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P� a �Yi��'�� � �� �. 5 <br /> page 1 <br /> Work Activity Work Order 5/23/2019 �4:z5 <br /> - - - - - --- — <br /> -- <br /> Issued By SRA SORGEN,R08ERT A. <br /> Issued DepartmentaW PUBucwoaKs <br /> Date Issued s�tazota Activi <br /> Fund �zo Account5 Program ear Function �08 �' 6�� <br /> Program <br /> TIIIB SIDEWALK REPIACEMENT 1801 COLBY AVE <br /> Work Order No 20141204 PfOJ2C� Activity Type CORRECTIVE MAINTENANCE StBfUS CL <br /> St�tus sr2anota Time ta:z� Original UJO _ _-- - . _ __ Billing _ - -- - -- - <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P Change Map Y/N <br /> Subdivision <br /> Phone No ( ) - Ext ___ __ ' <br /> Second Phone ( 1 • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address Street <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem Date Requested <br /> Requested By Related Request <br /> Agency <br /> Initiated �rom <br /> Utility Locate(USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Prionty Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date _____ To Be Comp Date ___ <br /> Scheduled Date ___ Scheduled Time ___ <br /> Route Route Sequence <br /> Comments <br /> Action Taken BILL TO: MARY BALLOU <br /> 1801 COLBY AVE <br /> EVERETT,WA 98201 <br /> CUSTOMER REQUESTS PAYMENTS OF SSO.OU PER MONTH. <br /> Recommended Action <br /> I — <br />