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3 <br /> Work Activity Work Order Pa9e 1 <br /> 6/26/2006 9:47 <br /> ISSUBd By CAG CRUM,GERRY <br /> Issued Depa. ment Pw PUBLIC WORKS <br /> Date Issued s��tnoos <br /> Fund 40� Account s Program �to Function t�e Activity ssa <br /> Program <br /> TIIIC SO 2 INCH 11610 EVERGREEN WAY 710119664 <br /> WOfk OfdBf NO Z006���6 �fOJBCf Activity Type CORRECTIVE MAINTENANCE SfOtUS CL <br /> Date 5I11I2006 TIfTIB 1034 Ofl9if181 WO 12036 Blllifl9 <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Zip <br /> Subdivision Change Map YIN <br /> Phone No ( 1 • Ext <br /> Second Phone f ) • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address ��g�p Street EVERGREENWAY <br /> From Cross Street <br /> To Cross Streel <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <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 /> Route Route Sequence <br /> Comments <br /> Action Taken NORTH SIDE OF SOUTH WAL•MART ENTERANCE IN BACK OF SIDEWALK. <br /> ICOfilpl0�8d By KTJ KELSO,'fHOMAS J. APpfOVBd By <br /> Start Date i � Time Date Completed W6I2006 Time <br /> Job Cost Information(Y/N) Follow Up? Permit No <br /> Problem Details <br /> a� <br />