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� <br /> � <br /> Vllork Ar,tivi�y Work Orcier `°`�' : <br /> ISSu2d By WMF WELLMAN,MARK F. <br /> Issued Department�w PUBLIf,WORKS <br /> Dale Issued sivzoos <br /> Fund aoi Account s Program i�o Function tts Activity 66a <br /> Program <br /> TIIIB 50 2INCH 2527 LOMBARD AVE 710119664 <br /> � WOfk O�def i JO 20050549 ProjBCt ACtlVlty Typ2 GORREC?IVE MAINTENANCE SIBtUS CL <br /> Date sni2oos Timei3:�o Or,,�inal WO 2oosos52 Billing <br /> Customer Information <br /> Customer Name !MMANUEL LUTHERAN CHURCH CUStOfTlef Id <br /> AddfBSS 2521 StfQ2t LOMBARD AVE <br /> Apartment No �%��Y <br /> State ZiP <br /> Subdivision Change Map Y(N <br /> Phone No ( 1 - Exl <br /> S�cond Phone l > - Ext <br /> E-Mail AdJress <br /> Problem Information <br /> Address Streel <br /> From Cross Street <br /> To Cross Streel <br /> Ci;y Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Dale Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priorily Estimated Hours <br /> Crew <br /> Contractor <br /> AssiSned To <br /> Assic�ned By <br /> Assi�ned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Raute Sequence <br /> Comments <br /> ActionTaken METEIt#90419350 <br /> Completed By wmp WELLMAN, MAP,K F. JOb COSI Ifl(OffT1�lI0f1(Y/N) <br /> Start Dale � � Time Date Completed s�vzoos Tieie <br /> Approved By Follow Up? Permil No <br /> Problem Details �� <br />