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�Q �ArERlq�s <br /> Work Activity Work Order Pn3e 1 <br /> iz/ze/zoii e:i� <br /> ISSU2d By AGA AHLES,GREGORY A. � � <br /> Issued Department rw PUBLIC WORKS <br /> Date Issued iviei2oti <br /> Fund �ot Account s Program »o Function �Z� Activity e�t <br /> Program � <br /> Tifle ADJUST 812 W CASINO RD 710127671 <br /> WOfk OfdBf NO 20��252� P�OJECt Activiry Type CORRECTIVEMA!NTENANCE S�8fU5 CL <br /> Status iv�eno>> Time ioa� OriginalWO Billing <br /> Customer Iniormation <br /> Customer Name Customer ld <br /> Address etz Sireet wcnsiNo rto <br /> Apartment No City <br /> State Zip <br /> Subdivision Change Map Y/N <br /> Phone No 1 1 • Ext <br /> Second Phone l I - Ext <br /> E•Mail Address <br /> Problcm Iniormadon <br /> Ad ress g�y Street yyCASINO RD <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem DRAIN DRAINAGE <br /> Sub Problem CB'S ALL CB EXCEPT CLEAN <br /> Requested By oeM� 000�nN, eainN rn. Date Requested <br /> Agency Reiated Request <br /> Initiated From <br /> Utiliry Locate(USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Pw PUBLIC WORKS Priority Estimated Hours <br /> CfBW SCONST SEWER CONSTRUCTION(AHLES) <br /> Contractor <br /> Assigned To IJM IMHOF,JAMES M. <br /> Assigned By AGA AMLES.GREGORY A <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comme:its <br /> Actlon Taken RAISED F8G <br /> R@COIT1R10I1(IBfI AC�IOf1 ADJUST CB TO ROAD SURFACE <br /> Approved By IJM IMHOF,JAMES M, JOb COSf Ifl(Of1118I1Of1(Y/N) <br /> Start Date � i Time Date Completed t�nenott Permit No <br /> Compieted By Time Follow Up7 <br /> � <br />