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Work Aciivity Work Order <br />ISSU2d By WMF WELLMAN, MARK F. <br />Issued Deparlment aw PUBLIC WORKS <br />0 <br />Page 1 <br />3/13/2007 9:31 <br />Date Issued toizs�zoos <br />Fund ao� Account 5 Program »a Function ��g Activity 673 <br />Program <br />TIll2 INSTALL 2 INCH 922 51 ST ST SW 710119673 <br />WOfk OfdBf NO 20061527 PfOjOCI ACIIVIIy TyPB CORRECTIVE MAINTENANCE StBfUS CL <br />Date 10I25I2006 Time oe:es Original WO Billing <br />Customer lnformation <br />Customer Name <br />Address <br />Apartrnent No <br />State <br />Subdivision <br />Phone No l 1 - <br />Second Phone ( ) - <br />E-Mail Address <br />Problem Information <br />Address <br />From Cross Streel <br />To Cross Street <br />Ci�y <br />Subdivision <br />Probiem <br />Sub Problem <br />Requested 8y <br />Agency <br />Initiated From <br />Utility Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assig�ied By <br />Assigned Date <br />Scheduled Date _ <br />Route <br />Comments <br />Action Taken INSTALL 250' OF 2" POLY. <br />Street <br />Ciry <br />Zip <br />Exl <br />Ext <br />Street <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Customer ld <br />Zip <br />Change Map YIN <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Comoleted By WMF WELLMAN, MARK F. ApP�OVBd BY <br />-- _ — -- -- — <br />Start Date I � Time Date Completed vuzoo� ___ _ <br />Job Cosl Information(Y/N) Foliow Up? Permit No _ <br />Problem Details <br />Time <br />