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Page 1 <br /> Work Activity Work Order 10/29/2013 �5:4� <br /> ISSIJed BY SRA SORGEN,ROBERT A. <br /> Issued Deparlment Pw PUBLIC WORKS <br /> Date Issued 1 012 912 01 3 Account 5 Program eao Activi e1� <br /> Fund t2o Function tos �Y <br /> Program SIDEWALK REPLACEMENT 3521 NORTON AVE <br /> Title <br /> Work Order No 20133515 PfOJ2Ct Activity Type CORRECTIVE MAINTENANCE SI8tU5 CL <br /> Status toizenota Time t5:3a _Original WO __ Billing <br /> Customer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No City <br /> State Z�p <br /> Subdivision Change Map YIN <br /> Phone No ( ) • Ext _ __ <br /> Second Phone ( ) - Ext <br /> E-Mail Address -- - — <br /> Problem Information <br /> Address 3521 Street NORTON AVE <br /> From Cross Street <br /> To Cross Street <br /> Zip <br /> ��ty Map Book Map Reference <br /> Subdivision <br /> Problem <br /> Sub Problem Date Requested <br /> Requested By Related Request <br /> Agency <br /> Initiated From Ex iration Date <br /> Utility Locate (USA) No Called Date P <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> C rew <br /> Contractor <br /> Assigned To <br /> Assigned By To Be Comp Date <br /> Assigned Date ___ — - - <br /> Scheduled Date _ Scheduied Time __ _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken BILL T0: RICHARD CRUVER <br /> 3521 NORTON AVE <br /> EVERETT,WA 98201 <br /> Recommended Action <br /> Approved By MKC2 MCAULIFFE,KERRYN C. JOb COS�IflfOfttl8t10�(YIN) __ <br /> Start Date i I <br /> Time Date Completed eienola Permit No <br />