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V11ork Activity Work Order �age 1 <br /> 9��a��oia iz:ss <br /> ISSU2d BY CSG CAVANAH,SHANE G <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued 8179/2014 <br /> Fund aoi Account s Pragram »o Function i�9 Activity e�s <br /> Program <br /> TIfl2 KILL.751NCH 3709 25TH ST 710119675 <br /> Work Order No 20142732 Project Aclivity Type SERVICE RE�UEST Status c� <br /> Status ___ __ e��9�zoia Time t5:oa Original WO_ __ Billing _ __ <br /> Customer Information <br /> Customer Name BENTON,RICK Customer ld <br /> flddfESS 2426 SIfBEf E GRAND AVE <br /> Apartment No City <br /> State ZiP <br /> Subdivision Change Map Y/N <br /> Phone No I 425 ) 2aa-oaoa Ext <br /> Second Phone ( � - Ext — <br /> E-Mail Address <br /> Problem Information <br /> Address 37pg Street ySTH ST <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem LEAK LEAK <br /> Requested By ccM cnse,cHno M Date Requested ene�zo�a <br /> Agency Related Request ooia3ieo <br /> Initiated From PUBLIC PUOLIC <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Pw PUBLIC WORKS Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To ASP ANDERSON,SHAN P. <br /> Assigned By <br /> Assigned Date ___ __ To Be Comp D�te <br /> Scheduled Date Scheduled Time _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken KILLED SERVICE <br /> Recommended Action <br /> Approved By RJA RAPELYEA,JASON R JOb COSI IflfOffil2�lOf1(YIN) _ <br /> Start Date � ! Time Date Completed 9Iy2014 PermihNo <br /> Completed By _ Time _ Follow Up? _ <br />