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- - c� <br /> Work Activity Work Order ' "' � <br /> z. _ <br /> Issued By CAG CRUM,GERRY <br /> issued Department rw PUBLIC WORKS <br /> Date Issued 9172/2005 <br /> Fund 4ot Account s Program »o Function tty Activity 66a <br /> Program <br /> T1�10 SO.751NCH 8838 3RD AVF SE 710179664 <br /> �Vork Order No 2U050860 project Activity Tvpe CORRECTIVE 61AINTENANCE Status c� <br /> Date �n2izoos TimeuS:sa Original WO t»ao Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> S�bdivision Change Map Y/N <br /> Phone No ( � • Ext <br /> Second Phone ( � • Ext <br /> E-Mail .Address <br /> Problem Information <br /> Address 8838 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 /> Requesled By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utiliry Locate (USA) No Called Date Eapiration Date <br /> Assignment Information <br /> Dept Priorily Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Dale To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Roule Route Sequence <br /> Comments '"� r p� <br /> Action Taken � �r ' "'�� ��5�'e�«o�1 _! ,Z�l�O 7 ��C.Q � <br /> I ! <br /> �S 5 ���G��`u�Q-- ���U 3 r�/l �(J�L S� <br /> -Q - <br /> �I� <br />