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: . .. �; ,��. � �-. E�...��� <br />�li�ork Activity WaYk Order• <br />--�--� ---- ---------- ------------ - -------- <br />Issued By CAG CRUM GERRY <br />Issued Department aw PusuC wortKs <br />Date Issued 612812005 <br />Fund ao� Accounts <br />Program <br />TIIIB SO 61NCH 620 SE EVERETT <br />Work Order No 20050627 Project <br />Date sizai2oo5 Timeoe:l2 <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phane No ( ) - <br />Second Phone ( 1 - <br />E-Mail Address <br />Problem Information <br />Addrass <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 Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />Route <br />Comments <br />Action Taken TAP FOR FIRE SERVICE <br />Completed By css <br />Start Date i <br />Approved By <br />Problem Details <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street <br />� <br />Fage 1 <br />10/28/2005 13:21 <br />Program »o Function ��y Activity ssa <br />_L WAY #200 710119664 <br />ACtiVity Type CORRECTIVE MAINTENANCE StaluS CL <br />Original WO 11639 Billing <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Roule Sequence <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Reiated Request <br />Expiration Date <br />Priorily Estimated Hours <br />CAVANAH, SHANE G. JOb COSt If1fOfI118fi0(1(Y/N� <br />_. _ _ _ _ <br />I Time Date Completed �m���zoos Time <br />_ _ __ __ _.__ <br />Follow Up? Permit No <br />�� <br />