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li�1 91� ��6�. 3 Va 7 G b d��S� <br /> Work A�tivity Work Order ' � �� � <br /> ,. , ; , . : :� <br /> Issued By CAG CRUM,GE4. � <br /> Issued Departmentpw PUBLICWCRHS <br /> Date Issued 6120IY006 <br /> F,,nd qpt Account 5 Program »o Function >>s Aclivity 6s4 <br /> Program <br /> T111C SO 1 RJCH 122 112'H ST SE pL0' I 7101 iMG4 <br /> WO�k OfdC� NO Z0�6���9 Project Activiry Type CORRECTIVE�1AINTENANCE $121U5 CL <br /> Date r,2a:noe Ticie �a ,a Original WO �zoea Billing <br /> Customer Informatlon <br /> Custamer Name Cusfomer ld <br /> Address Streel <br /> Aparimenl No Cily <br /> Statc Zi� <br /> Subdivision Chan�e Map Y/N <br /> Phone No � � - Ex� <br /> Secand Phone i 1 • Exl <br /> E-M�il Addr[tss <br /> Problom Informatlon <br /> Address �yp Street ��pTHSTSE <br /> From Crqs_s_Streel <br /> To Cross Sireet <br /> City Zip <br /> Subdiwsion Map Dook Map Reference <br /> Problem <br /> Sub Problcrn <br /> Requested �y Date Requested <br /> Agency Rel�led Request <br /> Inilialed From <br /> Ulility Locale (USA) No Called Date Expiralion Date <br /> Assignment Information <br /> Dept Priorily Eslimated Hours <br /> Crew <br /> Con ractor <br /> Assigned lo <br /> Assigned Oy <br /> Assi�nnd Datc To He Comp Datr. <br /> Scheduled D�te ScheUuled Time <br /> Rouie Roule Soquence <br /> Commmits <br /> AC��r�n Taken �'�R MIKE WARD: THERE i� NO TIME OR MATERIALS. THE SERVICE WAS ACTUAILY PUT IN A <br /> COUPLE OF YEARS AGO BV THE CONiRACTOR DOING THE 712TH 5T IMPROVEMENT PROJECT. <br /> THE MFTER N��9�ROBABLY CHARGED OUT ON THE CONTRACTOR INSTALLED WORK ORDER.I AM <br /> TURNING TI115 IN SO THE AS•BUILT CAN BE MICROFILMED. <br /> Completed Oy wrnw �vnien, nucr�ne�w Approved By <br /> Sta�t Date � � Time Dale Completed en�som Time <br /> .lob Cosllnfonnat�on�Y/N) Follow Up9 Permif No <br /> �'�� <br />