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Work Activity Work Order `'`'9� ` <br /> :/71/:G:S :2:14 <br /> ISSUEd By SJT2 � SPOONER,JAMES T. <br /> Issued Department pw PUBUC WORKS <br /> Date Issued uts�iots <br /> Fund �ot Ar.count s Program Function AcLw.y <br /> Program uraua 5 � <br /> TiN2 CONVERT 751NCH 701 AWEHSON BWO UTJC7}SJ <br /> WOfI; Order No 20150196 Ff0f2Cl Act�wty Type CORRECTIVE IdAINTf.NANCL' $181U5 Cl <br /> $tBIUS 1i15l2015 TifTIC 0949 Of191f1811�/� BIIIIf19 _ . <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No C�ty <br /> State Z�P <br /> Subdrv�s�on Change Map Y/N <br /> Phone No � � - Ext <br /> Second Phone � � - Ext --�� <br /> E-Mad Address <br /> Problem Information <br /> 4ddress �p� Street ALVERSON BLVD <br /> From Cross Street <br /> 7o Cross Street <br /> City ----- zip <br /> Subdiwsion Map �ook Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTMER OTHER <br /> Requested By Date Requested <br /> Agency Related Requesl <br /> Initialed From <br /> Uld�ty Locate(USF+) No Called Date Ezp�rahon Date <br /> Assignment Inlormation <br /> Dept Prionty EsUmated Haurs <br /> Crew <br /> Conlractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date _ r �, <br /> ����w:�'�?rl , ' <br /> Scheduled Date Scheduled Time � ����' <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.75INCFI CURBS70P T0.751NCH SETTER WI1H METER AND 80%. FLAT TO METER <br /> PROJECT <br /> Recommended Action <br /> Approved By HW HUSBV LANCF J Job Cost In(ormalion(Y/N) <br /> � -- — ------- <br /> —�- ---------- - — <br /> Start Dale � � TIfT1P. Date Completed uzei2ois Permit No <br /> - - -- - -- - — <br /> Completed By Time Follow Up? <br />