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Work �',ctivity Work Order <br />� <br />Paqa 1 <br />5/27/^'105 9:10 <br />ISSUBd By WMW W/►p'�, MICHAEL W. <br />Issued Departmenl Pw pUPIIC WORKS <br />Dale Issued an/sooe <br />Fund ro� Fund s Pro9rem �ta FuncNon ��a Acavity e�e <br />Program Function Activity <br />TIdB REPAIR 3523 FEDERAL AVE 710119875 <br />Work Order No 20050453 Pro�ect Activity Type CORRECTIVE MAINTENANCE StaWs a <br />Date __ 5�2noos Time�o:3t O�iginal WO Bflting <br />Customer Infortnation <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No ( ) - <br />Second Phone ( ) - <br />E-Mail Address <br />Problem Information <br />Address 3523 <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No <br />Assignment Iniormation <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />Route <br />Commenta <br />Actton Taken sETTERINSTALLED PER <br />Customer ld <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />St� FEDERAL AVE <br />Zip <br />Map Book <br />Called Date <br />Prioriry <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Completed By wo� WEAVER, DEAN L. <br />Start Date i i Time <br />Approved By <br />ON CHART. <br />Change Map YM <br />Map Reference <br />Date Requested <br />Related Request <br />Expfration Date <br />Estimated Hours <br />Job Cost Information(Y/N) <br />Date Completed yy200S Time <br />Follow Up7 Permit �s <br />Problem Detafls ��p 151005 <br />