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Issued By oB5 <br />Issued DepartmentPw <br />Date Issued v2sizou <br />Fund aot <br />Program <br />Work Activity Work Order <br />OLMAVA, BRAD S. <br />PUBIIC WORKS <br />Page 1 <br />iz/�o;zoia is:os <br />Account s Program »o Function �oe Activity s�s <br />TiiIC REPAIR 2512 HARRISON AVE 710709675 <br />Work Order No 20142999 Project ActiviN Type SERViCE REOUEST Status c� <br />Status ^___ 9nanoia Time �3os Ori�inal�'JO Billing <br />Customer Iniorm�tion <br />Customer Name ORTIZ MIGUEI <br />AddreSs 2512 <br />Apartment No <br />State <br />Subdivision <br />Phone No ( �zs ) z3�-sea <br />Second Phone ( 1 • <br />E-Mail Address <br />Problem information <br />Address 2g�y <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Pro I m SEWER SEWER <br />Sub Probiem SS SIDE SEWER <br />Requested By GMJ2 GESIAK, MARTY J. <br />Agency <br />Initiated From rus�iC PUBUC <br />Utility Locale (USA) No 1lt66277 <br />Asaignment Iniormation <br />Dept Pw PUBLIC WORKS <br />Crew <br />Contractor <br />Assigned To �cR <br />Assigned By <br />Assigned Date __ <br />Scheduled Date ____ <br />Roule <br />Comments <br />SI�2E� MARRISOH AVE <br />CiN <br />Zip <br />Ext <br />Ext <br />Street HARRISON i7VE <br />Map Bcok <br />Customer ld <br />Change Map Y/N <br />?�P <br />Map Referenr.e <br />Called Date <br />Priority <br />GR[NZNER, CHRIS R. <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Expiration Date <br />Aetion Taken REPUCED SS FROM MAIN TO PROPERTY IINE. CONCRETE PATCH. <br />Recommended Action Rertnce sioe sewert <br />Date Requested erertou <br />Related Request oo�a�ott <br />Esiimated Hours <br />Approved By oes o�Hqvn, aano S, Job Cost Information(YIN) <br />Start Date r � Time Date Completed 912{I2010 <br />Completed By _ Time _ Follow Up? <br />Permit No <br />