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Work Activity Work Order Pa9e 1 <br /> ��,�zoi5 i�:3� <br /> ISSUBd BY HLJ HUSBY,LANCE J. <br /> Issued Departmentaw PueuCwoRKs <br /> Date Issued umzots <br /> Fund �ot Account s Program Function Activity <br /> Program uraaa 5 a <br /> T�fIC CONVER?.751NCH302ALVERSONBLVDUi747�•5-7 <br /> Work Order No 20151036 PfOJ2C1 Activity Type CORRECTIVE MAINTENANCE $�81U5 CL <br /> Status a�anzo�s Time t352 Origmal WO Billing ___ _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State ZiP <br /> Subdivision Change Map Y/N <br /> Phone No 1 ) - Ext <br /> Second Phane ( 1 - Exl - - - <br /> E-Mail Address <br /> Problem Iniormatlon <br /> Address 30Y Stree ALVERSON BLVD <br /> From Cross Street <br /> To Cross Street <br /> City - Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Dale Expiration Date <br /> Assignment Information <br /> Dept Prwnty Est�mated Hours <br /> C rew <br /> Contractor ������f <br /> Assigned To L��� <br /> Assigned By <br /> Assigned Date _ _____, To Be Comp Date <br /> Scheduled Oate _ acheduled Time _____ <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.761NCH CURB5TOP TO.75 INCH SETTER WITH METER AND BOX.FLAT TO METER <br /> PROGRAM. <br /> Recommended Aetion <br /> Approved By HLJ HUSBV.LANCE J ' JOb COSt IfIfOfR18fi00(Y/N) <br /> Start Date i i Time Date Completed 5�v2ois Permit No <br /> � Completed By____ _ _ Time Follow Up? _ _ <br />