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Work Activity Work Order <br />Yage 1 <br />izni�zo:z is:sz <br />ISSUed By CSG CAVANAH, SHANE G. <br />Issued Department Pw PUBLIC WORKS <br />D e lssued �o�tizot2 <br />Fund ao� Account 5 Program �io Funclion �iy Activity e�s <br />Program <br />Title REPAIR 75INCH 4219 S 3RD AVE 770119675 <br />WOfk OfdOf NO ZO�ZZ267 PfOJ@Cf ACtIViiY Typ2 CORRECTIVE MAINTENANCE St2fU5 CL <br />Sta;us �orznotz Time �s:as Original WO Billing <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No � > <br />Second Phone ( ) <br />E•Mail Address <br />Problem Information <br />Address qy�g <br />�rom Cross Slreet <br />To Cross Streel <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Utiiity Locate (USA) No <br />Assignment Informatfon <br />Dept <br />Crew <br />Contraclor <br />Assigned To <br />Assigned t3y <br />Assigned Date <br />Scheduled Date <br />Route <br />Comments <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Streel S 3RD AVE <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Action Taken FROZE SERVICE AND REPAIRED. <br />Recommended Action <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Re(erence <br />Date Requesled <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Approved By wo� WEAVER. DEAN L. JOb COSt IflfOffTlB�lOf1(YIN) <br />Start Date i � Time Date Completed ionorzo�z <br />Completed By Time Follow Up? <br />Permit No <br />