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Work Activity Work Order pa9e 1 <br />a/ls/zoiz is:oz <br />ISSllOd By AGA AHLES, GREGORY A. <br />Issued Department aw Pusuc wortKs <br />Date Issued sr6i2otz Activi <br />Fund �ot Account s Program �to Function tzs ty 673 <br />Program <br />TIflB REPLACE 3906 GRAND AVE 710123673 <br />WOfk O�dOf NO 2��2�424 PfOjBCt Activity Type CORRECTIVE MAINTENANCE Ste�US CL <br />SlBIUS 3/612012 TIR12 0924 Original WO Bllllfl9 <br />Customer Information <br />Customer Name <br />Address 7906 SlfB81 GRAND AVE <br />Apartment No City <br />State Z�p <br />Subdivision <br />Phone No ( ) - Ext <br />Second Phone ( > • Ext <br />E-Mail Address <br />Problem Information <br />Address 3906 Street GRANDAVF <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision Map Book <br />Problem DRAIN DRAINAGE <br />Sub Problem DL DRAIN LINES <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No 12036347 Called Date <br />Assignment Information <br />Dept Pw PUBLIC WORKS <br />C(8W SCONST SEWER CONSTRUCTION (AHLES) <br />Contractor <br />ASsigned To IJM IMHOF, JAMES M. <br />Assigned By A�A AHLES, GREGORY A. <br />Assigned Date To Be Comp Date <br />Scheduled Date <br />Route <br />Comments <br />Scheduled Time <br />Route Sequence <br />Customer ld <br />Zip <br />Prioriry <br />Change Map YIN <br />Map Reference <br />Expiration Date <br />Action Taken REPLACED �EFECTIVE 61NCH CMP WITH B INCH PVC. ADDED GAS TRAP � CB. <br />RBCORlfi1011dBd ACiI011 REPLACE DRAIN LINE <br />Approved By IJM IMHOF, JAM :S M. <br />Start Date � � Time <br />Completed By <br />Date Completed <br />Time <br />Date Requested <br />Related Request <br />Estimated Hours <br />Job Costlnformation(YIN) <br />312 612 01 2 Permit No <br />Foilow Up? <br />