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� <br /> Work Activi�y Work Order pa9e 1 <br /> 7/19/2005 10:36 <br /> . . --- -- ------------- ------ . . _.__� - -_. _ _ _. <br /> ISSued By WMW WARD,MICHAEL W. <br /> Issued Department Pw PUBuc wORKs <br /> Date Issued enertoos <br /> Fund �ot Account s Program �to Function �t9 A�h�ity a�a <br /> Program <br /> TItIC REPAIR 3809 BROADWAY 710119675 <br /> WOfk Ofd@f NO Z���63� PfOJBCi Activiry Type CORRECTIVE MAINTENANCE S►BlU3 CL <br /> Date �rzsrzoo5 Time12:o9 Original WO Billing _ ____ _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 • Ext <br /> Second Phone ( ) - Ext --— <br /> E-Mail Address <br /> Problem Information <br /> Address 3809 Street BROADWAY <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested 8y Dete Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate(USA) No Called Date Expiration D�te <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date __ _ Scheduled Time _ __ <br /> Roule Route Sequence <br /> Comments RECORDS <br /> Actian Taken TM S METER TO BE ASSIGNED NEW ADDRE53 OF 3801 BROADWAY APPLICATMON N 29728 JUL 2 91005 <br /> Completed By Krd_ KELSo,THOMAS J. .lOb Cost lnformation(YIN) � <br /> Start Daie � � Time Date Completed &2erzoos�C�� "me I <br /> --- --- - ---- -- — <br /> Approved By — _ _ __ -__— __ —-- Follow Up? __ Permit NoJ�L� 9 2 — <br />