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�111ork Ac�ivity Work Order <br />ISSUed BY SRA SORGEN, ROBERT A. <br />Issued Department pw �ug�.►c vvot�Ks <br />Date issued s�si2o�s <br />Fund �2o Account 5 Program s4o <br />Program <br />Title SIDEINALK REPLACEMENT - 3230 COLBY AVE <br />Function �os <br />� <br />°���.�.. �i�i��� <br />Page 1 <br />9/13/2016 11:01 <br />Activify s�1 <br />Work Ofder No 20162177 Project Activity Type CORRECTIVE MAINTENANCE <br />Status 9/13/2016 Time �0:05 Oriqinal WO Billing <br />Custom�r Informa�6on <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No ( ) - <br />Second Phone ( ) - <br />E-Mail Address <br />Problem 4��ar�a�ian <br />Address <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No <br />Assigr�rnent lr�for�ation <br />Dept <br />C rew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />Route <br />Cosnrne��s <br />Ac�ion �akes� BiLL TO: JIM COURRIER <br />1054 B P.4RK DI2 <br />EVEREiT, WA 38201 <br />��co�rt�ended Aetaon <br />Approved By EGS EATON, GREG S. <br />Start Date i � <br />Street <br />C ity <br />Zip <br />Ext <br />Ext <br />Street <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Time <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expirati�n Date <br />Priority <br />Estimated Hours <br />Status C�. <br />Job Cost Information(Y/N) <br />Date Completed sr�i2o�s Permit No <br />