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S ` <br /> Work �ctivity Work Order � � °' <br /> , <br /> ISSUCd�y CAG CRUM,GERRY <br /> Issucd Departmenl Pw PUBLIC WGRKS <br /> Daie Issued �o�zzi�ao� <br /> Fund qui Accounl s Program 7to Function »g Achvity 6» <br /> Program <br /> Ti11C T�('B INCH 1110 CHESTNUT ST 71011967J <br /> WOfk OfdCf�d0 20�709�2 PfO�CC� Activity Type COf2RECTIVE MAIN7ENA�'CE $�elu5 CL <br /> Dale �onvz�o� Time �3 3A Oric�mal WO 20o�o��a Billing <br /> Custamor Intormation <br /> Cuslomer Name Cuslomer ld <br /> Address Street <br /> Apariment No City <br /> State Zip <br /> Subdivision Cha,ige blap Y/N <br /> Phone No 1 I • Exf <br /> Second Phone 1 1 - [xt <br /> E�Mail Address <br /> Problom Information <br /> Address ���p $heel CHESTNUTST <br /> Prom Cross Strecl <br /> To Cross Sirec� <br /> Ciry Zip <br /> Subdrvision Map E3ook A1ap Re(crence <br /> Problem <br /> Sub Problem <br /> Requested By Dale Requested <br /> Agency Related Request <br /> Ini�iated From <br /> Utility Locate(USA) No Called Date Expiratwr. Date <br /> Assignment Information <br /> Dept Priority Estimaled Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned �y <br /> Assigned Dale To Be Comp Date <br /> Scheduled Oate Scheduled Time <br /> Routc Roule Sequencc <br /> Camments aa oi���oo <br /> Aclion Taken 6'TAP WIGAT[VALVE WAS DONE BY CITY Of[VERETT. <br /> Compleled Dy cnc ci+uM, c[izier Approved By <br /> Start Date i i Timc Date Comploted �zin�soo� Time <br /> Job Cost In(ormahon(Y/N) Follow Up? Permit No <br /> Problem Details <br />