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Work Activity Work Order Pa°� ' <br /> �i3oizo�a ia:=o <br /> ISSUQd By AGA AHLES,GREGORY A. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued 312912010 <br /> Fund aot Acco�nt s Progrem �to Function �oe Activity e�s <br /> Program <br /> Titie REPAIR 2201 RUCKER AVE 710709675 <br /> Work Order No 20100797 Project Activity Type SERVICE REQUEST Status c� <br /> StaWs 3�zsizo�o Time tz29 Original W0 __ _ _ Billing_ _ ___ _ _ <br /> Customer Information <br /> Customer Name BOLDUAN,JOHN Customer ld <br /> Address zzot Sl�@E� RUCKER AVE <br /> ApartmEnt No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( azs 1 879-7279 Ext <br /> Second Phone ( 1 - Ext - <br /> E-Mail Address _ __ <br /> Problem Iniormation <br /> Address yyp1 Street RUCKERAVE <br /> From Cross Street <br /> �o Cross Street <br /> Ciry zip <br /> Subdivision Map Book Map Reference <br /> Problem SEWER SEWER <br /> Sub Problem SS SIDE SEWER <br /> Requested By HSR HOFFMAN,STEVEN R. DBte REQUCS�@d 312612010 <br /> Agency Related Request 000e�toa <br /> Initiated From PUBLIC PUBLIC <br /> Ulility Locata (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Uept PW PUBLIC WORKS Priority Estimated Hours <br /> CfBW SCONST SEWERCONSTRUCTION(AHLES) <br /> Contractor <br /> Assigned To oBs OLHAVA,BRAD S. <br /> AssignedBy AGA HHLES,GREGORYA. <br /> Assigned Date _ To Be Comp Date <br /> Scheduled Dale Scheduled Time _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPAIRED 4"SIDE SEWER BROKEN BY PUD POLE. <br /> Recommended Action EXCAVATE WITH VACTOR AND REPAIR SIDE SEW[R <br /> Approved By oas O�Hnvn,ertno s. Job Cost Information(YIN) <br /> _ ___ -- --- - <br /> Slart Date � � Time Date Completed sizs�zoto Permit No <br /> - -- <br /> Completed By Time _ Follow Up? __ __ <br />