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City of Everett Work Activity <br /> 'Mork Order Information <br /> service Requxt N E WON '—Igned <br /> Date Issued <br /> Issued By <br /> Initials Full name <br /> Fund ❑3❑ Program 7 p Function �� Activity rs ?s <br /> Job Cost No ❑❑ Project No. <br /> c <br /> Title 7�i9 A-- -,A' j ovr. til A) <br /> Rel Work Order 9 Q <br /> Problem Information <br /> Address Predirection Street Streit Type Postdirection <br /> L-71 <br /> F5 c <br /> Ciry <br /> 'Ifnnt "Everett"specowhich City* <br /> Structure/Equipment Information <br /> Struct/Equip Type w IN S J Problem <br /> Struct/Equip No t„� Sub Problem <br /> Structure/Equipment type when applicable <br /> Feet �� Description <br /> Comments 7„CitX�C� <br /> Bald Type—Mandatory fields to be populated <br /> Italic a Optional fields <br /> FORMS:WRKACTVY3(CM 01/26199) <br />