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Page 1 <br /> Work Activity Work Order a;,,,Zol, 1z:;, <br /> ISSU2d By CSG CAVANAH,SHANE G. <br /> Iss�ed Department rw PUBLIC WORKS <br /> Date Issued smzo�a Account s Program �io Activi <br /> Fund ao� Function tty ty 675 <br /> Program <br /> Title REPAIR 75INCH 2O21 CLEVEIAND AVE 7101196i5 <br /> Work Order No 20130920 Project Activiry Type SERVICE REOUEST Status c� <br /> Status 5/72013 Time �ea� OriginalWO Billing <br /> Customer Information Customer ld <br /> Customer Name WIDGREN,PWAYNE <br /> Address 1071 $VeOI CLEVELAND AVE <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No � a25 1 259-+zz� Ext _ <br /> Second Phone � 1 • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address ?py� Street CLEVELANDAVE <br /> From Cross Street <br /> To Cross Slreet ZiP <br /> City Ma Book Map Reference <br /> Subdivision p <br /> Problem WATER WATER <br /> Sub Problem LEAK LEAK Date Requested ei�i2o�a <br /> Requested By S�T SKAGEN.JEFFREY T. <br /> Related Request ooi�9ae5 <br /> Agency <br /> Initiated From PUBLIC PUBUC Ex iration Date <br /> Utiliry Locate (USA) No Called Date P <br /> Assignment Information <br /> Dept PW PUBLIC WORKS Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To HMAJ HERNANDE2.MIGUEL A <br /> Assigned By To Be Comp Da?e <br /> Assigned Date <br /> Scheduted Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Takeii yRITTLE POLY.REPA�RED FROM CORP AT MAIN TO BREAK 10 FEET OF POLY. <br /> Recommended Action <br /> ApFroved By eRP BIGLEY, RVAN P JOb COSI IflfOff118I1Of1(Y/N� <br /> Start Date � � <br /> Time Date Completed s�ao�zo�a Permit No_ _ <br /> Cornpleted By Time Follow Up� _ ___- -- I <br /> I _— - <br />