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�' D i�r9�,T� �� if�� i. S <br /> Work Activity Work Order P�ae 1 <br /> _ :,,,:�i3 :s: �e <br /> Issued By OBS OLHAVA, BRAD 5. <br /> Issued Department rw PUBLIC WORKS <br /> Date Issued 91191201] <br /> Fund aa� Account 5 Progr2m »o FuncUon �09 Activity e7a <br /> Proqram <br /> Tdl2 REPAIR 1302 CASCADE DR 710109674 <br /> Work Order No 20133000 Project Activiry Type SERVICE REQUEST Status c� <br /> Status �ns2o�a Time �3os Original WO Billing <br /> Customer Iniormatlon <br /> Customer Name CONCERNED GTI2EN Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No � � - Ext <br /> Second Phone � 1 - Ext <br /> E-Mail Address <br /> Problem Informatlon <br /> Address 130p Street CASCADE DR <br /> From Cross 8treet <br /> To Cross S reet <br /> City Z�P <br /> Subdivision Map Book Map Re(erence <br /> Problem SEWER SEWER <br /> Sub Problem <br /> Requested By Mea MOSS, BRIAN R Date Requested e�2eiso�a <br /> Agency Related Request 00122795 <br /> Initiated From Pueur. PUBLIC <br /> Utdiry Locate(USA) No Called Date Expiration Date <br /> Assignment Information <br /> Depl Pw PUBUC WORKS Priority z Es6mated Hours <br /> Crew <br /> Contractor <br /> ��ssigned To MGF MCM4NIS.GERALD F <br /> Assigned By oes OLHAVA.Br7AD S <br /> Assigned Date 9179I2077 To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken pppR COMPACTION. ADDED MATERIAL,RE�ASPHALTED ROAD. <br /> Recommended Action REPAIR SINK HOLE <br /> AUP�OVQd By GCR GRENZNER,CHRIS R. JOb C051 If1(OfR18f10f1(Y/N) <br /> ;tart Date � i Time Date Compleled 9nono�s Permit No <br /> C��n,�i�ted ey Time Follow Up? <br />