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Work Activity Work Order pa°e 1 <br /> 5/8/2013 14:39 <br /> ISSUBd BY SRA SORGCN,ROBERTA. <br /> Issued Departmenl Pw PUBLIC WORKS <br /> Date Issued 71812073 <br /> Fund �so Account�� Program sao Function �os Aclivity F» <br /> Program <br /> TitIC SIDEWALK REPLACEMENT 1108 RUCKER AVE <br /> Work Order No 20130925 {�fOJBCI Activity Type CORRECTIVE MAINTENANCE S18IU5 CL <br /> Status srenoi3 Time ia:s3 Original WO __Billing _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 - Ext <br /> Second Phone ( ) • Ext - – — <br /> E-Mail Address <br /> Problem Information <br /> Address »pg Street RUCKER AVE <br /> From Cross Street <br /> To Cross Street <br /> Ciry Z�P <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate(USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority cstimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> A,signed Date To Be Comp Date _ _ <br /> Scheduled Date Scheduled Time _ _ _ <br /> Route Roule Sequence <br /> Comments <br /> Action Taken BILL T0: KATHERINE BENUSA <br /> 1708 HUCKER AVE <br /> EVERETT,WA 98201 <br /> Recommended Action <br /> Approved By ecs BISNETT.GREGG S. JOb COSI Itl(OfR18tI0f1(Y/N) <br /> Start Dale r r Time Date Completed a�zam�s Permit No <br />