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Page 1 <br /> Work Activity Work Order lZ�ll,Zolz e:so <br /> Issued By �c� <br /> Issued Department rw PUBLIC WORKS <br /> Date Issued tono�2o�2 Activi <br /> Fund 4ot Account s Program tto Function toe �Y 876 <br /> Program <br /> Ti�IC REPAIR 7772 OLYMPIC DR 770709675 <br /> WOr1C OfdBf NO 20121315 P�OjBCi Activity Type SERVICE REQUEST SietUS CL <br /> Status �onono�z Time �s2a Ori inal WO Billing _ <br /> – - — ___ — <br /> Customer Infortnation Customer ld <br /> CustomPr Name HEPFENBTALL,RON <br /> Address �tt2 S�feSt OLYMPIC DR <br /> Apartment No Ciry EVERETT <br /> State WA Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 426 ; ;i2-2esa Ext _ _ <br /> Second Phone ( ) • Ext <br /> E-Mail Address – <br /> Problem Infortnation <br /> i.d ress »�y treet OLYMPIC DR <br /> From Cross Street <br /> To Cross Strget <br /> City EVERETT Z�P <br /> Subdivision Map Bock Map Reference <br /> Problem SEWER SEWER <br /> Sub Problem SS SfDE SEWER <br /> Requested By BTM1 BERGER,rirn M. Date Requested tono�zot2 <br /> Agency Related Request oottasa5 <br /> Initiated From PueuC PUBLIC <br /> Utility Locate(USA) No t2232o9� �alled Date Expiration Date <br /> Assignment Informatfon <br /> Dept vYv PUBLIC WORKS priority � Estimated Hours <br /> CfeW SCONST SEWER CONSTRUCTION(AHLES) <br /> Contractor <br /> Assigned To OBS OLHAVA,BRAD S. <br /> Assigned By AGA AHLES,GREGORY A. <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequance <br /> Comments <br /> Action Taken REPUCED 8 FEET OF SIDE SEWER AT PROPEltTY LINE AND INSTALIED CLEANOUT WITH U1MP <br /> HOLE COVER. <br /> R@CORIII1B11d@d AC1I011 REPAIR SIDE SEWER <br /> Approved By oas OlI1AVA,9RAD S. JOb COSt I�fOfR18IlOf1(Y/N) <br /> Start Date i � Time Date Completed ton�2at2 _ Permit No <br /> Completed By Time Follow Up? <br />