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Page 1 <br /> Work Activity Work Order q�3��013 �S:o6 <br /> ISSU2d By HLJ HUSBY,LANCE J. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued aisixot� <br /> Fund 4ot Account s Program Function Activity <br /> Program ursera z � <br /> Title CONVERT ]5 INCH 2321 CiEVELAND AVE UT3473�2•5 <br /> Work Order No 20130575 Project Activiry Type CORRECTIVE MAINTENANCE $fatUS CL <br /> Status 3/5R013 Time �4 �o Original'NO Billing _ <br /> Curtomer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No l 1 • Ext <br /> Second Phone l 1 • Ext <br /> E-Mail Address <br /> Problem In(ormation <br /> Address 43y� Street CLEVELANDAVE <br /> From Cross Street <br /> To Cross Street Z�p <br /> City <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTNER Date Requested <br /> Requested By Related Request ; <br /> Agency <br /> Initiated From Ex iration Date <br /> Utility Locnte (USA) No Called Date P <br /> Assignment Iniormation <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By To Be Comp Date <br /> Assigned Date -- <br /> Scheduled Date Scheduled Time <br /> P.oute Route Sequence <br /> Coniments <br /> Action Taken CONVERT.751NCH CURBSTOP TO.751NCH SETTER WI METER AND BO%.FLAT TO METER <br /> PROJEi.i. <br /> Recommended F'�ction <br /> Approved By RJF �PELYEA.JASON P JOb COSI If1fOfR12�lOff(YIN) <br /> . __—___._. <br /> Start Date � � <br /> Time Date Completed 3ienoia Permit No <br /> Completed By Time Follow Up? <br />