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Work Activity Work Order �'a9e ' <br /> it/iz/zois i3 :av <br /> ISSUed BY HLJ HUSBY,LANCE J. <br /> Issued Departmentaw PUBLIC WOAKS <br /> Date Issued toiv�ots <br /> Fund �ot Accounts Program Function Actwiry <br /> Program urun e a <br /> Tdl2 CUNVER7 75 INCH 711 ALVERSON BLVD UTJ47J-6•7 <br /> Work Order No 20152195 Pf0�2Cf ACtlVity Typ2 CORRECi IVE MAINTENANCE SfBlUS Cl <br /> Status ia2no�s Time u se Origiral WO Bilhng_ ___ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Slreet <br /> Apartment No Ciry <br /> State Z�p <br /> Subdivision Change Map Y/N <br /> Phone No � � - Ext <br /> Second Phone � � • Ext - <br /> E-Mad Address <br /> Problem Information <br /> Address 311 Street ALVERSONBLVD <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdwision Map Oook Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Uldiry Locate(USA) No Calted Date Expiration Date <br /> Assignment Intormation <br /> Oept Pnonry Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To ,' { � � <br /> Assigned By To Be Com Dale �� �� � ��a�� ` ' � <br /> Assigned Date P ____ � :i� ', � ,, , <br /> � : . <br /> Scheduled Date Scheduled Time � � <br /> Roule Route Sequence <br /> Commenta <br /> AcNon Taken CONVERT.75INCH CURBSTOP T0.751NCN SETTER WITN METER AND BOX.FLAT TO METEH <br /> PROGRAM. <br /> Recommended AeNon <br /> Approved By EAL [RICKSON,ANDREW L Job Cost InformaGon(YIN) <br /> Start Date i � Tlme Date Compleled �ois�zo�s_ Permit No __ <br /> -- - — -- <br /> Completed By T�me Follow Up� <br />