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Work Activity Work Order PaQe ' <br /> 4/3/2013 15:11 <br /> ISSUOd By HLJ HUSBY,IANCE J. <br /> Issued Department vw PUBLIC WORKS <br /> Date Issued 3/512013 <br /> Fund aot Account 5 Program Function Activity <br /> Program utae�a z � <br /> TItlB CONVERT 75 INCH 2117 CLEVELAND AVE UT3473•2-3 <br /> Work Order No 20130565 PfOJeCf Activity Type CORRECTIV�MAINTENANCE $fa�US CL <br /> StaWs J1512013 Time iaaa OriginalWO Billing _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartmenl No City <br /> State Z�P <br /> Subdivision Ghange Map Y/N <br /> Phone No 1 l - Ext <br /> Second Phone l 1 • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address y��7 Street CLEVELANDAVE <br /> From Cross Street <br /> To Cross S�ree� <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WA1'ER WATER <br /> Sub Problem OTHER OTHER <br /> Requested Bv Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate(USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> C rew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time __ <br /> Route Route Sequence <br /> Comme�ts <br /> Action Taken CON�ERT.751NCH CURBStOP TO .761NCH SETTER WI METER AND BOX.FLAT TO METER <br /> PRGJECT. <br /> Recomrnended Action <br /> Approved By HLJ HU56Y, LANCG J Job Cost Information(Y/N)_ _ <br /> Start Date � i Time Date Completed anvzata Permit No__ <br /> Completed By Time Follow Up7 <br />