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�10 MATERIALS <br /> Work Activity Work Order F3O` 1 <br /> 9iz�izoio io:z� <br /> ISSUed By AGA AHLES,GREGORY A. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued enonoto <br /> Fund ao� Accounl s Program �io Function tza Activity s73 <br /> Program <br /> TIt10 REPAIR 6119 iST OR SE 710123673 <br /> Work Order No 20102291 Project Activity Type SERVICE REQUEST Status c� <br /> Status anoizo�o Time oe z3 Original WO _ _ _ ___Billing __ <br /> Customer Information <br /> Customer Name AMANDA Customer ld <br /> Address Slreet <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 206 ) 458•1249 E%� <br /> Second Phone ( ) • Ext —— — — <br /> E-Mail A�ldress <br /> — _ _ _ -- _ __ <br /> Problem Information <br /> Address s��g Street �ST DR SE <br /> From Cross Slreet <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem DRAIN DRAINAGE <br /> Sub Problem <br /> Requested By MBR MOSS,BRIAN R. D2tE R2qU@Si2d i�z��zoto <br /> Agency Related Request 000eeaa� <br /> Initiated From PUBLIC PUBLIC <br /> Utility Locate (USA) No 1017W74 Called Date Expiralion Date <br /> Assignment Information <br /> Dept PW PUBLIC WORKS Priority Estimated Hours <br /> CfeW SCONST SEWERCONSTRUCTION(AHLES) <br /> Contractor <br /> Assigned To IJM IMHOF,JAMES M. <br /> Assigned By AGA AHLES,GREGORY A <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken EXCAVATED CAVE IN. BAD BACK-FILL JOB BY CONTRACTOR PUTTING IN UNDERGROUND <br /> UTILITIES. <br /> RE'COrt101Bf1d0d ACtiOfl DIG UP CAVE•IN DETERMINE PROBLEM AND FIX <br /> Approved By t�M IMHOF,JAMES M JOb COSI IflfOffllBllOf1(Y/N) <br /> Slart Date � i Time Date Completed 9naroto Permit No <br /> Completed By Time Follow Up? <br />