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Work Activity Work Order Ya�� 1 <br /> i2/i�/zoiz is:az <br /> _ _ . _ _ _ - - ------- <br /> ISSUed By � GCR GRENZNER,CHRIS R. <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued tllenolz <br /> Fund 4ot Account 5 Program �to Function �za Activity s�a <br /> Program <br /> TIfIB REPAIR 5021 CREST LN <br /> Work Order No 20122540 Project Activity Type SERVICE REQUEST Status c� <br /> Status iveno�2 Time �t5� Ori inal W0 Billing _ _ .__ ___._ <br /> 9 ------ __ <br /> Customer Information <br /> Customer Name MACHER,PAT Customer ld <br /> Address sozt Street cResT LN <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No ( 425 ) 2593748 EX� __ _ <br /> Second Phone ( ) - Ext — <br /> E-Maii Address <br /> Problem Information <br /> Address 5021 Street E CREST LN <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem DRAIN DRAINAGE <br /> Sub Problem DL DRAIN LINES <br /> Requested By Hsrt HOFFMAN,STEVEN R. D8f@ R2qUBS�Ed tons�zo�z <br /> Agency Related Request oott3sz� <br /> Initiated From Pueuc PueuC <br /> Utility Locate (USA) No Cailed Date Expiration Date <br /> Assignment Information <br /> Dept Pw PueuC woRKs Priority Estimated Hours <br /> CfBW SCONST SEWER CONSTRUCTION(AHLES) <br /> Contractor <br /> Assigned To IJM IMHOF,JAMES M. <br /> Assigned By GCR GRENZNER,CHRIS R. <br /> Assigned Date _ To Be Comp Date <br /> Scheduled Date Scheduied Time _____ <br /> Route Route Sequence <br /> Comments <br /> Action Taken REJPAIRED 81NCN DRAIN LINE,BEDDED IN GRAVEL,COMPACTED.TOPPED WITH TOPSOIL <br /> AND GRASS SEED. <br /> RecOttIRlCllded ACt1017 REPAIR SEPEFATION IN PIPE <br /> Approved By wM IMHOF,�nn-tes M. Job Cost Information(YIN) <br /> Start Date � � Time __ Date Completed tv�anoiz______ Permit No <br /> Completed By Time Follow Up? <br />