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� . ' d� <br /> Work Activity Work Order ` °"' '_ <br /> ISSU2d BY CAG CRUM,GERRY <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued snzizoos <br /> Fund ao� Account s Program »o Function »y Activity ew <br /> Program <br /> TI110 SO]51NCH 8832 3RD AVE SE 710N9664 <br /> Work Order No 2��508�� PfOjCC1 Activity Type CORRECTIVE AIAINTENANCE $f81U5 �L <br /> Dale sn2�zoos fin�eo9:ea Original WO Billing <br /> Customer Information <br /> Cuslomer Name Customer ld <br /> Address Slreet <br /> Apartment No Ciry <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 - Ext <br /> Second Phone l ) - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address 8832 Street 3RD AVE SE <br /> From Cross SUeet <br /> To Cross S�reel <br /> Cily ZiP <br /> Subdivision Map Book Map Reterence <br /> Problem <br /> Sub Probiem <br /> Requested By Datr Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Eslimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Dale Scheduled Time <br /> Roule Route Sequence <br /> Comments ,^,� _ `. �,... 1p 1 r' /� <br /> ActionTaken "'�� �'"� ��.�G••�`•¢� I/1.`��07 l^OG#Ge� �'J-}'� <br /> A�c�,re.ss c�,,,�- �l���s 3 r� �o�e S r l� <br /> ��// <br />