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2120 JACKSON AVE 2016-01-01 MF Import
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2120 JACKSON AVE 2016-01-01 MF Import
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Last modified
2/19/2017 9:28:56 AM
Creation date
2/19/2017 9:28:52 AM
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Template:
Address Document
Street Name
JACKSON AVE
Street Number
2120
Imported From Microfiche
Yes
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Work Activity Work Orde�• ;,,,;_;;"Y ._. ,_ <br /> ISSUcd BY GCR GRENZNER,CHRIS R. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued tnano�a Activi <br /> Fund qo� Account 5 Program »o Function �09 �Y 675 <br /> Program <br /> Tlil� REPAIR 2720 JACKSON AVE 710109675 <br /> ZQ�Q�244 Pro ect Activiry Type SERVICE REQUEST St2fU5 CL <br /> Work Order No � Billing <br /> S(atus vtar2o�a _Time ia:3i Origi�alWO__ _ _ _ <br /> Customer Information Customer ld <br /> CUStOfllBf Nifi1B DILLON,BRIAN <br /> Address 2120 Stf2@I JACKSON AVE <br /> Apartment No City <br /> State Z�p <br /> Subdivision Change Map Y/PJ <br /> Phone No ( zoe ) �ia-a�ss Ext _____ _ ____ _ <br /> Second Phone ( 1 • Ext <br /> E-Mail Address — - <br /> Problem Information <br /> Address yiyp Street �,qCKSONAVE <br /> From Cross Street <br /> To Cross Str=et <br /> City ZiP <br /> Subdivision Map Book Map Reference <br /> Problem SEWER SEWER <br /> Sub Problem SS SIDE SEWER Date Requested v�aizcia <br /> Reqcested By GGW GRAVES,GARY W. <br /> Related Request oot2ess� <br /> gency <br /> ' �itiated From PUBLIC PUBLIC <br /> 1t:'Jty Locate (USA) No 14009685 Calied Date Expiration Date <br /> ;' signment lnformation <br /> �zPt pw PUBLIC WORKS Priority Estimated Hours <br /> C�OVlSCONST SEJJERCONSTRUCTION(GREN2NER) <br /> ! Contractor <br /> ' ,4ssigned To OBS OLHAVA, BRAD 5. <br /> Flssigned By GCR GRENZNER,CHRIS R. <br /> Assigned Date _ __ To Be Comp Date <br /> Scheduled Date _ Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> , <br /> Action Taken REPLACED SIDE SEWER FROfJ�MAIN TO PROPERTY LiNE. <br /> � RCCOO7I11BOdBd/�Ct100 REPAIR SIDE SEWEK <br /> Approved By MGF MCMANIS,GERALD F. JOb COS? I�(Offil2flOt1(YIN) <br /> Time Date Complzted 112912014 Permit No <br /> Slart Dzte � I I -- �-- � <br /> Completed By _ Tima Follow Up? <br />
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