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City of Everett Work Activity <br /> Work Order Information <br /> fyYJ`.: <br /> Service Request p WON Assigned La L b qM <br /> Date Issued 99 <br /> Issued By G A 6w r /�1LCi✓ <br /> ' Initials Full name <br /> Fund 4p / 57 Program 'j/p Function // 9 Activity 67S <br /> Job Cort No E= Pro/err No. <br /> Title Reti Iw- J14 IbLY/GG <br /> Rel Work Order 999 al 75/ <br /> Problem Information <br /> Address Predirection Street Street Type Postdirection <br /> S/p F-1 M <br /> Cio, <br /> Yf not "Everett"spec fy which City <br /> Structure/Equipment Information <br /> Struct/EquipType logs RVG Problem <br /> Struct/Equip No k/S 06ZrS,1�/o y6 Sub Problem <br /> Structure/Equip)nent type when applicable <br /> Feet �� Description <br /> Comments ,d ,veY iYlAir <br /> Bold Type- Mandatory fields to be populated <br /> Italic — Optional fields <br /> FORMS Ww Arnvs tent 01126/99) <br />