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. , � <br /> Work Activity Work Order page 1 <br /> 6/9/2005 ;:53 <br /> ISSUBd By CAG CRUM,GERRY � <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued eie�2oos <br /> Fund ao� Account s Program �to Function »s Activity eea <br /> Program <br /> Tifl2 SO 6 INCH 1102G 19TH AVE SE 770119664 <br /> WOfk Ofd2f NO 20050565 P�OjOCi AC�IVIfy Type CORRECTIVE MAINTENANCE SfBttJS pR <br /> Date 6/812005 TIf1lB15,18 OriginalWO 20050563 Bllllfl9 <br /> Customer Information <br /> Customer Name CustomEr ld <br /> Address ttozo Stf28I 197H AVE SE <br /> Apa�tment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 - Ext <br /> Second 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 ��1ap Book Map Reference <br /> Problem <br /> Sub Problem <br /> R�quested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility �ocate(USA) No Called Date Expiration Date <br /> Assignment information <br /> Dept �%✓/�1-T'�/= Priority Estimated Hours <br /> Crew �v;�'-,� . <br /> Contractor <br /> Assigned To ����/��'� <br /> Assigned By /�'+�'=� i✓ • <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> ActionTaken - _ _ _ _ _ _ . __ - -- -- — - _ -- -- - _ _ _ _ _-- -- <br /> - ��i <br /> � <br />� � <br />