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;; � � S :� � � r. <br /> J .,� �". <br /> Work Activity Work Orde� " ' ` <br /> ,. . . . . <br /> I55uCd By WMW WARO,MICHAEL W. <br /> Issued Deparlment Pw PUBLIC WORKS <br /> Dale Issued �o�s�isoo� <br /> Fund aot Accounl s Program »o Funclion �t5 Activity svs <br /> Program <br /> TIUB REPAIR 225 AWERSON ULVD 71011�J675 <br /> WOfk OfdBf NO �0��09�5 PfO�CCf Activi�y 1'ype CORRECTNE MPVJTENANCE SI0W5 CL <br /> Date ton3nom Time oe2o Original WO Billing <br /> Customer Inlormation <br /> Customer Name Cuslomer ld <br /> Address Street <br /> Apartment No City <br /> Slato Z�P <br /> Subdivision Change Map Y/N <br /> Phone No 1 I • Exl <br /> Second Phone 1 1 • Ext <br /> E•Mail Address <br /> Problem InformaHon <br /> Address yyg Slrect AWERSON BLVO <br /> From Cross Street <br /> To Cross Streel <br /> Cily 2ip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Froblem <br /> Requested t�y Dale Requested <br /> Agency Related Request <br /> Iniliated From <br /> Utility Localo (USA)No Called Dale Expiration Dale <br /> Assignment Information <br /> Depl Priority Estimaled Hours <br /> Crew <br /> Conlractor <br /> Assigned To <br /> Assigned By <br /> Assiqned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Commants INSTALLEO 1B"RESETTER 6 STACKED TWO BOXES TO BRING TO <br /> GRADE. <br /> Action Takon BILL TO : JEFF MCCALLUM <br /> 225 ALVERSON BLVD <br /> EVERETT,WA. 98401 <br /> Completed By DKR DAY.KFViN R. Ap��Oved By <br /> Slart Date � i Time Date Compleled tana�2oo7 Time <br /> Job Cost Information(YM) Follow Up? Permit No <br />