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Work Activity Work Order Pa9e 1 <br /> s/i�/zoia is:sz <br /> ISSlled By GCR � GRENZNER,CHRIS R. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued 411 412 0 7 4 <br /> Fund aot Account s Program �to Function �05 Activity s�s <br /> Program <br /> TIfIe REPAIR 303 SKYLINE DR 710109675 <br /> Work Order No 20140876 PfOJBCI Activity Type CORRECTIVE MAINTENANCE SIa1U5 CL <br /> Status vtarzoia Time ts2a Original WO _____ Billing <br /> Customer Intormatfon <br /> Custumer Name Customer ld <br /> Address Street <br /> Apartrc�ent No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) - Ext <br /> Second Phone ( > • Ext — - <br /> E-Mail Address _ __ <br /> Problem Information <br /> Address 3p; Street SKYLINE DR <br /> From Cross Street MEDORA WAY <br /> To Cross Street <br /> City EVERETT Z�P <br /> Subdivision Map Book Map Reference <br /> Problem SEWER SEWER <br /> Sub Problem SS SIDE SEWER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utiliry Locate(USA) No 14074912 Called Date Expiration Date <br /> Assignment Information <br /> Uept Pw PUBLIC WORKS Priority Estimated Hours <br /> CfCW SCONST SEVJERCONSTRUCTION(GRENZNER) <br /> Contractor <br /> Assigned To OBS OLHAVA,BRAD S. <br /> Assigned By GCR GRENZNER,CHRIS R. <br /> Assigned Date _ _ _ To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPLACED SIDE SEWER FROM MAIN TO PROPERTY LINE. <br /> Recommended Action RepqiR sioe seweR <br /> Approved By oes o�Hnvn,ertno s. Job Cost Information(Y!N)_ <br /> Start Date i i Time Date Completed am�zo�a _ Permit No <br /> Completed By Time Follow U ?_ <br /> p --- __ <br />