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�� <br /> :� <br /> - c�... <br /> Work Activity Work �rder ` ' <br /> ISSUCd BY L'SG CAVANAH,SHANE G. <br /> Issued Departmenl Pw PUBLIC WORKS <br /> Date issued �onsizooe <br /> Fund ao� Account s Program �10 Funclion tie Act�vity a�; <br /> Program <br /> TIfIG RENEW 75 374 42ND ST SW 710119675 <br /> \NOfk Ofd�f NO 20092963 PfOJCCI Aclivity l�ype CORRECTIVE MAWTENANCE SI:]lU5 CL <br /> SldlllS 102�I2U09 Time t2:3� Ofl9l�al WO 20092A71 Blllifl(� <br /> Customer Information <br /> Customer Name Custonier W <br /> Address Slreel <br /> Apartment No Cily <br /> State Z�P <br /> Subdivision Ch�nge Map YIN <br /> Phone No 1 1 - Ext <br /> Second Phone ( i - [xt <br /> E-Mail Address <br /> Problem Information <br /> F�ddress 3�q Street 42N0 ST SW <br /> Fram Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map ReFerence <br /> Problem <br /> Sub Problem <br /> Requested Dy Date Requesled <br /> Agency Related Requesl <br /> Initiated From <br /> Ulilily Locate (U�;Aj No Called Date Expiration Date <br /> Assignment Infc�anation <br /> Dept Priority Estimated hlours <br /> Crew <br /> Contractor <br /> � Assigned To <br /> Assigned By <br /> Assigned Dale Tu 13e Comp Da;� <br /> Scheduled Date Scheduled Time ����i`�,f��Y:-. <br /> Roufe Route Sequence <br /> Comments ��� �� �������' <br /> � 1 <_ <br /> Action Taken CONNECIED TO NEW MAIN. <br /> Recommended Action <br /> Approved By BGM2 6EUKERS,GEORGE na. Job Cost Information(Y/N) <br /> Slari Date i � Time Oate Completed 1012812009 Pernnl No <br /> Completed By Time Follow Up7 <br /> — — � <br />