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Work Activity Work Order <br />t;� � ��. �� <br />,. .��.-- <br />x <br />page 1 <br />9/13/2016 10:33 <br />ISSU2d By SRA SORGEN, ROBERT A. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 5/9/2016 <br />Fund �2o Account 5 Program sao Function �os Activity s�� <br />Program <br />Title SIDEWALK REPLACEMENT - 2405 GRAND <br />Work Order No 20162163 Project Activity Type CORRECTIVE MAINTENANCE StatUS CL <br />Status 9/13/2016 Time os:as Oriqinal WO Billinq <br />Customer Information <br />Customer Name <br />Address Street <br />Apartment No City <br />State Zip <br />Subdivision <br />Phone No ( ) - Ext <br />Second Phone ( ) - Ext <br />E-Mail Address <br />Problem Information <br />Address Street <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 Called Date <br />Assignment Information <br />Dept <br />C rew <br />Contractor <br />Assigned To <br />Assigned By <br />Map Book <br />Assigned Date To Be Comp Date <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken BILL TO: DON 8� NANCY VALKENBERG <br />395 WISCONSIN AVE <br />LONG BEACH, WA 90814 <br />6?ecommended Action <br />Approved By EGS EATON, GREG S. <br />Start Date i i Time <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Job Cost Information(Y/N) <br />Date Completed 5/�/2016 Permit No <br />