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Work Activity Work Order <br />Page 1 <br />�e/z/zoiz s:os <br />Issued By HMP HALE, MICHAEL P. <br />Issued Departmentrw PUBLICWORKS <br />Date Issued e��n2ou <br />Fund t2o Account s Program ero Function toe Activity e�� <br />Program <br />TiUe SIDEWALK REPLACEMENT 1515 R4INIER AVE <br />Work Order No Z0122257 Project AcGvity Type CORRECTIVE MAINTENANCE Status CL <br />Status torzr2o�z Time o�•5s Original WO Bflling <br />Customer Information <br />Customer Name <br />Address <br />ApartmentNo <br />State <br />Subdivision <br />Phone No ( > - <br />Second Phone ( 1 - <br />E-Mail Address <br />Problem Informatlon <br />Address 1515 <br />From Cross Street <br />To Cross Street <br />Ciry <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date _ <br />Scheduled Date <br />Route <br />Comments <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />r e Rq�N1ERAVE <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />ACtiotl Tak8I1 BILL T0: KIRK d ADRIANNE WEIBER <br />7615 RAINIER AVE <br />EVERETT, WA 98201 <br />Recommended Action <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority <br />Estimated Hours <br />Approved By ecs FATON, GREG S. JOb COSt II1fOrtT18t10�(Y/N) <br />Start Date � � Time Date Completed 9/2W2ou Pertnit No <br />