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Work Activity Work Order pa9e 1 <br />5/16/2013 15:25 <br />Issued By SRA SORGEN, ROBERT A. <br />Issued Department aw PUBLIC WORKS <br />Date Issued 512/2073 <br />Fund izo Account s Program eao Function toa Activity ett <br />PfO9f2fll SIDEWALK REPLACEMENT 3218 ROCKEFELLER AVE <br />Title <br />Work Order No 20130995 PfOJeCi Activity Type CORRECTIVE MAINTENANCE St8tU5 CL <br />Status s�ic zo�3 Time i5 2z Original W0 Billing <br />Customer Information <br />Customer Name <br />Address Street <br />Apartment No City <br />State Z�P <br />Subdivision <br />Phone No � > • Ext <br />Second Phone ( ) - Ext <br />E-Mail Address <br />Problem Information <br />Address 3218 Street ROCKEFELLER AVE <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 />Cre�v <br />Contractor <br />Assigned To <br />ed B <br />Map Book <br />Called Date <br />Hssign y To Be Comp Date <br />Assigned Date _ <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken pILL TO: JIM LANGUS <br />902 WESTMINSTF.R CI. <br />EVERETT, WA 98203 <br />Customer ld <br />Change Map YIN <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Recommended Action <br />Approved 8y eGs sisNe�7. cREcc s. Job Cost Information(YIN) <br />Start Date i � Time Date Completed 51312013 Permit No <br />