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Work Activity Work Order Pag� 1 <br /> i��iz�zoiz �:a� <br /> ISSUBd By CSG CAVANAH,SHANE G. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued �ateno�z <br /> Fund eo� Account 5 Program ��o Function tts Activity e�s <br /> Program <br /> Title REPAIR.75 INCH 17507 2ND AVE SE 770719675 <br /> Work Order No 20�ZZ3�$ Project Activity Type CORRECTIVE MAINTENANCE SI8lU5 CL <br /> Status ionsrzot2 Time tz i� Original WO Billing <br /> Customcr 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 � > - Exl <br /> Second Phone ( 1 - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address Street <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested 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 /> C rew <br /> Contracror <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Dale <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPAIRED SERVIC[. <br /> Recommended Action <br /> Approved By wo� w�vER,�EnN�. Job Cost Information(Y/N) <br /> Start Date � � Time Date Compieted toi2si2o�z Permit No <br /> Completed By Time Follow Up? <br />