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1/Vork Activit,y Work Order <br />ISSUCd BY NSO NIELSEN, SCOTT O. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued z�zsizoo9 <br />Fund qui Accounl, Program >>o Function >>y <br />Program <br />TIIIB REPAiR 5721 LOMlIARD AVE 710179575 <br />Wark Order No L0090276 Project Activlty Type SERVICF REOUEST <br />Status zizr,izeo� Time oo:i� Qriginal WO Billing <br />Customcr Information <br />Customer Name VINCE LONG Customer ld <br />AddfE55 5721 SIfCC( LOMBARD AVE <br />Apartmenl No City <br />State Zip <br />Subdivision C�iange Map Y/N <br />Phone No ( 425 ) 347-296i Ext <br />Second Phone ( 1 - Ext <br />E-Mail Address <br />Problem Information <br />F,dtlress S�p� Sireet LOMBARD AVE <br />Prom Cross Slreet <br />To Cross Slreel <br />City Zip <br />Subdivision Map Book Map Ra(erence <br />Problem WATER WATER <br />Sub Problem <br />� <br />Activiry r,�s <br />S13W5 CL <br />Requested By SJT SKAGEN, J[FFREY T. D2fe R2ql1CSlCd 2/25I2009 <br />Agancy Related Request oomte�s <br />Inilialed F�om PUBLIC PUOLIC <br />Ulilily Locate (USA) No Called Dale Expiration Date <br />Assignment Information <br />Dept Pw ruouc woRKs P�ioriry Eslimated Hours <br />Crew <br />Contractor <br />ASSigned TO MTl2 MARKHAM, TIMOTHY' L. <br />Assigned By <br />Assigned Date _ To f3e Comp Date <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken pREVIOUSLY REPAIRED SERVICE REPAIRED AGAIN. WILL REPLACE FROM R7AIN.REPLACEO <br />POLY USED 21NSTA REPAIR KITS. <br />Recommended Action <br />An�fOVCd FiY HW HUSBY, LANCE J. <br />Slarl Date i � Time <br />Completed By <br />Job Cost Information(Y/N� <br />Date Completed 2izn2oos Pennit No <br />Time FolloH� Up? <br />