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G'� <br />Work Activity Work Order <br />ISSII�:d BY NSO NICLS[N, SCOTT 6. <br />Issued Deparlment rw PUDLIC WORKS <br />Datc Issued 7iza�zuo5 <br />Fund aot Accounl,, Program »o Function tie Activity 675 <br />Program <br />TiUE k[PAiR 1' 124 2JTH Sl� SE 710 118675 <br />Work Order IJo 20094550 Projecl Activity Type coreiz�cird[ r,t�aiutFuni:cr_ Status c� <br />Status 7%zarzoo� l�ime u�-��s Onginal WO Billiny <br />Customer Iniomiation <br />Custemer Namc <br />Address Strccl <br />Apartment No C�ty <br />Slale Z�P <br />Subdivision <br />Phone No l 1- Exl <br />Second Phone ( 1 - Exl <br />E-A4ail Address <br />Prablem Informalion <br />Address i�ipq Slreet ZOTHSTSE <br />Prom Cross S�rcel <br />To Cross Slreel <br />Ci�y <br />Subdivision Map Book <br />Problem <br />Sub Problem <br />Requested By <br />A�ency <br />Iniliated From <br />Utility Locate (USA) No Called Dale <br />Assignment In(ormalion <br />Gept <br />Crew <br />Conlractor <br />Assignetl To <br />Assigned By <br />Assigned Date To Be Comp Date <br />Scheduled Date Scheduled Time <br />Rou(e Roule Sequence <br />Commen[s <br />Action Taken MOVED M[TER TO OUTSID[ FENCE (NORTH OF PEhCE) <br />Recomrnended Action <br />Approved By NSO MELSEN, SCOTT O. <br />Start Dale / � 7ime <br />Compleled By <br />Customcr ld <br />Change Map Y/N <br />Zip <br />P�iap Re(erence <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimaled Hours <br />Job Cost Information(Y/N) <br />Date Compleled anenoos <br />T�n�e Follow Up? <br />Permit No <br />