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`No�k Activity Work Order � � " ' <br /> �,/:�/'-,�ts to: .a <br /> - -------- - - <br /> ISSUed By � � SJT: SPOONER,JAMES T. <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued 619/2015 <br /> Fund aot Account s Program Function AcUviry <br /> Program uTaa�a s a <br /> TIUE CONVERT JS INCH 1628 LOMBARD AVE UT3473-5•3 <br /> Work Order No 2��5�3�� Project Activity Type CORRECTIVE 61AINTENANCE Sl2lU5 CL <br /> Status si9no�5 Time os:aa Original WO _ _____ Billing <br /> Customer Infortnation <br /> Customer Vame Cusromer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Chang� ��'�p Y/N <br /> Phone No l 1 - E�R <br /> Second Phone f 1 - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address �gyg Street LOMBARU AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> SuSdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utiliry 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 _ <br /> ,;{rLI.�±.' <br /> T( (� <br /> ScheduledDale ScheduledTime � ����r� �4�;;:: <br /> Route Route Sequence �� � <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP 70.751NCH SEITER WITH METER AND 00X.fLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By Hu Nusev, u�Nce�. Job Cost Information(Y/N) <br /> Start Date � i Time Date Completed enono�5 __ Permit No <br /> Completed By Time Follow Up? <br />