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Work Activity Work Order <br />Issued By wMW WARD, MICHAEL W. <br />Issued Depa�tment Pw PUBLIC WORKS <br />Date fssued a��slza�s <br />Fund ao� Account s Program ��o Function q�s <br />Program <br />Title SO ,75 INCH 5109 50UND AVE 710119664 <br />Page 1 <br />7/9/2015 8:43 <br />Activity ss4 <br />Work Order No 2��i�J�70� f'roject Acfivity Type CORRECTIVE MAIN7ENANCE <br />Status 3lt6/2015 Time 12:09 Original WO so-�s4as Billing <br />Customer Information <br />Customer Name BELMARK LLC Customer ld <br />Address a22s Street �s7'€� sT N� <br />Apartment No ao5 City MARYSVILLf <br />State wa Zip ss27o <br />Subdivision Change Map Y/N <br />Phone No ( ) - Ext <br />Secand Phone ( ) - Ext � <br />E-Mail Address <br />Problem Information <br />Adciress Street <br />From Cross Street <br />To Cross Street <br />City Zip <br />Subdivision Map Book <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />initiated From <br />Map Reference <br />Date Requested <br />Related Request <br />Utility Locate (USA) No Called Date Expiration Date <br />Assignment information <br />Dept Priority Estimated Hours <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date To Be Comp Date <br />Scheduled Date Scheduled Time <br />Raute Route Sequence <br />Comments <br />Actfon TakEn INSTALLED NEW .75 INCH SERVICE <br />Recommended Action <br />_ ,,(` <br />- � r,;�=�. , � <br />-, �?����` <br />S�atUS CL <br />Approved By w�� WEAVER, oEAN �.. Job Cost Information(Y/N) <br />Start Date r 1 � Time Date Completed 4/16120'IS Permit No <br />Compfeted By � Time Follow Up? <br />� <br />