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Work Activity Work Order Pa°� ' <br /> :�iio/zois is:ii <br /> ISSUOd By HlJ HUSBY,LANCE J. <br /> Issued Department aw PUBLIC WORKS <br /> Datelssued �v�anois <br /> Fund ao� Account 5 Program Furct�on Act�wty <br /> Program ursa�a e a <br /> Title CONVERT 5 MCH 2t05 EVERETT AVE UT3473 8�3 <br /> Work Order No 20152493 Project Ac;v�ty Type co�:Rr-crive r.i�ir�TeNANce Status c� <br /> Slatus ��/1312015 Time o�59 Origmal WO Bdling <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No C�ty <br /> Siate Z�P <br /> Subdivision Change Map YIN <br /> Phone No � 1 - Ext <br /> Second Phone � > • Ext —"'— �--- ----- <br /> E-Ma�l Address _ _ _______ _ ___ <br /> Problem Information <br /> Address 2405 Slreet EVERETT AVE <br /> From Cross Streel <br /> To Cross Street <br /> City Z'p <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Init:ated From <br /> Utility Locate (USA) No Called Date ExpiraGon Date <br /> Assignment Intormation <br /> Dept Pnonty Estimaled Hours <br /> Crew <br /> Contractor <br /> Ass�gned To <br /> Assigned 8y <br /> Assigned Date ____._ To Be Comp Date ,. �. , , ���"�¢� � ��p`� ,,) <br /> Scheduled Time �'�� !``� <br /> Scheduled Date _____ __ <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT .S INCH CURBST(7P T0.751NCH SETTER WITH METER AND BOX. FLAT TO METER <br /> PROGRAM. <br /> Recommended Action <br /> Approved By wo� WEAVER, DEAN L JOb C051 IflfOff�81100(Y!N) <br /> Start Date � � Time Date Completed �vi�izo�s _ Permit No _ <br /> Completed By Time Follow Up� <br />