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Wor'�z Activity W�r��c Order -3J� ' <br /> 9/14/.�-Gi3 1::=3 <br /> __. —'_--__'_._'_______' __' ____ —. _—_.__—_ <br /> ISSt1Bd By GCR G `ENZNER,CHRIS R. <br /> Issued DepartmentPw PU6lICWORKS <br /> Date Issued aisizots <br /> Fund ao� Account e Program »a Function �oe Activity s7s <br /> Program <br /> Title REPAIR 6430 BROADWAY 710109'675 <br /> Work Ord=.r Nn 20130726 Project Activity Type SERVICE REQUEST Status c� <br /> Status a�sno�s Time tcoe Original WO _ Billing <br /> �,ustomer Information <br /> Custorner Name KEHOE,JIM I ST VINCENT DE PAU CU51Gn'G� Id <br /> AddfESS 6430 Slf22i8R0ADWAY <br /> Apartment No �'� <br /> S:ate Z�p <br /> Subdivision Change t�lap YIN <br /> Phone No ( 425 ) 517-6053 EXt _ __._ ___ <br /> Second Phone l 1 - Ext <br /> E-Mail Address - — <br /> Problem Information <br /> Address 6430 Street gROADWAY <br /> From Cross Street <br /> To Cross Street <br /> Suy Zip <br /> bdivis�on Map Book Map Reference <br /> Problem SEWER SEW�R <br /> Sub Problem SS SIDE SEWER Date Requested 3/2 812 01 3 <br /> R�'quested By CCM CABE,CHAD M. <br /> Related Request ao��a2as <br /> Agency <br /> Initiated From auauc PueuC <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Pw PUBLIC WORKS Priority Estimated Hours <br /> Crew SCONST SEWER CONSTRUCTION(GRENZNER) <br /> Contractor <br /> Assigned Tn <br /> A55igned P�y GCR GRENZNER,CHRIS R. <br /> Assigned Uate _ To Be Comp Dats <br /> Scheduled Date __._ ___ Scheduled Time ___ <br /> Route Route Sequence <br /> Comments <br /> Action Taken BROUGHT 6"CLEANOUT TO SURFACE AT P.L.6"CAP MARKED WITH METAL. BACKFILLED <br /> WITH GRAVEL,COMPACTED PREPR FOR SIDE WALK. <br /> RBCOI11R1BI1CICCI ACtI011 REPAIR BROKEN ELLBOW ON CITY SIDE AND INSTALL CLEANOUT. <br /> ApprOved By IJM IMHOF,JAMES M. Job Cost Infofm8ti0n(Y/N) _ <br /> Start Date i i Time Date Completed anm2ou __ _____ Permit No __ <br /> -- — <br /> ---- <br /> Completed By Time Follow Up. <br />