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City of Everett Work Activity <br /> WorK Order Information ,}t• <br /> servJce Request M W/MI Assigned <br /> Date Issued !/ <br /> p <br /> Issued By �j Gi9R .CLG.✓ <br /> initials Full name <br /> Fund /,/p� F7� Program rf/p Function //9 Activity 673' <br /> Job Cost No Project No. <br /> Title ecu <br /> Rel Work Order /99 9 o s <br /> Problem Information <br /> AddressPredirection Street Street Type Postdirection <br /> ❑ o s� <br /> City <br /> •lfnot "Everett"spec(fywhich City* <br /> Structure/Equipment Information <br /> Struct/Equip Type zws-'evc Problem <br /> Struct/Equip No also r;rS Af ad' Sub Problem <br /> structure/Equipment type when applicable <br /> Feet F Description <br /> Comments TeA�fFue ;to ruew .NA/n/ <br /> Bold Type-Mandatory fields to be populated <br /> Italic- Optional fields <br /> FORMS:W RKACTVYJ(CM 012699) <br />