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Issued By csc <br />Issued Departmer,t Pw <br />Date Issued siztno�a <br />Fund qpt <br />Program <br />Work Activity Work Order <br />CAVANAH, SHANE G. <br />PUBLIC WORKS <br />?�ce - <br />=�:s�zo:; ii:o�� <br />Account 5 Program �io Function i�y Activiry 6�s <br />Titl2 REPIAR .75 INCH 5711 LOMBARD AVE 71011967, <br />Work Order No 20141192 Project Activity Type SERVICE REQUEST <br />Status snvzoia Time i6:�s Original WO Billing <br />Customer Information <br />Customer Name HAGLUND, VICTOR <br />Address s»� <br />Apartment No <br />Stat� <br />Subdivision <br />Phone No ( azs ) 353-6590 <br />Second Phone i ) - <br />E-Mail Address <br />Problem Information <br />Address 97�� <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />SlfBef LOMBARD AVE <br />City <br />Zip <br />Ext <br />Ext <br />Sireet LOMBARD AVE <br />Prob�em WATER WATER <br />Sub Problem LEAK LEAK <br />Requested By CCM CABE, CHAD M. <br />Agency <br />Initiated From PUBLIC PU6LIC <br />Utiliry Locate (USA) No <br />Assignment Information <br />Dept rw PUBLIC WORKS <br />Crew <br />Contractor <br />Assigned To csc <br />Assigned 8y <br />Assigned Date _ ___ __ <br />Scheduled Date <br />Route <br />Comments <br />Map Book <br />Called Date <br />CAVANAH, SHANE G. <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Slatus c� <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested snvzo�a <br />Related Request oo�aosa� <br />Expiratinn Dale <br />Prioriry Estimated Hours <br />Action Taken BRITTLE POLY REPLACED FROM MAIN TO NEWLY INSTALLED SETTER WITH JUMPER AND BOX. <br />Recommended Action <br />Approved By RJP RAPELYEA, JASON P. JOb COSt IflfOffT18t10f7(Y/N) <br />Start Date ! � Time Date Completed sm�zo�a Permit No <br />Completed By Time _ Follow Up? _ <br />