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k, �''c. �- �. :� � � . y' ;� "��� <br /> i��..�,' '�':�i: -�i �� ., d <br /> Page 1 <br /> Work Activity Work Order ll,l,Zol, la:Z, <br /> IS5U0d By WMW WARD,MICHAEL W. <br /> Issued DepaitmentPw PUBLICWORKS <br /> Date Issued ��zs�2ott <br /> Fund 3as Account s Program Function Activity <br /> Program uPsazt e <br /> TIIIB REPAIR EIGHT INCH 710 EDWARD AVE UP3427-5 <br /> Work Order No 20111275 PfOjeCl Activity Type CORRECTIVE MAIl1TENANCE S�etUS CL <br /> Status n2snot� Time �e:as Original WO __ Billing _ ____ _ ___ <br /> Customer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) • Ext ------_----_ --. <br /> Second Phone ( ) - Ext <br /> E-Mail Address ----- ---- — —-- <br /> Problem Information <br /> Address ��p Street EDWARD AVE <br /> From Cross Street <br /> To Cross Street <br /> Y Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem Date Requested <br /> Requested By Related Request <br /> Agency <br /> Iniliated From <br /> Utility Locate(USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Eslimaled Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By To Be Comp Date <br /> Assigned Date _______ <br /> Scheduled Date _ Scheduted Time __ <br /> Route Route Sequencu <br /> Comments <br /> Action Taken MADE CONNECTION TO EXISTING MAIN. <br /> Recommended Action <br /> Approved By WDL WEAVER,oenN�. Job Cost infom�ation(YIN) _ <br /> Slart Date � i Time __ __ Date Completed �ms�2ot� Permit No <br /> ComptetedBy_ __ __ _ Time _ FoilowUp? <br />