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Work Activity Work Order page � <br /> iz/ze/zoii is:ze <br /> Issued By CSG CAVAI:AH,SHANE G. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued �tmzoit <br /> Fund ao1 Account s Program »o Function tts Activity 675 <br /> Program <br /> TI[le REPAIR.75 INCH 910 PARK DR 770119675 <br /> WOfk OIdBf NO 20112589 PI'OjECf ACtlVlty Typr• CORRECTIVE MAINTENANCE S�e�US CL <br /> Status �zmzoii Time �s:�o Original WO Billing _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment 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 g�p Street pARK DR <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requestetl 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 /> Contractor <br /> Assigned To <br /> Assigned By <br /> AssigneC Date __ ___ To Be Comp Date <br /> Schedulad Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken INSTALLED SETTER AND JUMPER DURING BLOW OFF REPAIR <br /> Recommended Action <br /> Approved By BGM2 BEUKERS,GEORGE M. JOb COSt IflfOff112110f1(Y/N� <br /> Start Date � � Time Date Compieted �tienott Permit No _ <br /> – — — — — <br /> Completed By Time Follow Up? <br />