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Work Activity Work �rder �z�` ' <br /> sii/zoos ��:2z <br /> ISSi1Bd BY WMF WELLE7AN,MARK F. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued en�2oos <br /> Fund aoi Fund s Program �to Puuciion tts Ac�ivity aea <br /> Program Function Activity <br /> Title S0 2 1NCH 2521 LOMBARD AVE 710119664 <br /> � � <br /> WOlk OfdB�NO 20050549 Pf0J0Cf Activity Ty;�e CORRECTIVE MAINTENANCt Sf8YU5 PR <br /> Date 6/1/2005 Timeis:io Orig�nal WO Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment !Jo City <br /> State Z�P <br /> Subdivision Ch2nge Map Y'N <br /> Phone No ( 1 - Ext <br /> Second Phone ( ) • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address Street <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Referer�ce <br /> Problem <br /> Sub Problem <br /> Reques!ed By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> �ssignment Information <br /> Dept Priority F.stimated Hours <br /> Crew <br /> Contractor <br /> Assigned To / � _ _ <br /> Assigned By - - � � <br /> Assigned Date To Be Comp Daie � - <br /> Scheduled �ate Scheduled Time <br /> Route Route Sequence <br /> Comments _ <br /> Action Taken /�� �--" :-.`,-> � (=:'" �-I ( ��5 �._�� <br /> y�9 <br />