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,. �n, �.��'i�� ( �� h.1?-�cf � � ` Iti.'"1��� 3nnC.:�✓-/ !�°" C� "!:7- �'� Il.'�7S c'i"lft'/�PC� INtc. <br /> . ll � ' �c ; ; c <br /> � R�.���i.' �� ���� � /, � <br /> Work Activity Work Order �y" � <br /> ��iFizno; io:n <br /> Issued Lly CAG CRUM,GERRY <br /> Issued Uepartment PW PUBLIC WORKS <br /> Date Issued 9I1Y/2005 <br /> Fund aot Accounl5 Program �ta Function »g Activity :ea <br /> Program <br /> TIfIC SO.751NCH 8820 3RD AVE SE 710119664 <br /> Work Order No 20050880 PfOJBCI Activity Type CORREfTIVE MAINTENANCE SlBtUS CL <br /> Date snzizoo5 Time os:s4 Original WO it�ao Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Slreet <br /> Aparimenl No � i <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No l ) - Ext <br /> Second Phone 1 ) - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address 8820 Street 3RD AVE SE <br /> From Cross Street <br /> To Cross Street <br /> City ZiP <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Requesl <br /> Initiated From <br /> Utility Locate (USA)No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> C rew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Dale To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Roule Sequence <br /> Comments <br /> A:�ion Taken <br /> \ <br /> ����� <br />