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. �1 <br /> � Work Activity Work Order p3,E ' <br /> 1/31/ifi06 3:55 <br /> ISSIJed By CAG CRUM,GERRY <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued tonanoos <br /> Fund aot Account s Program »o Function �t9 Activity fifia <br /> Program <br /> TIflO SO.75 INCH 3121 LOMBARD AVE#D 710119fi64 <br /> WOfk OfdBf NO ZOO5O962 PfOJOCf ACliVlfy TyP2 CORRECTIVE MAINTENANCE Sf8tu5 CL <br /> Dale tai3noo5 Timeoe:n Original WO tten Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�p <br /> Subdivision Change Map YIN <br /> Phona No ( ) • Ext <br /> Second Phone 1 ) - Ext <br /> E-Mail Address <br /> Problerti Information <br /> Address 3�Z� Stree: LOMBARD AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Bcok Map Reference <br /> Prohlem <br /> Su� Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Cont�actor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route oute Sequence <br /> Comments INVENTORY MATERIAL IN THE AMOUNT OF$264.18,WAS <br /> � JOURNALIZEO IN 2005 <br /> �-� <br /> ....— <br /> Action Taken <br /> �I S <br />