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Work Activity Work Order <br />� <br />`� <br />:,:�. <br />����F��ao; _:_._. <br />ISSU2d By CAG CRUM,GERRY <br />Issued Department Pw PUBLIC WORKS <br />Date Issued Wze�zoos <br />Fund 4ot Account s Program »o Function ��g Activity fifiq <br />Program <br />Tille S021NCH 3722RUCKERAVE 710119664 <br />Work Order No Z�050622 PfOf@Cf Activity Type CORRECTIVE MAINTENANCE $f81U5 CL <br />Date si2eizoo5 Timeoe:oo Original WO Billing <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No ( 1 <br />Second Phone ( 1 <br />E-Mail Address <br />Problem Information <br />Address <br />From Cross Street <br />To Cross Street <br />Ciry <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Iniliated From <br />Utility Locate (USA) No <br />Assignment Information <br />Dept <br />C rew <br />Conlractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />Route <br />Comments <br />Street <br />Cily <br />Zip <br />Ext <br />Exl <br />Street <br />Map Book <br />Called Dale <br />To Be Comp Dale <br />Scheduled Time <br />Route Sequence <br />ACt1011 T0k¢tl IN SIDEWALK NORTH OF STAIRS <br />Completed By KTJ <br />Start Date � <br />Approved By <br />KELSO,THOMASJ. <br />� Time <br />Cuslomer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Relaled Requesl <br />Expiretion Date <br />Prioriry Eslimated Hours <br />Job Costlnformation(Y/N) <br />Date Completed �m�ei2oos <br />Follow Up? Permil No <br />Time <br />Problem Details � <br />� <br />