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Work Activity Work Order pa9� 1 <br /> 7/:5/Zv15 3:07 <br /> ISSUEd By OBS OLHAVA,BRAD S. I <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued anenou <br /> Fund ao� Accou�t 5 Program ��o Function �py Activity 575 I <br /> Program <br /> Title REPAIR 342E BROADWAY 770109675 <br /> Wo�k O�de�No 20150988 Project Activiry Type SERVICE REDUEST StatuS CL <br /> Status arie�zou Time is:az Original WO g�����9 <br /> Customer Intormation <br /> Customer Name TRUJILLO,aic Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No l zas ) 35a•i29z Ext <br /> Second Phone ( 1 • Ext <br /> GMad Address _ <br /> Problem Information <br /> Address 3428 Street BROADWAY ' <br /> From Cross Slreet 35TH ST <br /> To Cross Slreet <br /> City EVERETT Z�P <br /> Subdivision Map Book Map Reference <br /> Problem SEWER SEWER <br /> Sub Problem SS SIDE SEWER <br /> Requested By GCR GRENZNER,CHRIS R. D2Ie R2QU2Sf8d 417JI2015 <br /> Agency Related Request ao�see�a <br /> Initiated From PUBLIC PUBLIC <br /> Utdity Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Pw PU�LIC WORKS Priority Estimated Hours <br /> Crew <br /> Contraclor <br /> Assigned To LBM LESTER,BRIAN td. <br /> Assigned By oes ouinvA, ow+o s <br /> Assigned Date To Be Comp Date <br /> Scheduled Oate ____ Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken F2EPLACED SIDE SEWER FROM PROP IINE OUT 9'.SIDE WALK PATCH 12'X 8'X 4". <br /> ReCOtnmCnded ACti011 REPAIR SIDE SEW[R UNDER SIDEWALK <br /> Approved By LBM LESTER,BRIAN M. JOb COS�Ifl(Off1101i0t1(Y/N) <br /> Start Date � � Time Date Completed aHnzots Permit No <br /> Completed By Time Follow Up7 <br />