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" I <br /> -. K . . �. �a <br /> ` � _ -� ;� <br /> Work Activity Work Order =°'e : <br /> �oi�eizoos iz:s� <br /> ISSUBd By CAG CRUM,GERRY <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued e�eizoo5 , <br /> Fund ao� Account g Program »o Function »g Activity fifiq I <br /> Program i <br /> TIflB SO 61NCH 11020 �9TH AVE SE 710119E64 � <br /> Work Order No 20050565 PfOjeCl ACtlVlty TypO CORRECTIVE MAINTENANCE StBWS Cl I <br /> Date 6I8/2005 Timeis:is Ofl,�l�81 WO 20050563 Billi�9 ! <br /> Customer Information <br /> Customer Name Customer ld <br /> Ad(1fCSS 11020 S��281 19TH AVE SE <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No � � - Er.t <br /> Secono Phone ( � • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address Street <br /> From Cross Street <br /> To Cross Street <br /> City ZiP <br /> Subdivision Map Book Map Referenr.e <br /> Problem <br /> :;ub Prablem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate(USAj No Called Date Expiration Date <br /> Assignment Information <br /> Dept Prioriry Estimated 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 /> 3�/� ' <br />