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Work Activity Work Order <br />Page 1 <br />B/16/2011 10:06 <br />ISSUBd By SRA SORGEN, ROBERT A. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued siaizott p�o ram e4o Function toa Activity et� <br />Fund txo Account s 9 <br />Program <br />Title SIDEWALK REPLP CEMENT 2602 HARRISON 8;010B67 7 <br />Work Order No 20111778 PfOJOC► Activity Type CORRECTIVE MAINTEMANCE Si8fU5 CL <br />Status 811 612 01 7 Time oe:ss Original WO Billing _ <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No � > - <br />Second Phone � > - <br />E-Maii Address <br />Problem 9ntormation <br />Adaress 2602 <br />From Cioss Street <br />To Cross Street <br />Ciry <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 />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date __ __ _ <br />Scheduled Date __ __ _ <br />Route <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street HARRISON AVE <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Comments BILL TO: MICHAEL CULL <br />2602 HARRISON AVE <br />EVERETT, WA 98201 <br />Action Taken <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />