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Work Activity Work Order :a" �: <br /> 1C/:C;2015 :5: i1 <br /> ISSUBd By SRA SORGEN,ROBERT A. <br /> Issued DepartmentPw PUBLICWORK$ <br /> Date Issued 911 612 0 1 4 <br /> Fund o2a Account s Program eao Function �oa ,�ctivity 6t� <br /> Program <br /> Title SIDEWALK REPLACEIdENT 93t PAGFIC AVE <br /> Work Order No 20143113 PfOJ2CS Activiry Type COftRECTiVE Ie1AINTENANCE $�BI115 CL <br /> Status �onazoia Time_s cy Ong�nal WO _ _Billing _ ____ _ _ . <br /> Customer Information <br /> Customer Name Customer ld <br /> ACdress S;reet <br /> Apartment No Ciry <br /> State Z'P <br /> Subdivision Change �✓�ap Y/N <br /> Phone No c l • Ext , <br /> Second Phone � � • Ext — <br /> E-MailAddress __ _______ ___ _ ____—— <br /> Problem Information <br /> Address 931 SVeet pqCIF1C AVE <br /> From Cross Street <br /> To Cross Street <br /> ��ty Zip <br /> Subdivision Map Book I�4ap Reference <br /> Problem <br /> Sub Problem <br /> Req�ested By Date Reques;ed <br /> Agency Related Requesl <br /> Initiated From <br /> Utility Locate(USP) No Called Date Expiration Date <br /> Assignment Intormation <br /> Dept Pnonty EsUmated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned E3y <br /> Assigned Dale _ _ To De Comp Date <br /> Scheduled Dete __ _ Scheduled Time <br /> Route Route Sequence ��� �f i �E <br /> Comments � ��-s-��!�e'"E ��i�' � <br /> Action Taken BILL TO: PETER AGNOS <br /> 19017 9TH PL NW <br /> SEATTLE,WA 98177 <br /> Recommended Action <br /> Approved By ecs rsroN,�Rec s Job Cost Information(Y/N) <br /> Slart Date i � Time Date Completed 9116l2014 Permit No <br />