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Work Activity Work Order °a°P 1 <br /> �/io��ois ii:i4 <br /> ISSU2d By SJT2 SPOONER,JAMES T. � <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued 61312015 <br /> Fund ao� Account 5 Program Function Activity <br /> Program UT3473 6 3 <br /> Tifl2 CONVERT.75 INCH 1013 LOMBARD AVE UT3473-6�3 <br /> Work Order No 20151263 Project Activity Type CORRECTIVE MAINTENAYCE Si81US CL <br /> Status 6/3/20�5 Time oe v Original WO __ Billing _ _ <br /> Cusiomer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Zip <br /> Subdivision Change Map Y/N <br /> Phone No ( ) • Ext <br /> Second Phone ( 1 - Ext - <br /> E-Mail Address <br /> Problem Information <br /> Address 1013 Street LOMBARD AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdiv�sion Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Proble�n OTHER OTHER <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 Prioriry Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Dale '���(y <br /> ••����/ <br /> Scheduled Date __ Scheduled Time ��_�4`�+� <br /> Route Route Sequence �" <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP TO.75 INCH SETTER WITH METER AND BOX. FLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By HLJ HUsev, �nNCE�. Job Cost Information(Y/N) <br /> Start Date i r Time Date Completed 61312D15 Permit No <br /> Completed By Time Follow Up7 <br />