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� <br /> Work Activity Work Order ' ��� <br /> ISSUCd By CAG CRUM,GERRY <br /> Issued Deparlmenl rw PUBIIC WORKS <br /> Date Issued �onZ2oos <br /> Fund ao� Accounl s Program �ia Fundion ttg Aclivity eea <br /> Program <br /> T1�IB S021NCH37108ROADWAY7 7 07 7 9664 <br /> WOfk OfdCE NO 20050950 PfOJCCI Activity Type CORRECTIVE MAINTENANCE SI8W5 CL <br /> Date �onznoos Time os:as Oriyinal WO itaot Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartmenl No City <br /> Stale Zip <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 - Ext <br /> Second Phone ( ) � Exl <br /> E-Mail Address <br /> Problem Information <br /> Address 37f0 Street BROADWAY <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Re(erence <br /> Problem <br /> Sub Problem <br /> R�quested By Date Requested <br /> Agency Related Requesl <br /> Initiated From <br /> Ulilily Locate (USA)No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority [stimaled Hours <br /> Crew <br /> CoMractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken <br /> COfnplElBd By MiL2 MARKHAM,TIMOTHY L. AppfOVCd By <br /> Start Date i � Time Date Completed 7/1y2006 Time <br /> Job Cost In(ormation(Y/N) Follow Up? Permit No <br /> Problem Details <br /> � <br />