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Work Activity Work O�-der <br />ISSULd By WMW WARD, MICHAEL W. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued snnoo� <br />Fund qot Account s Program �to Function �te <br />P�,c 1 <br />sni:=;,o�� ,:5�� <br />Activiry e�s <br />Program <br />TIUQ CONVERT 3920 GRAND AVE 710119675 <br />Work Order No Z00%O3H% PfOJeCI Activity Type CORRECTIVE MAINTENANCE Sl2lUS PR <br />Date 5nnoo� Time or5z Original WO Billing <br />Customer Informatian <br />Cuslomer Name Customer ld <br />Address Slreet <br />Apartment No Ciry <br />State Z�P <br />Subdivision Change Map Y/N <br />Phone No � 1 - Ext <br />Second Phone f 1• Exl - <br />E-Mail Address <br />Problem Information <br />Address 3920 Street GRAND AVE <br />From Cross Streel <br />To Cross Street <br />Cily Z�P <br />Subdivision Map Book <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Map Reference <br />Oate Requested <br />Related Request <br />Uliliry Locate (USA) No Called Date Expiralion Date <br />Assig��r.+en[ Information <br />Depl Priority Estimated Hours <br />Crew <br />Contraclor <br />Assigned To <br />Assigned By <br />Assigned Dale To Be Comp Date <br />Scheduled Date _ Scheduled Time <br />Route Roule Sequence <br />Comments <br />ActionTaken - - __ . _.------ — -- -- - - -- --- <br />