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Pege 1 <br /> Work Activity Work Order 6,Z„�al, ,5:5; <br /> ISS:IEd BY WMW WARD,MICHAEL W. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued 217 912 01 3 Account s Program �to Function ��s Activity 675 <br /> Fur,d aot <br /> Program <br /> TIfIB REPAIR]51NCH 408 VERALENE WAY SW 7101196-5 <br /> Work Order No 20130471 PfOJ2Ct Activity Type CORRECTIVE h7AWTENANCE SlBWS CL <br /> 2/19/2013 Tlfl'10 13:34 Of191f121 WO . Billitl9 _ _ _ . -- - <br /> Status ---- - -- — -- <br /> Customer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No City <br /> S!ate Z�P Change Map Y/N <br /> Subdivision <br /> Phone No ( ) - Ext __ ___ _ _ <br /> Second Phone ( ) - Ext <br /> E-Mail Address - <br /> Problem Information <br /> Address 408 SL-eet VERAL�NE WAY SW <br /> From Cross Street <br /> To Cross Street ZiP <br /> City Map Book Map Reference <br /> Subdivision <br /> Problem <br /> Sut Problem Date Requested <br /> Requested By Felated Request <br /> Agency <br /> Initiated From Ex irelion Dale <br /> Utility Locate (USA) No Called Date P <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> C rew <br /> Contractor <br /> Assigned To <br /> Assigned By To Be Comp Date <br /> Assigned Date <br /> Scheduled Dale Scheduled Time <br /> i <br /> Route Route Sequence <br /> Comments <br /> ACtI0I1 TdkCft CONVERTED TO SETTER WITH JUMPER AND BCX. <br /> R�commended Action <br /> Job :ost Information(Y/N) <br /> Approved By RJP �PELYEA,.IASON P. — FC;iilit NO <br /> —— Date Completed v�vzo�a ___ <br /> Start Date � � Time -- - " - <br /> - - <br /> -- <br /> Completed Hy <br /> Time Follow Up. ____ _ ___ __ <br />