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City of Everett Work Activity <br /> Work Order Information <br /> Service Request K WON Assigned tJ <br /> Dn.e Issued —t/ <br /> Issued By CS <br /> Initials Full name <br /> Fund Program ? Function Activity �r <br /> Job Cost No C� - - Project No. --1 <br /> Title �rVS r e^�` /o �!T[,J /1l,✓ <br /> Rel Work Order 12 `j o 3)7 <br /> Problem Information <br /> Address Predirection Street Street Type Postdirection <br /> El 1 168 <br /> City <br /> *If not "Everett"specfywhich Ciry• <br /> _ Structure/Equipment Information <br /> Struct/E[Ec Type S Problem <br /> Struct/Equip Mn o 6 �S 3 Sub Problem <br /> Structurc/Equipment type when applicable <br /> Feet Description <br /> Comments <br /> Bold Type-Mandatory fields to be populated <br /> Italic -Optional fields <br /> FORMS:WRKACTVYI(CM 0UMM) <br />