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�, <br /> Work Activity Work Order �39e � <br /> 10/3/2005 12:56 <br /> �SSUOd Bf CAG CRUM,GERRY <br /> Issued Departmenl Pw PUBLIC WORKS <br /> Date Issued s�aizoos <br /> Fund ao� Account s Program +�o Funclion iiy Activiry s6y <br /> Program <br /> TIIIC SO.75 INCH 11230 3RD AVE SE pL0T2 710119664 <br /> WOfk OfdBf NO 20050567 PfOJ@Cl Activity Type CORRECTIVE MAINTENANCE SI�Il15 CL <br /> Oat� e�ai2oo:, Time�s:z� Original WO tts25 Billing <br /> Customer Information <br /> Cvstomer Name Customer ld <br /> Addf2S5 1129U S�fBBI JRD AVE SE <br /> nnartment No Ciry <br /> State Zip <br /> Subdivision Change Map Y/N <br /> Phone No 1 ) - Ext <br /> Second Phone ( ) - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address Streel <br /> From Cross Sireet <br /> To Cross Streel <br /> City ZiP <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utilily Locate(USA)No Called Date Expiration Date <br /> Assignment Information <br /> �QP� Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assic�ned Dale To Be Comp Date <br /> Scheduled Dale Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Takei� IN ACCESS ROAD BETWEEN 11230 8 ?7232 9RD. <br /> Compleled By wo� WEAVER,DEAN L. JOb COSI If1fOfR1B�lOf1(Y/N) <br /> Start Date r � Time Date Completed g��q�yo05 Timz <br /> Approved By f-'ollow Up? Permit No <br /> Problem Details <br /> � <br />