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Vldork Activity Wc�rk Arder Pa9e 1 <br /> i</20/2019 13:21 <br /> Issued By OBS OLHAVA,BRAD S. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued �onenola <br /> Fund aoi Account s Program no Function io9 Activity 675 <br /> Program <br /> Titl2 REPAIR 2107 LOMBARD AVE 770109675 <br /> Work Order No 20143152 Project Activiy Type SERVICE REQUEST Status c� <br /> Status �onarzota Time �o:z� Originai WO Billing <br /> Customer Information <br /> Customer Name WILSON,ERIC Customer ld <br /> Address 2105 Sff28� LOMBARD AVE <br /> Apartment No City <br /> State ZiP <br /> Subdivision Change Map Y/N <br /> Phone No ( ass ) aoa-osss Ext <br /> Second Phone ( 1 • Ex: <br /> E-Mail Address <br /> Problem Information <br /> Address Z�p; Street LOMBARD AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Bo�k Map Reference <br /> Problem STREET STREETS <br /> Sub Problem ALLEY ALLEYS <br /> Requested By cea CLEMANS,BRUCEA D8�2 RBQl1BS�Bd enano�a <br /> Agency Reiated Request aou���a <br /> Initiated From PUBLIC PUBLIC <br /> Utility Locate (USA) No �4zsseoe Called Date Expiration Date <br /> Assignment Information <br /> Dept aw PUBLIC WORKS Prioriry Estimated Hours <br /> C(8W SCONST SEWER CONSTRUCTION(OLHAVA) <br /> Contractor <br /> ASSIgf1Bd TO OBS OLHAVA, BRAD S. <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> r, <br /> f��.�c( 'F.- <br /> Scheduled Date Scheduled Time e :�.;d'"�,���g � ��, <br /> � � � ..;u, : <br /> Route Route Sequence - <br /> Comments <br /> Action Taken REPLACE 8'MAIN AND SIDE SEWER TO PROP LINE.ASPHALT PATCN 14X11X1.5" <br /> ReCOfflfTlBflded Acti0fl REPAIR SIDE SEWER <br /> Approved By oss o�Hnvn, eRno s. Job Cost Information(YIN) <br /> Start Date i � Time Date Completed tazvzola Permit No <br /> Completed By Time _ Follow Up? _ <br />