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e <br />Work Activity Work Order <br />Page 1 <br />iz�ia�zoiL io:zs <br />ISSUOd By HMP HALE, MICHAEL P. <br />Issued Department aw PUBLIC WORKS <br />Date Issued tznvzo�i <br />Fund �2o Account s Program eaa Function �os Activity s�� <br />Progrem <br />TIfl2 ��DEWALK REPLACEMENT B37 RUCKER AVE <br />WOfk Ofd2f NO 2���26�� PfOJ@Cf Activity Type CORRECTIVE MAINTENANCE Sf8fU5 CL <br />Status iuta�zoti Time to_zs Ori inai WO g�����9 <br />Customer Information <br />Customer Name <br />Address <br />ApartmentNo <br />State <br />Subdivision <br />Phone No � 1 <br />Second Phone ( 1 <br />E-Mail Address <br />Problem Information <br />Address 831 <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Ulility Locale (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned Ta <br />Assigned By <br />Assigned Date <br />Scheduled Date __ <br />Route <br />Comments <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street RUCKER �7VE <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Action Taken BILL TO: ED GLAZER AND CATHY WHITE <br />831 RUCKER AVE <br />EVERETT, WA 98207 <br />Recommended Action <br />Approved By B00 BREKHUS. DENNIS B. <br />Start Date i � Time <br />Customer ld <br />Change Map YIN <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Job Costlnformation(Y/N) <br />DateCompleted �v,v2o�� PermitNo <br />�� <br />