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• 5 a ! �`- <br /> : ��, <br /> „ ; , . <br /> „'�: .'.� l`c�� s , ..�'i '. : : _.�:;! ,���.,F� � • �• <br /> Work Activity Work Order ''a�` ` <br /> �/za/zois _ . <br /> 155u�d BY SRA SORGEN,ROBERT A. <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued s�za�Zo�s <br /> Fund �zo Accounts Program g4o Function �oa Aclwiry bi� <br /> Program <br /> Ti110 SID[tN�LK REPIACEMENT 1J32 RUCKER AVE <br /> VJork Order No 20150771 Pro�ect Aclrv�ty Type CORRLCTIVE�dA1NTENAWCE Status c� <br /> Stat�s a�zaizois T�me o� si Original WO Billing <br /> Customer Information <br /> Customer Name Customer la <br /> Address Street <br /> Apartment No C�ty <br /> State Z�P <br /> Subd�v�sion Change ��1ap Y/N <br /> Phone No ( 1 • Ext <br /> Second Phone ( 1 - Ext — — <br /> E-Mad Address <br /> Problem Information <br /> Address Street <br /> From Cross Streel <br /> To Cross Street <br /> City Zip <br /> Subdiwsion tJlap Book �viap Referencs <br /> Problem <br /> Sub Problem <br /> Rcquested By Da!e Reques'ed <br /> Agency Related Request <br /> Indiated Prom <br /> Utility Locate (USA) No Called Date Fxpirat�on Date <br /> Assignment Informa[ion <br /> Dept Pncnty FsUmatr_tl Nours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned E3y <br /> Assigned Date __ To l3e Comp Date _ <br /> Scheduled Date Scheduled iime _ _ <br /> Route Route Sequence i �, <br /> Comments <br /> �l`�.�lC;.r'�;;,)9'`y'� � '�`�;u' <br /> Action Taken DILI TO: TRACY GILSON <br /> 13J2 RUCKER AVE <br /> EVERETT,WA 98201 <br /> Recommended Aclion <br /> Appwved By ecs �+ror+ caE_c s Job Cost Informati�m(Y/N) <br /> Start Date � r Time Date Compteted a�a2o�s Permit No <br />