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Work Activity Work Order Poqe 1 <br /> 5/8/2015 9:26 <br /> ISSUOC By HLJ HUSBY,LANCE J. � � <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued an3izat5 <br /> Fund 4a� Account s Program Function Activity <br /> Program ursa�a s � <br /> Tdle CONVERT.75 INCH 1925 COLBY AVE UT3473•5-3 <br /> WOfk OfdOf NO 2��5�92� PfOJBCI Activity Type CORRECTIVE MAINTENANCE Sf8fU5 CL <br /> Status ar�3no�s Time oe:oz Original WO Billing _ _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No Ciry <br /> State Zip <br /> Subdivision Change Map YIN <br /> Phone No ( . • Ext <br /> Second Phone ( 1 • E� <br /> E-Mail Address <br /> Probiem Information <br /> Address 1925 Street COLBYAVE <br /> Fram Cross Street <br /> To Cross Stmet <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By 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 /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By -� <br /> Assigned Date __ _ To Be Comp Date _ �1!�� �;� �y�� �,1�;�' �J <br /> Scheduled Oate Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP TO.751NCH SETTER WITH METER AND BOX.FLAT TO METER <br /> PROJECT. <br /> Recommended Actian <br /> Approved By HLJ Husov,tANce� Job Cost Information(Y/N) <br /> Start Date � � Time Date Compieted aHariot5 Permit No <br /> Completed 6y_ ___ ___ _ Time __ Follow Up^ _ _ <br />