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�,Nork Activity Work Order <br />,, . <br />Issued By CSG CAVANAH, SHANE G. <br />Issued Department Pw PUBLIC WORKS <br />Dalelssued �nsnota <br />Fund eot <br />Account5 Progrm 7�o Funchon i�y Act�viry e�s <br />Program <br />T111P. REN[W 751NCH 920 120TH ST SE 710119675 <br />Work Order No 20131536 Pro;ect Activity Type coaaecrive �rniNreNnNce Stalus c� <br />StaWs 7rzsrzot� T�me ��,�; On�inallNO ���'->»�'� B�Il�ny <br />Customer Information <br />Custumer Name <br />Address Street <br />Aparimenl No Gty <br />State Z�P <br />Subdivision <br />Phone No ' ' I' <br />Second Phone ` ' <br />E-Mail Address <br />Problem Inform.dion <br />Address �'�""�� <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision Map Book <br />Problem <br />Sub Problem <br />Requested By <br />P�ency <br />Initiated From <br />UUlity Locate (USA)'�o Called Dale <br />Assignment Informalion <br />Depl <br />Crew <br />Contraclor <br />l�ssigned To <br />Assigned �} <br />Assigned Dale To t3e Comp Date <br />Scheduled Date Scheduled Time <br />Route Roule Sequence <br />Comments <br />ACl1O0 T0kCi1 CONNECTED SERVICE TO NEW 8 INCH MAIk. <br />Recommended Actlon <br />(�p�fOVEd BY HW NU56Y. LANCE J <br />Start Date i i Time <br />CpmplulCd �y <br />Customer ld <br />'; <br />7_�p <br />P�1ap Reference <br />Datr. Requested <br />Relaled Fequest <br />Expiration Date <br />Pnonty FSUmaled Hours <br />Job Cosllntormation(Y/N) <br />Date Completed eni2o�a Permit No <br />T,i��A Foilow Up� <br />