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Work Activity Work Order <br />ISSU2C1 By SRA SORGEN, ROBERT A. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 4/21/2016 <br />Fund �2o Account5 <br />Program <br />Title SIDEWALK REPLACEMENT - 2605 MAPLE <br />Work Order No 20162162 Project <br />Program s4o Function �os <br />Status 9/13/2016 Time os:a� Oriainal WO <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 />Problern 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 />;_:, � �.� .� � �`a, <br />Page 1 <br />9/13/2016 10:22 <br />ACtlVity 611 <br />Activity Type CORRECTIVE MAINTENANCE <br />Billinq <br />Map Book <br />Called Date <br />Assigned Date To Be Comp Date <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken BILL TO: JOSEPH LACH <br />2605 MAPLE ST <br />EVERETT, WA 98201 <br />F2ecommended Action <br />Approved By MKC2 MCAULIFFE, KERRYN C. <br />Start Date � � Time <br />Customer ld <br />� <br />Change Map Y/N <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 4/21/2016 Permit IVo <br />