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NO MATERIALS <br /> Work Activity Work Order Pa9e 1 <br /> iz/2s/zoii s:sa <br /> ISSUOd BY AGA AHLES,GREGORY A. <br /> Issued Department aw PueLlc woR�cs <br /> Date Issued tv�ano�s <br /> Fund aot Account 5 Program ��e Function tos Activity eis <br /> Program <br /> Title REPAIR 4826 DELAWARE AVE 770109675 <br /> Work Order No 20112611 Project Activity Type SERVICE RE�UEST Stat�s c� <br /> Status tznano�t Time ta:z� Original WO _ Billing _ <br /> Customer Information Customer ld <br /> Customer Name RANOLPH,WILLIAMS <br /> Address 4826 SIf00f DELAWARE AVE <br /> Apartment No City <br /> State Z�p <br /> Subdivision Change Map YIN <br /> Phone No ( �Zs ) 750•3152 Ext ___ <br /> Second Phone ( azs ) 876-1387 Ext <br /> E-Maii Address purplelowrider45@YAHOO.COM ____ __ — <br /> Problem Information <br /> �ddiess 4826 Street DELAWAREAVE <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem SEWER SEWER <br /> Sub Problem SS SIDE SEWER Date Re uested tysi2o�t <br /> Requested By HSR HOFFMAN,STEVEN R. RCIBIBd R2GUBSt 00103954 <br /> Agency <br /> Initiated From PUBLIC PUBLIC <br /> Utility Locate (USA) No Caiied Oate Expiration Date <br /> Assic�nment Information <br /> Dept PW PUBLIC WORKS Priority Estimated Hours <br /> CfOW SCONST SEWER CONSTRUCTION(AHLES) <br /> Contractor <br /> Assigned To aBs OLHAVA,BRAD S. <br /> Assigned By A�A AHLES,GREGORY A. <br /> Assigned Date To Be Comp Date ___ <br /> Scheduled Date _ Scheduled Time _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken EXCAVATED CAVE•IN.FOUND ROTTING 701NCH WOOD STAVE WATER L�NE.FILLED JVITH <br /> CDF. <br /> Recommended Actinn EXCAVAiE CAVE•IN AND MAKE REPAIRS <br /> Approved By oes o�Hnvn,sano S. Job Cost Information(YIN) <br /> Start Date � i Time ___ Date Completed tvts�2o�i _ Permit No__ <br /> Compieted By Time Follow Up? ^ <br /> Cy.� <br />