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Work Activity Work Order "'P 1 <br /> �ia/zo:� _3 :oi <br /> — -- ---- - ---- ____ <br /> --- — <br /> ISSUBd By HLJ HUSBY,LANCE J. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued a�snota <br /> Fund �o� Account 5 Program Function Activity <br /> Program uram s a <br /> TItIC �CONVERT JS INCH 2602 CLEVELAND AVE UTJ473-2J <br /> Work Order No 20130551 PfOf2Cl ACIIVIfy TyPE CORRECTIVE MAINTENANCE $12tU5 CL <br /> Billin <br /> St0tU5 3/S1201J Tirt18 10 23 .Oflgtnal WO .-._ ..— _ . ------- <br /> Customer Information <br /> CustomerName Customer ld <br /> Address Street <br /> Apartment No City <br /> Stale Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 • Ext _--_-_.-_- <br /> Second Phone c 1 - Ext <br /> ------ - --- __ _ _ <br /> E-Mail Address ----- - -- ----- <br /> Problem Information <br /> Address Y60y Street CLEVELAND AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Date Requested <br /> Requested By Related Request <br /> Agency <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Informatlon <br /> Dept Priority Estimated Hours <br /> C rew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Oate <br /> Scheduled Dale Scheduled Time ______ <br /> Route Roule Sequence <br /> Comments <br /> Actfon Taken CUNVERT.151NCH CURBSTOP T0.76 INCH SETTER WI METER AN�BOX.FLAT TO METER <br /> PROJECI. <br /> Recommended A^tion <br /> Approved Dy HW NUSBV.LANCE J Job Cost Information(YIN) <br /> ---— - Time Date Completed annota__ ___ Permit No <br /> Start Date � � <br /> ___ _ <br /> Completed By Time Follow Up <br />