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HomeMy WebLinkAboutReimbursable Work Request - Public WorksGRANT COUNTY REQUEST TO THE COUNTY ROAD DEPARTMENT FOR REIMBURSABLE WORK To The Cotaity Engineer: Pursuant to terms of an agreement between the County and Port District of Ephrata (Name of Requesting Agency) adopted and approved on 0 the undersianed hereby requests the - --- -- --------- . %11 1 1 County to perform the work fisted below at a time and in a manner convenient to the County. The undersigned hirther requests that the work be completed. no later than Nov. 30 2021 and hereby guarantees reimbursement to the County for all work one up to a maximum. of 12000 Work to be Completed: Overlay and patch railroad street. DATED.- 9-20-2021 SIGNATURE 6'yRufte-sentati v e) To The Board of County Commissioners: DATE , 7/2 1 have examined the above request and made the following recon nen. dAtions .- Comity Road. Engifteer��� Action of heBoard of County Commissioners: DATE The Engineer's recommendation is hereby approved. 0 The Engineer's recommendations is disapproved or modified as follows,,, est: t.t: ....... ---- - Ilc of tj th1 e 0 rk of ' Recommended for use with Section 2 of Form: CRAB 1.01 and WAC 136-J2-030 BOARD OF COUNTY COMMISSIONERS OF COUNTY. WASHINGTON -------------