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Page 1 <br /> Work Activity Work Order 5,1„zo:, 1,:,� <br /> -____ __ _ ------- <br /> ISSUBd By� � GCR GRENZNER,CHR7S R. <br /> Issued Department rw PUBLIC WORKS <br /> Date Issued 71Y012014 <br /> Fund to� Account s Program 7to Function to9 Activity s�6 <br /> Program <br /> TiP': REPAIR 4723 ALGER AVE 710109675 <br /> Work Order No 20�4�48g PfOf @C1140000J8 Activiry Type CORRECTIVE MAINTENANCE $lB�US CL <br /> Status srzazo�e Time oe se_ _Ori�inal W0 ________ Billin�_ ____________ _--- <br /> Cuatomer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Anertment No City <br /> State Z�p <br /> Subdivision Change Map Y/N <br /> Phone No ( ) • Ext _ ._ —_---- .--- <br /> Second Phone ( ) • Ext <br /> E-Mail Address - - - - -- — ------ <br /> Problem In(ormatlon <br /> Address 4723 Gii�! ALGER AVE <br /> From Cross Slreet <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Ma� Reference <br /> Problem SEWER SEWER <br /> Sub Probiem SS SIDE SEWER <br /> Requested By Date Requesied <br /> Agency Related Request <br /> Initiated From INTER INTERNAL EX iration Date <br /> Utiliry Locate(USA) No taozetot Called Date P <br /> Assignment Information <br /> Dept Pw PUBLIC WORKS Priority Estimated Hours <br /> CfBw SCONST SEWER CONSTRUCTION��RENZNER) <br /> Contractor <br /> Assigned To PWR PUGSLEY,WILLIAM R. <br /> Assigned By GCR GRENZNER,CHRIS R. <br /> Assigned Date ___ , To Be Comp Dato __ <br /> Scheduled Date _ Scheduled Time ____ <br /> Route Route Sequence <br /> Comments <br /> Action Taken _ — -- -------- -- <br /> ---- <br />