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Work Activity Work Order Pa9P 1 <br /> �i,izo�5 �- :�9 <br /> _ _. .. -- -- — — <br /> ISSUEd BY HLJ HUSBY,LANCE J. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued <is7no�s <br /> Fund qot Account s Program Function Activdy <br /> Program utaaa s � <br /> Tttle CONVERT 75 INCH 240 ALVERSON BLVD UTJ473-5�) <br /> Work Order No 20151035 PIOjOCt ACIiVity Typ@ CORRECTIVE MAINTENANCE St8fU5 CL <br /> Status <rzn2o�5 Time »ae OngmalWO BilGng <br /> Customer In(ormatlon <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No ( 1 • Ext <br /> Second Phone 1 I • Ext <br /> E-Mail Address _ <br /> Problem Iniormation <br /> Address y�p Street ALVERSON BLVD <br /> From Cross Street <br /> To Cross Street <br /> City ZiP <br /> Subd�vision Map 800k Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utihty Locate(USA) No Called Dat� Expiretion Date <br /> Assignment In(ormation <br /> Dept Pnority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To ����r��1r <br /> Assigned Date To Be Comp Dale vr'���� <br /> Scheduled Date Scheduled Time _ ____ <br /> Route Route Sequence <br /> Comments <br /> Actlon Taken CONVERi.751NCM CURBSTOP T0.75 INCH SERER WITN METER AND BO%.FIAT TO METER <br /> PROGRAM. <br /> Recommended AcHon <br /> Approved By Hw Nuser,uNCE� . Job Cost Information(YIN) <br /> Start Date � � Time _ Date Comp!eted 4/2812015 Permit No <br /> Completed By Time Fallow Up7 <br />