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� <br /> Work Activity Wo��k Order <br /> ISsiied E3y MWE MOORE,WARF2EN E. <br /> Issued Depar�ment PW PUBLIC WORKS <br /> U.ile ISSUCd 9/30/2008 <br /> Fund qot Account 5 Program >>p Function >» i�.r.ir�ity ��; <br /> Program <br /> Title RGPAIR 3412 LOh1DAHD�VE 710119675 <br /> Work Order No 20080881 Project Activity Type c��!�t:r�,i���-:_ ;.�:,inrt_r!:,�;��;� Stntus c� <br /> Stalus �c?o:?oeri llme i3�:itt Original W0 E3illing <br /> Customer Information <br /> Customcr Name Customcr ld <br /> Address Street <br /> Apartment No Ciry <br /> State Z�P <br /> Subdlvision Change �;i;+p 1?tJ <br /> Phone No ( � - �xt <br /> Second Phone l � - L=xt <br /> GMail Address <br /> Problem Information <br /> Adciress 3412 S-«'O� LOMBARD AVF <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdfvision Map 800k t�1ap Rc(erence <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated Front <br /> Utility Locate (USA) No Called Date Expiration Datu <br /> Assignment Information <br /> Dep� Prio�ity Estimaled Hours <br /> Crew <br /> Contractor <br /> �ssigned To <br /> Assigned By <br /> l;ssi�ned Da�c To Cie Comp Date <br /> Sc;heduled Date Scheduled Time <br /> houte Route Sequence <br /> Comments <br /> Action Taken SETT[F2 INSTALL[D 2' L[FT OF LEFT AND 3G'OIIT. <br /> Recommended Actioii <br /> �lpproved By wMw ::�'��;��. �:+i�;�inF�ti'� Job Cost Infurmalion(Yl�J) <br /> Stort Dale i � Time Dale Completed io�v2ooe Permit No <br /> Completed f3; Time Follow Up? <br />