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Work Activity Work Order <br />Issued By SRA SORGEN, ROBERT A. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 6/24/2016 <br />Fund �zo Account 5 Program sao <br />Program <br />TItI2 SIDEWALK REPLACEMENT - 1717 LOMBARD AVE <br />Function �os <br />Y���� ��� <br />Page 1 <br />9/13/20i6 10:57 <br />Activity s�� <br />Work Order No 20162174 Project Activity Type CORRECTIVE MAINTENANCE StatUS CL <br />Status 9l13/2016 Time io:o� Oriqinal WO Billinq <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No ( ) - <br />Second Phone ( ) - <br />E-Mail Address <br />Probiem Information <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 />Assignment Information <br />Dept <br />C rew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />Route <br />Comments <br />Action Taken gILL TO: BRIAN MALONE <br />1717 LOMBARD AVE <br />EVERETT, WA 98201 <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street <br />Map Book <br />Calied Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Recommended Action <br />Approved By GCE GILLIS, CHADWIK E. <br />Start Date � � 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 si24i2o�s Permit No <br />