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� <br /> ��t�,r .��� � <br /> VVork Activity Wo�•k Order °a9" ' <br /> ici2oizoo; �3:oa <br /> I55u0d By CAG CRUM,GERRY <br /> Issued Department aw PUl7LIC WORKS <br /> Date Issued s�2enoo5 <br /> Fund aot Account s Program �io Function »y Activity esa <br /> Program <br /> TIIIB S0 81NCH 10001NDUSTRY ST 710119664 <br /> Work Order No 2��5�629 PfOJQCI Activity Type CORRECTIVE MAINTENANCE Sf8fU5 CL <br /> Date si2eizoos Timeoe:3a Original WO 2ooso�2e Billing <br /> Customer Information <br /> Customer Name Cuslomer ld <br /> Addrese Street <br /> Aparlmenl No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No � > - Ext <br /> Second Phone � ) • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address Street <br /> From Cross Street <br /> To Cross Street <br /> Cily Z�P <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub 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 Priorily Estimated Hours <br /> C rew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Dale To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken PRQ READ QAD•2;N MI60LE BLDG <br /> Completed E'y WTE V'lESTVANG,TERRY E. JOb COSt IYifOffll0ll0f1(Y/N� <br /> Slart Dale i i Time Date Completed �on3noos Time <br /> Approved By Follow Up? Permit No <br /> Problem Defails �l <br /> _I� <br />