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Work Activity Work Order � � <br /> Issued By HLJ HUSBV,LANCE J. f� <br /> Issued DepartmentPw PUBIICWORKS <br /> Date Issued enono�s <br /> Fund ao� Account s Program Function Acc�v r; <br /> Program ur�n3 s � <br /> T�tle CO�NERT 751NCH 17J2 COLBV AVE UT3473-6-3 <br /> Work Order No 20152142 Project Actiwry Type CORRECTIVE IJIAINT[NANCE $I81U5 CL <br /> St8tu5 9�30/2015 TImQ 0803 �fi9if101 W� _ Edlir,r� <br /> Customer Intormation <br /> Customer Namn Custcmer I� <br /> Address Stree! <br /> Apartment No ���Y <br /> State Z�P <br /> Subd�wsion Ghange Map Y,N <br /> Phone No l ) • Ext <br /> Second Phone � 1 • Ext -- <br /> E-I�Aad Address <br /> Problem Iniormalion <br /> Address �73P Street COLBYAVE <br /> From Cross Street <br /> To Cross Street <br /> Gty I r� <br /> Subdrvisior h1ap Bock I�Aap Referer��e <br /> Prob�em WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested Dy Da;� Reque;ted <br /> Ageney Rela,ed Reyuest <br /> Initialed From <br /> Utihty Locate (USA) No Called Date Expirahon Date <br /> Assignment Information <br /> Dept Pr�onty Eshmated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned 13y <br /> Assigned Date lo Be Comp Late , ;. ,;; �; , . . " <br /> Scheduled Date Scheduled Time <br /> Route Route Sequerce <br /> Comments <br /> Action Taken CONVERT .751NCH CURBSTOP TO 751NCN SETTER WITH N[TER ANU�OX.FLAT i0 NET[R <br /> PROGMM. <br /> Recommended Action <br /> ApprovedBy EAL ERICKSON,ANDFEVJL ,lOb �oSlln(Ofrn2li0lt(Y!N) <br /> Start Date � � Time Date Completed siamzo�s_ Permd No <br /> Completed By Time Follew Up7 <br />