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Work Activity Work Order <br />Page 1 <br />12/10/2014 9:54 <br />Issued By SRA SORGEN, ROBERT A. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 6/1712014 <br />Fund 120 Accounts Program 840 Function tog Activity 611 <br />Program <br />Title LONGFELLOW SIDEWALK IMPROVEMENTS • 34TH ST. <br />Work Order No 20141549 Project Activity Type CORRECTIVE MAINTENANCE Status CI - <br />Status 6/17/2014 Time 08:40 Original WO_ _ Billing _ <br />Customer Information <br />Customer Name <br />Customer Id <br />Address <br />Street <br />Apartment No <br />City <br />State <br />Zip <br />Subdivision <br />Change Map YIN <br />Phone No ( 1 <br />Ext <br />Second Phone ( 1 - <br />Ext <br />_ <br />E-Mail Address_ <br />— <br />Problem Information <br />Address <br />street <br />From Cross Street <br />To Cross Street <br />City <br />Zip <br />Subdivision <br />Map Book <br />Map Reference <br />Problem <br />Sub Problem <br />Requested By <br />Dale Requested <br />Agency <br />Related Request <br />Initiated From <br />Utility Locate (USA) No <br />Called Date <br />Expiration Dale <br />Assignment Information <br />Dept <br />Priority Estimated Hours <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date _ <br />To Be Comp Date <br />Scheduled Date _ <br />Scheduled Time <br />Route <br />Route Sequence <br />Comments <br />Action Taken BILL TO: PLANNING 8 COMMUNITY DEVELOPMENT DEPT. <br />JAN MESTON <br />Recommended Action <br />Approved By <br />Job Cost Information(Y/N) <br />Start Date i / <br />Time Date Completed 121112014 Permit No <br />_ <br />Completed By <br />_ Time <br />__ Follow Up? <br />