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Work Activity V'Jork Order <br />Pacn ] <br />, :r;/3o. '_-.... <br />ISSUed By WMW WARD, MICHAEI. W. <br />Issued Oepartment Pw PUBLIC WORKS <br />Date Issued sizzna�a <br />Fund aot Accouni s Program »o Function >>y Activity 664 <br />Program <br />Title 50 ]5 INCH 1311 h1ADRONA AVE 710119664 <br />Work Order No Z��4��96 PfOfCCf Activity Type CORRECTNG MAINT[NANCE <br />Status s�zzrzoia Time �a:5s Original WO so-isze5 __ Billing __ __ __ ____ <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No � � <br />Second Phone ( 1 <br />E-Mail Address <br />Problem Information <br />Address �3» <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 />Contraclor <br />Assigned To <br />Assigned 13y <br />Assigned Date <br />Scheduled Date _ . ____ <br />Route <br />Comments <br />Cusromer ld <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Slreet MADRONA AVE <br />Zip <br />Map Book <br />Called Date <br />Priority <br />To Be Comp Date <br />Scheduled Time <br />Reu.te Sequence <br />ACtiOtl TakCf1 INSTAlLEO METEP a94027419, RF19504725°9. WATER ON. <br />Recommended Action <br />Change Map Y/N <br />SI2IU5 CL <br />��1ap Reterence <br />Date Requested <br />Related Request <br />Expiration Date <br />Estimated Hours <br />Approved By wo� w[AoeR, oenN �. Job Cost Informalion(Y/N) <br />Start Date � i Time Date Completed s�zz�zo�a_ _ Permit No <br />Completed By _____ Time _ Follow Up? __ <br />