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Work Activity Work Orde� Pa9� 1 <br /> io�2��zoii ia:zi <br /> -- -- -- <br /> — -- <br /> ISSUedBy SRA SORGEN,ROBERTA. <br /> issued Department Pw PUBLIC WORKS <br /> Date Issued toiz5izatt <br /> Fund t2o Accounts Program eao Function toe Activity ett <br /> Program <br /> TItIB SIDEWALK REPLACEMENT 1732 WETMORE 840108611 <br /> WOfk OfdBf NO Z���Z45Z Project Activiry Type CORRECTIVE MA�MTENANCE StefUS CL <br /> Status �orz�rzo�i Time ia:i3 OriginaiWO Billing_ __ ____ ___ __ __ _ __ <br /> Customer Intormation <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No Ciry <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No ( ) - Ext ---- - -- -- -- - <br /> Second Phone ( ) - Ext <br /> E-Mait Address - - - - <br /> Problem Informatlon <br /> Address »3y Street yyETMOREAVE <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Man Reference <br /> Probiem <br /> Sub Problem Date Requesled <br /> Requested By Related Request <br /> Agency <br /> Initiated From <br /> Utility Locate(USA) No Called Date Expiration Date <br /> Assignment laformation <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time _ _ _ _ <br /> Route Roule Sequence <br /> Comments <br /> Action Taken - - - -- — " --- <br />