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Work Activity Work Order �°°` ' <br /> iz!:?/:cis is �o5 <br /> ISSUBd By HLJ HUSBY,U1NCE J. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued 7 117 312 01 5 <br /> Fund ao� Account 5 Program Function Activity <br /> Program uraa�a s a <br /> Tllle CONVERT 51NCH 2301 tVERETT AVE UT3473�8-3 <br /> Work Order No 20152493 PfOJ@Cl AdiVlty Type CORRECTIVE NAINTENFNCE SlatUS CL <br /> Status �v»�zo+5 Time cs iz Original WO Bilhng <br /> Customer Information <br /> Customer Name Custemer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivis�on Change Map Y/N <br /> Phone No 1 1 • Exl <br /> Second Phone � ) • Ext <br /> E-Mail Address <br /> Problem Iniormation <br /> Address P301 Street gVERETT AVE <br /> From Cross Street <br /> To Cross Street <br /> City ZiP <br /> Subdrvision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requesled By Date Requested <br /> Agency Related Request <br /> Inihaled From <br /> Utihty Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Depl Prionty Eslimaled Hours <br /> Crew <br /> Conlractor <br /> Assigned To � �p���,�,-',� <br /> �8�� 1y��e <br /> Assigned Date ___ _ To Be Comp Date __ __ _ � d �� <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.51NCH CURBSTOP T0.751NCH SETTER WI1 H M[TER AND BOX. FLAT TO METER <br /> PROGRAM. <br /> Recommended Action <br /> Approved By woL WEAVER, DEAN L Job Cost In(ormahon(Y/N) <br /> Start Date i i Time Date Compieted �vi�izois_ _ _ Permit No _ <br /> Completed By Time Follow Up? <br />