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Work Activity Work 4rder F�ge 1 <br /> 7/15/2015 10: 3! <br /> ISSU2d By SJT2 SPOONER,JAMES T. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued 6I312015 <br /> Fund aot Account s Program Function Activiry <br /> Program UT3473 c a <br /> TiU2 CONVERT.75 INCH 1116 LOMBARD AVE UT3473�-3 <br /> WOfk �fd2f NO ZQ�5�z�5 PfOJOCf Activity Type CORRECTIVE MAINTENANf:E Sf2tUS CL <br /> Status sr3rzois Time �325 Original WO Billing <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Slreet <br /> Apartment No City <br /> State Zip <br /> Suboivision Change Map Y!N <br /> Phone No ( ) - E� <br /> Second Phone ( 1 - Ext ---- - - <br /> E-Mail Address <br /> _ _ _ — <br /> Problem Information <br /> Address ���g Street LOMBARDAVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reterence <br /> Problem WATER WRTER <br /> Sub Prablem OTNER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utiliry Locate(USA) No Called Dale Expiration Date <br /> Assignment Information <br /> Dept P :::�:r, Estimated Hours <br /> Crew <br /> Contractor � <br /> Assigned To <br /> Assigned By <br /> Assigned Date _ To Be �omp Date _ ��'�' :�'�` �', �9 � � , ,-� <br /> �F �c. <br /> Scheduled Date Scheduled Tir:�e <br /> Route Ro�le Sequence <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP TO .751NCH SETT�R!'�'!TN METER AND BOX. FLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By HLJ HUSDY, LANCE J. JOb COS�IflfO(R18110f1�Y/N) <br /> Start Date � i Time Date Completed 6/8I2015 Permit No <br /> Completed By Time Follow Up? <br />