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Worlc Activity Work Order <br />ISSUBd By GCR GRENZNER, CHRIS R. <br />Issued Department aw PUBLIC WORKS <br />Date Issued aiznzo�a <br />Fund ao� Account s Program »� Function �09 <br />Program <br />Tlfle REFAIR 528 ROSE WAY 710709675 <br />Work Order No 20140644 Project Activity Type SGRVICE REQUEST <br />Status srz��zoin Time o� os Original WO __ _ 6illing <br />Customer Information <br />Customer Name BISSELL, LAVONNE <br />Address sze Slreet Rosewnv <br />Apartment No City <br />State Z�P <br />Subdivision <br />Phone No ( azs ) 478•6555 Ext <br />Second Phone ( 1 - Ext <br />E-Mail Address <br />Problem Information <br />Address 528 Street ROSEW.aY <br />From Cross Street EAST GR <br />To Cross Street CYPRESS ST <br />City EVERETT <br />Subdivision Map Book <br />Customer ld <br />Problem SEWER SEWER <br />Sub Problem B-FLDS BASEMENT FLOOD SEWER MAIN BU <br />ReqUBSIPd By CBA CLEMANS, f3RUCE A. <br />Agency <br />Initiated From PUBLIC PUBLIC <br />Utility Locate (USA� No Called Date <br />Assignment Information <br />Dept Pw PUE3LIC WORKS <br />C�2W SCONST SEWER CONS'iRUCTION (GRENZNER) <br />Contractor <br />Assigned To OBS 6LHAVA, BRAD S. <br />Assigned By GCR GRENZNER, CHRIS R <br />Assigned Date _ To Be Comp Date <br />Scheduled Date . Scheduled Time <br />Route Route Sequence <br />Conn�ients <br />ZiF <br />Priority <br />Change Map Y/N <br />Map Reterence <br />Expiration Dale <br />page 1 <br />5/'-7/�074 15:53 <br />Activity e75 <br />SYAiUS CL <br />Date Requested aizei2o�a <br />Related Request ooizeas� <br />Estimated Hours <br />Action Taken RERPLACED SIDE SEWER FROM PFOPERTY LINE TO STAND PIPE USING 6" PVC. SS BROKE <br />BY CONTRACTOR. <br />RBCOI1107811dCC1 AC►IOII REPAIR SIDE SEVJER <br />Approved By oes OLHAVA, BRAD S. <br />Start Date i � Time <br />Completed By <br />Job Costlnformation(YIN) <br />Date Compteted an9noia Permit No <br />Time Follow l'p7 <br />