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Issued By AGA <br />Issued DepartmentPw <br />Date �ssued a�anoi� <br />Fund aot <br />Prc,�ram <br />Work Activity Work Order <br />� AHLES, GREGORY A. <br />PUBLIC WORKS <br />Account s Program �to Function �ae <br />Page - <br />12/28/2011 8:34 <br />Activity e7� <br />��IIIQ ADJUST 5418 S 2ND AVE 710109671 <br />WOfk Ofd@� NO Z����58a PfOJBCt ACUVIfY TypO CORRECTIVE MAINTENANCE <br />Slatus aia�zoti Time oa:zs Original WO ____ __. _ Billing <br />Customer Information <br />Customer Name <br />Address sala Street s zr�o AVE <br />Apartment No City <br />State Z�p <br />Subdivision <br />Phone No l ) • Ext <br />Second Phone 1 1- Ext <br />E-Mail Address <br />Problem Iniormation <br />Address 5418 Slreet S 2ND.4VE <br />From Cross Street <br />To Cross Street <br />City Map Book <br />Subdivision <br />Problem SEWER SEWER <br />Sub Problem R8L RING AND LIDS <br />Requested By <br />Agency <br />Init�ated From <br />Utility Locate (USA) No Called Date <br />Assignment Information <br />Dept Pw PUBLIC WORKS <br />Cf�W SCONST SEWC-R CONSTRUCTION (AHLES) <br />Contractor <br />Assigned To IJM IMHOF, JAMES M. <br />ASSiyfl2d By AGA FHLES. GREGORY A. <br />Assigned Date To Be Comp Date <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comments <br />Action Taken RAISED SEWER MLT TO GRADE <br />Recommended Action anise rts� To �rtnoE <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Dale Requ=sted <br />Related Request <br />Expiration Date <br />Priority Eslimated Hours <br />Approved By IJM IMHOF, JAMES M. JOb COSt If1f0�rt18tI0f1(Y/N) <br />Start Date � i Time Date Completed iz�sreoti_ ._ <br />Completed Ey Time Follow Up? _ _ <br />$10W5 CL <br />Permit No _ _ <br />