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Work Activity Work Order Pas� ' <br /> ����ZoiS is:i, <br /> Issued By SJT2 SPOONER,JAMES T. <br /> Issued Departmentaw PUBLICWORKS <br /> Date Issued siznzou <br /> Fund ao� Account s Progrem Function Activity <br /> Program UTJ473 6 J <br /> Tifle CONVERT.751NCH 1731 LOMBARDAVE UT3473�6-3 <br /> WOfk OfdOf NO 20151194 P�OJ2Ct Activity Type CORRECTIVE MAINTENANCE Sf2tU5 Cl <br /> Status s�z�izot5 Time o529 Original WO Billing ___ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 - Ext <br /> Second Phone ( 1 • Ext -- - -- <br /> E-Mail Address <br /> Problem Information <br /> Address �731 Street LOMBARDAVE <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Probiem 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 Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assi ned Dale To Be Comp Date f �, , <br /> Sch duled Date Scheduled Time _ _ _ _ _ l�'���� ��� `'�� �� <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT 751NChi CUR�STOP TO JS INCH SETTER WITH METER AND BOX fLAT TO h1ETER <br /> PROJECT. <br /> Recommended Action <br /> Approved By HW HUSBY,LANCE J. ' JOb COSt In(O�filBtlOf1(Y/N) <br /> Start Date � i Time Date Completed sisenois Permit No_ <br /> Completed By Time Follow Up? <br />