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' ' / <br /> `' � ,' ' i' <br /> �� � �' .� "�� � <br /> Work Activity Work Order r�<,,= 1 <br /> IssuedBy -wMF - — -- - _ _ iiiir�izoo ; ii:a:, <br /> WELLMAN,MARK F. <br /> Issued Dep2rlment Pw PUHLIC WORKS <br /> Datelssued cnznoos <br /> Fund aoi Accounl5 Program ��a Function t�s Activit <br /> Program y 6G4 <br /> Tille SO 6INCH 1130 SE EVERETT MALL WAY 710119664 <br /> 1h'ork Order No 20050599 PfOJBCI P,Cliylf T 8 CORRECTIVE MAINTG <br /> Date snvzoos Timeo,;3s Original WO vssa Y YP 5illin NANCE S�ati c� <br /> _-- - -- 9 <br /> Customer Information <br /> Customer Name Custoi ner ld <br /> Address 1130 $lf8ef 5E EVERETT MALL WAY <br /> Apartment No Cily <br /> State Z�P <br /> Subdivision <br /> Phone No ( � _ Change Map Y/N <br /> Ext <br /> Second Phone f � - Ext <br /> E-Mail Address <br /> Problem I�formation - - - <br /> Addresa Street <br /> From Cross Street — <br /> To Crr,ss Street <br /> City ZiP <br /> f-roblemion Map Book Map Reference <br /> Sub Problem <br /> Requesled By <br /> Agency Date Requesled <br /> Initiated From Related Request <br /> Utility Locate (USA) No Called Dale Expiration Date <br /> Assignment Informatian <br /> Dept Priorit <br /> Crew Y Estimated Hours <br /> Contractor <br /> P.ssigned To <br /> Assigned By <br /> Assigned Date 7o Be Comp Date <br /> Scheduled Date _ Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken PROREAD-2l R=0 <br /> Completed By c'r� GALLAGHER,THOMAS J. JOb COSI IflfOff118GOf7(Y/N) <br /> Start Date i i Time Date Completed <br /> Approved By - 7ieizaos _ Time <br /> Follow Up? Permit No <br /> Problem Details <br /> 2/7 <br />