 z3
I have examined the above request and mad 0 g recions:
,Jn7ion
0.Approved
., Road Engine
Denied pebirector of PublicWorks
Z 'Oft
Action of the Board of County Commissioners: DATE, 7/a -5 Z
The Engineer's recommendation is hereby approved.
The Engineer's recommendations is disapproved or modified as follows:
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leg
,Orcle of the B
1,6p, 1 . .
Recommended for use with Section 2
of orm: CRAB #101 and WAC 136-32-030
BOARD OF COUNTY COMMISSIONERS OF
G� rctq.+ COUNTY, WASHINGTON