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. . �I�� �0� � � �������� ��K�, S <br /> ii�'ork Activity Work Order 'd9` 1 <br /> �/:s/�o�s �o:ze <br /> i55�ee ey sRn SORGEN,ROBERT A. <br /> Issued Departm�rtrw rueucwoRKs <br /> Date Issued tns�zo�s <br /> Fund tzo Account s Program aeo Function tos Activity s�i <br /> Program <br /> TillB SIDFVJALK REPLACEf✓ENT 1332 RUCKER <br /> Work Order No 20151614 Pro�ect Aciivity Type CORRECTIV[�dAINTENANCE Status c� <br /> Status �nsno�5 Time io-23 Original WO Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No ��h' <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No 1 1 • Ext <br /> Second Phone ( 1 - Ext <br /> E-Mail Address <br /> Problem InFormation <br /> Address Streel <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requesled By Date Requested <br /> Agency Related Request <br /> Irntiated From <br /> Ulility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date _ To Be Comp Date <br /> Scheduled Date Scheduied Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken BILL T0: TRACY GILSON <br /> 1372 RUCKER AVE <br /> EVERETT,WA 98201 <br /> Recommended Action <br /> Approved By ecs �+roN,�Rca s. Job Cost Iniormation(Y!N) <br /> Start Date i � Time Date Completed a�e�zots Permit No <br />