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Work Activity Work Order <br />� <br />Page 1 <br />B/1B/2005 7:49 <br />ISSUed By AOA AHLES, OREOORY A. <br />Issued Department vN PUBLIC WORK9 <br />Dale Issued &6rtoos <br />Fund 4ot Account a Program »p FuncNon �pp Activity eTs <br />Progrem <br />Tllle REPAIR 1808 112TH ST SE 710108875 <br />WOfk OfdBf NO 2OOrJOS�JA PfOJBCi Acllvity Type CORRECTIVE MAINTENANCE SIAfU3 CL <br />Dale srsnoos Timete:os Origlnal W0 B(Iling <br />Customer Information <br />Customer Name <br />Addf0S5 ig08 Slf9Bl 11ZTH 8T SE <br />Apartment No City <br />Stete Zip <br />Subdrvision <br />Phone No ( ) • Ext <br />Second Phone ( 1 • Ext <br />E•Mail Address <br />Problem Informatlon <br />Address �gpg Street ��pTHSTSE <br />From Cross Slroet <br />7o Cross Street <br />City <br />Subdivision Map Book <br />Problem SEWER SEWER <br />Sub Problem SS SIDE SEWER <br />Requested By <br />Agency <br />Initialed From <br />Utility Locate (USA) No Called Date <br />Asalgnment Iniormatlon <br />DOp� PW PUBLIC WORKS <br />CfBW SCONST SEWERCONSTRUCTION!qHLES) <br />Contrector <br />Assigned To AAL ARNOLD, ARiHUR L. <br />ASSiA�Bd By A6A ANLES, GREGORY A. <br />Assigned Dale To Be Comp Date <br />Scheduled Dele Scheduled Time <br />Roule Route Sequence <br />Commenls <br />Actlon Taken REPAIRED BROKEN SIDE SEWER. <br />Completed By qq� <br />Start Date � <br />Approved By <br />Problem Details <br />ARNOLD, ARTHUR L. <br />� Tima <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map ReFerence <br />Date Requested <br />Releted Request <br />Explration Date <br />Priorily Estimated Nours <br />RECORDS <br />s� o % ioos <br />Job Cost Information(Y/N) <br />Uate Completed ��p��yo0s <br />Follow Up7 Permlt Na <br />Time <br />