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���� �.��d�ru�� �.ht's���€� c�r�e��r �,�� � <br /> ioi3o!zoi3 is:s3 <br /> Issued By WMW WARD,MICHAEL VV. <br /> Issued DepartmentPw PUBLICINORKS <br /> Dale Issued 812912013 <br /> Fund aoi Account s Program »o Function >>g Aclivity e6a <br /> Prog�am <br /> Title SO 751NCH 9501 ]RD AVE SE L0T6 710179664 <br /> Work Order�Vo 20137.387 PfOfEC? AC6VIly Type CORRECTIVE LIAINTENANCE .$ldlll5 CL <br /> Status ar_o�zo��3 Time u 3s Origina11N0 So i3?zz Billiny <br /> C�stomer Iniormation <br /> Customer Name Customer id <br /> Aadress S;reet <br /> �partment No City <br /> Stale Z�P <br /> Subdivision Change Map Y/N <br /> Pi�one No ( ) • Ext <br /> Second Phone ( � - Ext —- <br /> E-Mail Address <br /> Probiem Information <br /> Address 9501 Street 3RD,4VESE <br /> From Cross Streel <br /> To Cross Street <br /> City �ip <br /> Subdivision Map Book Iviap Reference <br /> Problem <br /> Sub Problem <br /> Requesled By Date Requested <br /> Agency Related Request <br /> Initialed From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Depl Prionty Est,n ated Hours <br /> Crew <br /> Conlractor <br /> Assigned To <br /> Assigned By � <br /> Assigned Date _____._ To Be Comp Date __ _ _ <br /> Schedu!ed Dale Scheduled Time __ <br /> Route Route Sequence <br /> Comments <br /> Action Taken �hSTALLED METER q91411074,RFk1874857906. 14�ATER LOCKED OFF. <br /> Recommended Action <br /> Approved By HlJ HUSBY,LAN�E J. .10b COSi ICfOff112110f1(Y/N) <br /> Start Date r � Time Oale Completed 912612013 Permit No <br /> Completed By _ __ _ _ Time _ _ Follo�•✓ Up? _ __ <br /> ' I <br />