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Work Activity Work Order ��9� ' <br />3/19/20!5 '_C:39 <br />ISSU2d By OBS OLHAVA, BRAD S. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued znno�s <br />Fund aot Account 5 Program »o Function �09 Activiry 6�5 <br />Program <br />TIIIf: REPAIR1925HIGHlANDAVE 710109675 <br />WO�k OfdEf NO 20150344 P�OfOCt Activity Type SERVICE REOUEST St2tUS Ci <br />S12IU5 2!7/2015 _ Tirt12 C6 59 OfHJif101 W� __ _ Billlfl j _ _ <br />Customer Information <br />Customer Name AMBER <br />Addf255 1925 Stfe2l HIGHLAND AVE <br />Apartment No City <br />State Z�P <br />Subdrvision <br />Phone No ( aco 1 a96-iee3 Ext <br />Second Phone ( ) • Ext <br />E-Ma�l Address <br />Problem Information <br />Address �925 Street HIGHLAND AVE <br />From Cross Streel <br />To Cross Street <br />Ciry <br />Subdrvision Map Book <br />Problem SEWER SEWER <br />Sub Problem <br />Requested By MCL1 h1A�LAN�, CHAD L <br />Agency <br />Indiated From PUBLIC PU6LIC <br />UUhty Locate �USA) No �sazzaxe Called Date <br />Assignment Information <br />Dept PW PUBLIC WORKS <br />C�eW SCONST SFWERCONSTRUCTION(OLHAVA) <br />Contractor <br />Assigned To IJM IMHOF, JAMES M <br />Assigned By oes o�Hqvn, ertno s <br />Assgned Date v���Zo�s To Be Comp Date _ <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken REPLACED SIDE SEWER FROM MAIN TO PROP LINE. <br />Recommended Action REPIACE S�OE SEW[R <br />Approved By LBM LESTER, BRIAN M <br />Start Date � � Time <br />Completed By _ <br />Customer ld <br />Change Map Y!N <br />Zip <br />Map Reference <br />Date Requested vzv�oi5 <br />Related Request oou�eea <br />Expiration Date <br />Pnonty Estimated Hours <br />a!Rl��d�F�l..��l�� <br />Job Costlnformation(Y/N) <br />Date Completed �n3�zo�s __ __ Permit No__ <br />Time Follow Up� <br />