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City of Everett Work Activity <br /> Work Order Information <br /> Service Request M WON signed <br /> Date Issued <br /> Issued By Y ylLE.1/ <br /> Initials Full name <br /> Fund W4 / E-E] Program rJ/O Function //9 Activity �i^s <br /> Job Cost No C7 Project No. <br /> Title e" % � <br /> Rel Work Order 1 /999 CPS74/ <br /> Problem Information <br /> Address Predirection Street Street Type Postdirection <br /> �q El 6o sr SE <br /> city <br /> *If not "Everett"spec fy which City' <br /> Structure/Equipment Information <br /> Struct/Equip Type Skc Problem r <br /> Struct/EquipNo It"4 C FS•til03 Sub Problem <br /> Structure/Equipment type when applicable <br /> reef E—= Description L —� <br /> Comments to 71Zeti+/ <br /> Bold Type-Mandatory fields to be populated <br /> sialic - Optional fields <br /> ORMS.WRKACfVYJ(CM 01126/99) <br />