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RECORDS <br />OCT 0 71005 <br />� <br />Work Activity Work Order Pagr_ � <br />-___ . ___...-- � - --- -------.____ . . . . . . . . . <br />10/3/2005 13:49 <br />ISSl1Bd By WMW WARD, MICHAEL W. <br />Issued Department aw PUBLIC WORKS <br />Date Issued sll5izoo5 <br />Fund aat Account s Program »o Function ��g Activity s�s <br />Program <br />TiIIB REPAIR 3004 51ST PL SW. 710119671 <br />WOfk OfdBf NO 20050903 P�OJBC1 Activity Type CORRECTIVE MAINTENANCE SfB�US CL <br />Date snsi2oo5 Timeis:aa Original WO_ Billing <br />Customer Information <br />Customer Name <br />Address Street <br />Apartment No City <br />State Zip <br />Subdivision <br />Phone No ( ) • Ext <br />Second Phonc� ( ) - Ext <br />E-Mail Address <br />Problem Information <br />Address 3004 Street 51ST PL SW <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision Map Book <br />Problem, <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No Called Date <br />Assignment Information <br />Dept <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 ��CATION DIDSJT GHANGE ENOUGH TO CHANGE IDS <br />COmpleted By KTJ <br />Start Date i <br />Approved By <br />Problem Details <br />Customer ld <br />Ciiange Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimaled Hours <br />KeLso, 7HOMAs �. Job Cost Information(Y/N) <br />i Time Date Completed y��snoos <br />_ _ --- _ - — <br />Fo4ow Up? Permit No <br />Time <br />