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L�c���[- Y(o 1 � 'l �- <br />Work Activity Work Order <br />Fa�� i <br />a;,-;���; ,:�� <br />ISSU2d By WMW WARD, MICHAEL W. <br />Issued Dapartmentaw P�iBLICWORKS <br />Date Issued amzoo� <br />Fund aot Account s Program 7to Function »9 Activity e�s <br />Program <br />Ti110 CONVERT 9611 7TH AVE SE 710179675 <br />WOfk Ofdef NO 20���329 Projecf ACUvily Type CORRECTIVE td�INTENANCE StBtUS PR <br />Date an�noo� Time or�o Original WO Billing <br />Customer Information <br />Cuslomer Name <br />Address Street <br />Apartment No City <br />Slate Z�P <br />Subdivision <br />Phone No ( 1 - Ext <br />Second Fhone 1 1 - �xt <br />E-Mail Address <br />Problem Information <br />Address gg�� Street 7THAVESF_ <br />From Cross Sireet <br />To Cross Slreet <br />City <br />Subdivision <br />Prablem <br />Sub Prablem <br />P.equested By <br />Agcncy <br />Initiated From <br />Uliliry Locale (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Map Book <br />Called Date <br />CustomPr ld <br />Change hlap Y/N <br />Zip <br />Map ReferencP <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Assigned Date To Be Comp Date _ <br />Scheduied Date Scheduied Time <br />-- <br />Roule Route Sequence <br />Comments / /% /� � �J <br />Y—/ % —o �L i �ns_�s. [_l-�vl Se f'[-G�t� � _ _ ,. c' � !'�+u✓.L t a �r._-,..0 <br />Action Taken --- -- - — — — - /— V� <br />--- ----- <br />S't � t, wl�. _�G _ Tl� _ _ ---- ----- <br />_—__ _ ---- <br />