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� <br />Work Activity Work Order <br />ISSt1Cd BY S�TZ SPOONER, JA�dES T. <br />issued Department rw PUBLIC WORKS <br />Date Issued 5/2912009 <br />Fund aot Account 5 Program ��o Function >>� Activiry b�s <br />Program <br />TiIIC REPAIfi 5923 LOWELL RD 770119u75 <br />Work Order No 20090671 Project Activiry l ype coaRecnve �.vvr�rera.�.rice Status c� <br />Slatus ei2�zooe Timn io:oz Original WO Billing <br />Customer Im`ormation <br />Customer �ame <br />A�dress Slreet <br />Apartment No City <br />Slat� Zip <br />Subdivision <br />Phone No ( 1 - Ext <br />Second Phone ( ) - Ext <br />E-Mail Address <br />Problem Information <br />Address Sgy3 Street �OWELL RD <br />From Cross Street <br />To Cross Street <br />Cily <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Iniliated From <br />Ulility Locale (USA) No Called Date <br />Assignment Inform�tion <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Map Book <br />Assigned Date To Be Comp Dale <br />Scheduled Date Scheduled Time <br />Raute Route Sequence <br />Comments <br />Action Taken REPAIR SETTER WI SALVAGED PARTS <br />Recommended Action <br />APPfOVed By KTJ KELSO, THOMAS J. <br />Slart Dale � � Time <br />Cornpleled E3y <br />Customer ld <br />Change Map Y/N <br />a� '�f��'J <br />Zip <br />Map Reference <br />Date Requestc�l <br />Related Request <br />Expiralion Date <br />Priorily 6slimalcd Hours <br />Job Cost Information(Y/N) <br />Date Compleled e�z�zooe Permit No <br />Time Follow Up? <br />