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Work Activity Work Order <br />ISSU@d BY A6A AHLES, OREOORY A. <br />Issued Department rw PUBLIC WORKS <br />Date Issued 5�tvxots <br />Fund 4ot Accounts Program �to <br />Program <br />Title REPAIR 825 75TH ST SE 710109671 <br />Work Order No 20120660 Project A�tivity Type <br />S!atus 5nvzot2 Time oeo� Original <br />Cuatomer Information <br />Customer Name <br />Addf855 8I6 StfB@t 767H ST SE <br />Apartment No City <br />State Z�P <br />Subdivision <br />Phone No 1 ) • Ext <br />Se�:ond Phone l 1- Ext <br />E-Mail Address <br />Problum Iniormatlon <br />hdd�.� 625 �� 75TH SI St <br />From Cross Street <br />jQ�r S r e <br />City <br />Subdivision Map Baok <br />Problem SEWER SEWER <br />Sub Problem MANHOL MANHOLES <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No Calied Date <br />Assignment In(ortnatlo� <br />Dept Pw PUBLIC WORKS <br />CfBW SCONST SEYVER CONS7RUCTION (AHLES) <br />Contrector <br />ASSignBd TO OBS OLHA 'A, BRAD S. <br />Assigned By AGA AHLES, GREGCIRY A. <br />Assigned Date To Be Comp Uate __ <br />Scheduled Date Scheduted Time _ . <br />Route Route Sequence <br />Commente <br />Actlon Taken REPAIRED CiiANNEL. <br />R9COIIIRIBI1dBd ACtI0I1 RE•CHANNEL MH <br />Function toe <br />Page 1 <br />G/25/2012 15:00 <br />Activity e» <br />��ORRECTIVE MAINTENANCE S18lIlS CL <br />Customer ld <br />Change Map YIN <br />— _ _ _� <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Approved By oes o�rinvn, eRno s. Job Cost In(ormation(YIN) <br />Start Date i � Time Date Completed s�t�isott Pertnit No <br />Campteted By __ ___ __ _ ._ Time _ Follow Up? _ <br />