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Work Activity Work Order �'�` - <br /> 4;?C/2.,:5 ._ .2] <br /> ISSUEd By SRA SORGEN,ROBERT A. <br /> Issued Departmentrw rueucwoRKs <br /> Oate Issued a�erzois <br /> Fund �zo Account s Program eao Funct�on �oe A�����Y 6t� <br /> Program <br /> TitlO S�DEWALK REPLACEMENT 1402 COLBV <br /> Work Order Nu 2��5�059 PfOf2C1 AcLvity Type CORRECTIVE MAINTENANCE $1Bf115 CL <br /> Stalus <�3onois Time o9oi _ Ongmal WO _ __ Billing _J <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdiws�on Change Map YM <br /> Phone Na ( ) - Ert <br /> Second Phone ( 1 • E�R ------- <br /> E-��7ail Address <br /> Problem In(ormation <br /> Nddress Street <br /> From Cross Streel <br /> To Cross Street <br /> City Z�F <br /> Subdrv�sron Map Book Map ReFerence <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utihty Locate(USA) No Called Date Exp�ration Date <br /> Assignment Intormation <br /> Dept Pnonty Estimated Hours <br /> Crew <br /> Contractor <br /> Ass�gned To <br /> Ass�gned By <br /> Assigned Date _ To Be Comp Date _ __ <br /> Scheduled Date Scheduled T1me ___ <br /> Route Route Sequence <br /> Commenls <br /> Action Taken BILLTO: RALPH GELlER50N <br /> 14D2 COLBY AVE <br /> EVERETT,WA 98207 <br /> Recommended Action <br /> Approved By ecs EATON, GREG S Job Cost Information(Y/N) <br /> Start Dale i i Time Date Completed 4116'2015 Permit No <br />