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�� .��(Y 5 �` � �lcn2 � ' ��,; <br /> Work Activit�� 1rVork �rcler `'°�'� ' <br /> 7/ll/:n�.•�, 7:30 <br /> ISSUQCJ BY WMW WARD,MICHAEL W. <br /> Issued Department Pw PUBLIC 4JORKS <br /> Date Issued minooe <br /> Fund ao� Accounl s Program �to Function >>y Activity s�s <br /> Program <br /> Title REPAIR 8224 5TIi AVE W 710119675 <br /> Wark Order No 20061176 PfOf 8C1 Activity Type CORRECTIVE MAINTENANCE S�2lUS PR <br /> Date �n vzoos Time o�:z� Original WO 8illing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) - Ext <br /> Second Phone ( 1 - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address gyyq Street STH AVE W <br /> From Cross Street <br /> To Cross Sireet <br /> City Z�p <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Ca�led Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Roule Sequence <br /> Comments <br /> Action Taken _- _ — <br />