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City of Everett Work Activity <br /> Work Order Information <br /> Service Request N WON Assigned b <br /> Date Issued FY/.NNRc/V 99 <br /> Issued By G/9 tsARY �lLe.✓ <br /> Initials Full name <br /> Fund .S/O/ ETI Program ^J/p Function F //9 Activity <br /> Job Cost No Project No. <br /> Title /&,rie, V41 y <br /> Rel Work Order /999 0.17# <br /> Problem Information <br /> Address Predirection Street Street Type Postdirection <br /> Ciry <br /> *If not "Everett"sped which Ciry• <br /> Structure/Equipment Information <br /> Struct/Equip Type S VG Problem <br /> StrucvYquip No 4"/q a E p5 .t f O 4 o Sub Problem <br /> Structure/Equipment type when applicable <br /> Feet Description 1 — <br /> Comments <br /> Bold Type-Mandatory fields to be populated <br /> Italic = Optional fields <br /> FORMS:W RAACTVYJ ICM 0186199) <br />