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Work Activity Work Order Paae � <br />s/e/zois ia:se <br />Issued By SRA SORGEN, ROBERT A. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 412412013 <br />Fund izo Account s Program sao Function �oe Activity 6i� <br />Program <br />TIfIB SI�EWALK REPLACEMENT 3232 ROCKEFELLER AVE <br />Work Order No 20130924 P(OJ2CI Activity Type CORRECTIVE MAINTENANCE S[atUS CL <br />Status 5I812073 Time ia_si_ Original WO _ _ __ Billing_ _ _____,____ _ <br />Customcr Information <br />Customer Naine <br />Address Street <br />Apartment No Ciry <br />State Z�P <br />Subdivision <br />Phone No � > • EY� <br />Second Phone ( ) - Ext <br />E-Mail Address <br />Problem Information <br />Address 3p32 Street ROCKEFELLER AVE <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Problem <br />Sub Prcblem <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assi ned By <br />Map Book <br />Called Date <br />9 To Be Comp Date <br />Assigned Date <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken BILL TO: MITCH COGDILL <br />J2J2 ROCKEFELLER AVE <br />EVERETT, WA 98201 <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Prioriry Estimated Hours <br />Recommended Action <br />Approved By ecs eisNErr, GrteGc s Job Cost Information(Y/N) <br />Start Date � i Time Date Completed aizaizo�a Permit No <br />