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Work Activity Work Order <br />ISSU@d By SRA SORGEN, ROBERT A. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued sisi2o�s <br />Fund �2o Account s Program $ao <br />Program <br />Title SIDEWALK REPLACEMENT - 171 O LOMBARD AVE <br />Function �os <br />1fK� <br />�•���� ��,� <br />Page ? <br />9/13/2016 10:46 <br />ACtlVlty 611 <br />Work Order No 20162169 Project Activity Type CORRECTIVE MAINTENANCE <br />Status 9/13/2016 Time os:5s 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 <br />Assignment Information <br />Dept <br />C rew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date To Be Comp Date <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken BILL TO: LUCIA FISHER <br />1710 LOMBARD AVE <br />EVERETT, WA 98201 <br />Recorrimended Action <br />Approved By gD6 BREKHUS, DENNIS B. <br />Start Date i � Time <br />Map Book <br />Called Date <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 />Status c� <br />Job Cost Information(Y/N) <br />Date Completed 5/6/2016 Permit No <br />