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� <br /> �` <br /> Work Activity Work Order <br /> ISSUBd By CAG CRUM,GERRY <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued a�z�nooa <br /> Fund ao� A;count , Program »o Function >>y Activity 6�3 <br /> Program <br /> Till� TAP 8 INCN 12726 19TH AVE SE 710119673 <br /> WOfk OfdBf NO 20080350 Project Activity Type CORRECTNE MAINTENANCE $t8�115 PR <br /> Date ai2vzooa Time osw, Original WO 2ooer3si Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Slreet <br /> Aparlmenl No City <br /> Stale Zip <br /> �ubdivision Change tvtap Y/N <br /> Phone No 1 I - Exl <br /> Second Phone 1 i - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address �Z�Zg Streef 19TH AVE SE <br /> From Cross Streel <br /> To Cross Streel <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requeeted By Date Requested <br /> Agency Related Request <br /> Initiafad From ', <br /> Ufility Locate (USA) No Called Dale Expiration Date <br /> Assignment Information <br /> Dept Priorily Estimated � ;�urs <br /> Crew <br /> Contraclor <br /> Assigned To <br /> Assigned By <br /> Assigned Dale To Be Comp Date <br /> Schec�ulc-,; Dale Scheduled Time <br /> Route Route Sequence I <br /> Comments BILlJ08 I <br /> AchonTaken Yo 0"V�+���`� /1 �'O <br /> i <br /> �'I� <br /> S <br /> � — � <br />