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f� <br />Work Activity Work Order <br />IsSUCd By KTJ KELSO, THOMAS J. <br />Issued Depar�ment rw pUBLIC WORKS <br />Dale Issued �oize�zoos <br />Fund aoi Accoun� 5 Program »o Function t�� ;1ct����tv s�s <br />Program <br />TiIIC CONVERT 3606 W MUKILT[O �LVD 710119u75 <br />Work Order No 20080972 Project Activily Type coaaecnve niair�reNnNce Stalus c� <br />Slatus �mze�zoon Time oe-?3 Original WO Billing <br />Customer Information <br />Customer Name <br />Address Slreet <br />Apartmenl No City <br />State Zip <br />Subdivision <br />Phone No 1 1• �xl <br />Second Phone ( ) • Ext <br />E-Mail Address <br />Problem Intormation <br />Address 3606 Strcet �yMUKILTEO BLVD <br />From Cross Street <br />To Cross Street <br />Cily <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initialed From <br />Utilily Locate (USA) No Called Date <br />Assignment �nformation <br />Depl <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Map Book <br />Assigned Dale To Be Comp Date <br />Scheduled Date Scheduled Time <br />Roule Roule Sequence <br />Comments <br />ACt1011 T.7kCt1 INSTALLFn S[TT[R, M1IETER AN� BOX. <br />Recommended Action <br />Approved ay HLJ r�usi�v �;,r�ce.i. <br />S181� �J:71C I I TII11C <br />i;n;nplelcil [3y, <br />Custonmr ld <br />Chenge hiap Y!N <br />Zip <br />1�1ap Reference <br />Date Fequested <br />Rela�ed Request <br />Expiration Date <br />Priorily Es6m:ited Hours <br />Job Cosl Information(1'/N) <br />Dale Cornpleted 1012912008 Pernvl No <br />Time Follow Up? <br />