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� <br /> Work Activity Work Order 'aOz 1 <br /> LL�Zb�.�.�12 I5:?3 <br /> ISSIIBd BY HMP � HALE, MICHA[L P. <br /> Issued Department Pw PUBLIC WORKS <br /> Dale Issued �yino�z <br /> Fund �2o Account 5 Program eao Function ioa Activity ei� <br /> Program <br /> TIllO SIDEWALK REPLACEMEtJT 9315 tOTH AVE SE <br /> Work Order No z��2z69� PfOJBCf Activity Type CORRECTIVE MAINTENANCE Sl8lU5 CL <br /> Status izizsizoiz Time i5:ao Original WO __ _ _ _____8illing __ ___- <br /> Customer Informatio,. <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No Ciry <br /> State Z�P Change Map YIN <br /> Subdivision <br /> Phone No ( ) - Ext __ _ _ _ <br /> Second Phone ( ) • Ext <br /> E-Mail Address _ -- ---- - - - - - - - — <br /> Problem Information <br /> Address 931g Street 10TN AVE SE <br /> From Cross Street <br /> To Cross Street <br /> Ciry Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requesled <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> C rew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date __ To Be Comp Date <br /> Scheduled Date ___._. Scneduled Time _____ , <br /> Route Roule Sequence <br /> Comments <br /> Action Taken BILL T0:JAMES SCANLON <br /> 9915 10TH AVE SE <br /> EVERETT,WA 9b208 <br /> Recommended Action <br /> Approved By ecs eisNerr,crte�c s. Job Cost Information(YIN) _ _ <br /> Start Date � i Time Date Completed �y�vzo�2 Permit No <br />