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City of Everett Work Activity <br /> Work Oider Informatfon <br /> Scrvlct Requtsr N WOl1 Assigned �9 <br /> Date Isaue�f �r= p -y <br />' I�sued B� �J'/,�J �/y� i t�e <br /> Initials . Fu!!name <br /> ' Fuod � � Program s—,1j Fuoction /�� Activiry �)c. <br />�� <br /> k Jo6 Cosf �a C� ' � ' Projecr No. � <br /> I' '' <br />� - . Tiae /97�b /00�e /ylonRoe sr.� <br /> Rel Work Order C� ' I <br /> � . �.4 - . <br />� . <br /> . Problem luformation <br /> Addre�� Predirection Street Streel Type Po�tdirection <br /> Od � DD °C I�.�O�°o� � � <br /> ��n' �Yl a.v Roe. � <br /> •/jnor "Evereft"speri,'ry w6ich Ciry• <br /> �C�.- 14� (��' <br /> Structure/Equlpment InformaUon <br /> Struct/Equip Type Problem <br /> Struct/Equip No � Sub Problem <br /> Siruclure�Equiomenl fvpe when applica6le <br /> Feel �__� D/..tcriplion �-- <br /> 'Tv�� Ih, rJ J S e nJ � <br /> G�jI�A�..• 0!!T tj� /y1G ar 61J. r'/� Nt�7 (�.r�� <br /> Commen�s �o„�T-�p�7"'CI�AR<A �R�L <br /> ,¢,.+d ;ir•P�ti�ueR �r,t,��o „ �9Yis�y c ,�e <br /> 3Go-:+'Lff- � - � <br /> ,D�Scc,���s� o y:�� �.,.,rv� /yle,d•�„�T�a e w�t' D�s� <br /> ,v�i��Q, ,� <br /> &�Id Type�Mandotory ficlds lo be populaled <br /> lmfic =Oprional fields <br /> FOM15�.WRi:ACTVYJ(CM 0126/99) <br />