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. a <br /> IlVorr: Activity Work Order F°°° ' <br /> �izc;zoo, . :sy <br /> ISSU2d BY CAG CRl1M,GERRY <br /> Issued Deoartment Pw PUBLIC WORKS <br /> Dale Issued anvzaos <br /> Fund qo� Account s Program »o Function 1�g Activily ssa <br /> Program <br /> TIIIB SO 1 INCH 1618 47TH 5T SE ;10119664 <br /> Work Order No z0060878 Project Aclivity Type CORRECTIVE MAINTENa,P.oe Status a <br /> Date anvzoos Time os:n Original WO its�2 Billing <br /> Customer Information <br /> Customer Name Custome� Id <br /> Address Street <br /> Apariment No City <br /> State Zip <br /> Subdivision Change Map Y!N <br /> Phone No ( ) • Ext <br /> Second Phone ( ) - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address 1618 Street 47TH ST SE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problei�� <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Ulility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimaled 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 Route Sequence <br /> Comments <br /> Action Taken <br /> ��0 <br />