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Work Activity Work Order Pa9e 1 <br />12/29/2011 8:04 <br />ISSU2d B)� WMW WARO, MICHAEL W. <br />Issued Department Pw PUBLIC WORKS <br />Datelssued 9nsno�� <br />Fund ao� Account 5 Program �to Function »� Activity 664 <br />Program <br />TitlB S0 75 1NCH SFR 9205 4TH AVE W 7101196E4 <br />WOfk Ufd@f NO Z���z30� PfOJeC� Activity Type C�RRECTIVE MAINTENANCE SfBIIIS CL <br />Status vis�2oii Time ieoz Ori inaiWO tat�s Billic�_ _ __ _ ____ ____._ <br />9 -- - - --- — - <br />Customcr Information <br />Customer Name <br />Address Street <br />Apartment No City <br />State Z�P <br />Subdivision <br />Phnne No 1 ) - Ext <br />Second Phone ( 1 - Ext <br />E-Mail Address <br />Problem Information <br />Address gyps Street qTH AVE W <br />From Cross Street <br />To Cross Street <br />Ci!y <br />Subdivision blap Book <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initialed From <br />Utiliry Locate (USA) No Called Date <br />Assignment Information <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Dept Priority <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date To Be Comp Dale <br />Scheduled Date Scheduled Time <br />Roule Route Sequence <br />Comments <br />ACt10t1 T8kCi1 NEPTUNE METER N906028641NSTALLEO ON. RFi7831855372 <br />Recommended Actfon <br />APpfOVBd By HLJ HU58Y, LANCE J. <br />Start Date � r Time <br />Completed By _ <br />Eslimated Hours <br />Job Costlnformation(Y/N) <br />Date Completed tvztizai� ___ Permit No ____ <br />Time Follow Up9 _ <br />��y <br />