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City of Everett Work Activity <br /> Work Order Information <br /> Service Request# 1 I WON Assigned n97 3 9 <br /> 5K <br /> Date Issued <br /> Issued By Gig 6ARy %91Ltw <br /> Initials Full name <br /> Fund 4O/ Program '7/p Function //y Activity 67�" <br /> Job Cost No Project No. <br /> Title w-Vr.C;V <br /> Rel Work Order /999 O 7y <br /> _ Problem Information <br /> Address Predirection Street Street Type Postdireclion <br /> El E- SE <br /> Cit, <br /> *If not "Everett"sped which City* <br /> Structure/Equipment Information <br /> Struct/EquipType SR Problem <br /> StrucUEquip No y O��S.r�f O:6 Sub Problem <br /> Structure/Equipment type when applicable <br /> Fect —� Description <br /> Comments <br /> Bold Yype-Mandatory fields to be populated <br /> hotic -Optional fields <br /> FORMS:WRKACTVY](CM 01126/99) <br />