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'�G � <br /> Work r�ctivity Work Order Page � <br /> si�sizeca e:si <br /> ISSued By CAG CRUM,GERRY <br /> Issued Department�w PUBLIC WORKS <br /> Dalelssued snsnooe <br /> Fund qo� Accounl , Program ��o Funclion »g Activity ssa <br /> Program . <br /> Tille SO 4 INCH 12728 19TH AVE SE 710119864 <br /> WOfk Ofd2f NO Z�O8�4�2 PfOfBCI Activity Type CORRECTIVE MAINTENANCE $�B�US PR <br /> Date sn5i2ooa Time oe:as Original WO 2ooao3si Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Streel <br /> Apartment No City <br /> State Zip <br /> Subdivision Change Map 1'/N <br /> Phone No ( ) • Ext <br /> Secund Phone ( ) • Er.t <br /> E-Mail Address <br /> Problem Information <br /> Address 1Y7P8 Street �gTHAVESE <br /> From Cross Slreet <br /> To Cross Sireet <br /> City 7_ip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requesled By Date Requested <br /> Agency Related Reques, <br /> Initialed From <br /> Utility Locate (USA) No Called Date Expiration Dale <br /> Assignment Information <br /> Dept Priority Eslimated Hours <br /> Crew <br /> Contraclor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scfieduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments BILL JOB.NO DEPOSIT TAKEN ON THIS COST ESTIMATE.WILL BE <br /> BILLED.SHOULD BE ENOUGH MONEY TO COVER THIS FROM OTHER <br /> WORK ORDERS. <br /> Action Taken <br /> (�l � <br />