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Page 1 <br /> Work Activity Work Order 4,zl,Za1, 11:4� <br /> ISSU2d BY GCR � GRENZNER,CHRIS R. <br /> Issued Departmentaw PUBLICWORKS <br /> Date Issued 512812013 Function tos Activity e�s <br /> Fund qo� Account 5 Program »o <br /> Program <br /> TIfIB REPAIR 4638 MERMONT PL 710709675 <br /> Work Order No 20131067 PfOJBCf Activity Type CORRECTIVE MAINTENANCE SfaIUS CL <br /> Status sne�zots Time ts:3t 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 l ) - Ext <br /> E-Mail Address ----------- --— <br /> Probiem Information <br /> Address 4638 Street MERMONT PL <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <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 �a�2o25� Called Date P <br /> Assignment Information <br /> Dept P+N PUBLIC WORKS Priority Estimated Hours <br /> CfOW SCONST SEWER CONSTRUCTION(GRENZNER) <br /> Conlractor <br /> Assigned To OBS OLHAVA,6RAD S. <br /> Assigned By G�� GRENZNER,CHRIS R. <br /> Assigned Date ___ _ To Be Comp Date <br /> Scheduled Date . _____ Scheduled Time _ _ _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPLACED 6'OF MAIN AND SIDE SEWER TO PROPERTY LINE. <br /> Recommended Action REPAIR SEWER MAIN <br /> Approved By GCR GRENZNER,CHRIS R. JOl7 COSI I�fOf(T18[IOfI(YIN� <br /> Start Date � � Time ___ Date Compieted smzaia _ Permit No <br /> _ - -- -- <br /> Completed By ___ _ __.___ Time _ Follow Up7 <br />