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�w��i ���� <br /> . � ��_ � <br /> Work Activity Work Orde� n�°t � <br /> �s;t;,%ze�s io:ze <br /> ---- - _ --- - --- ------- - --- - <br /> ISSUedBy SRA SORGEN,ROBERTA. <br /> Issued Department Pw PUBLI�WORKS <br /> Date Issued 91112015 <br /> Fund iZ� Account s Program eao Function �oe Activiry a�� <br /> Program <br /> TiIIE SIOEWALKREPLACE�dEN724020AKES <br /> WOfk OfdEf NO Z��SZZ�� PfOJ2CI Activiry Type CORRECTIVE MAIhTENANCE StaiUS CL <br /> Status _ �onaizo�s Time io zs_ Original WO Biliing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Zip <br /> Subdivision Change Map Y/N <br /> Phone No 1 ) • Ext <br /> Second Phone ( ) - E�R — -- — — — -- - <br /> E-Mail Address <br /> Problem Information <br /> -- --- ----- _- <br /> Address Street <br /> From Cross Street <br /> To Cross Street <br /> Ciry Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Prablem <br /> Requested By Datz Requested <br /> Agency ReiateC Reques; <br /> IniUated From <br /> Utility Loca;e(USA) No Called Date Expiration Da;e <br /> Assignment Information <br /> Dept Priorily Estima;ed Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken BILL TO: NANCY RINERTSEN <br /> 2402 OAKES AVE <br /> EVERETT,WA 98201 <br /> Recommended Action <br /> Approved By Ecs �+roN.�rtec s. Job Cost Information(Y/N) <br /> Start Date i i Time Date Completed vieno�s Permit No <br />