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Work Activity Work Order `'a��° 1 <br />. .. _ ...._.._ ......___ . . . . .. . . . <br />G/20/2q06 10:29 <br />�ssued By WMW WARD, MICHAEL W. <br />Issued Oepartment Pw PUBLIC WORKS <br />Date issued 6/16I2006 <br />Fund qo� Account s Program �to Function >>y Activity s�s <br />Progrem <br />Title REPAIR 712 33RD ST 710179675 <br />WOfk OfdOf NO 20061093 PfOJOCf Activity Type CORRECTIVE MAINTENANCE Sf9f115 PP <br />Date 6/1 612 0 05 Time is:a3 Ofi91f181 WO BIIIIt19 <br />Customer Information <br />Customer Name Customer ld <br />Address Street <br />Apartment No City <br />State Zip <br />Subdivision Change Map YIN <br />Phone No ( ) - Ext <br />Sewnd Phone ( ) - Ext - <br />E-Mail Address <br />Problem Information <br />Address 71Y Street 33RD ST <br />From Cross Street <br />To Cross Street <br />City Zip <br />Subdivision Map Book Map Reference <br />Problem <br />Sub Problem <br />Requested By Date Requested <br />Agency Related Request <br />Initiated From <br />Utility Locate (USA) No Called Date Expiration Date <br />Assignment Information <br />Dept Priority Estimated 1'ours <br />Crew <br />Cantractor <br />Assigned To <br />Assigned By <br />.^.ssigned Dale To Be Comp Dale <br />Scheduled Date Scheduled Time <br />— __ _ _ _ <br />Route Route Sequence <br />Comments � /j� <br />Action Taken .._ ✓� �2'�-v"G l'1i-- --��/_p-G.p��r�crn� / V � �r�,Cr�__ <br />V– " l <br />