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Work Activity Work Order '''�° ' <br /> �:n��z „�> > , � .,, <br /> ----- <br /> ISSU2d By HLJ HUSBY,LANCE J. <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued iona�zou <br /> Fund aoi Account s Program Functicn Activity <br /> Program uraa�s 6 3 <br /> TiUO CONVFRT 75 INCH 1902 LOMBARD AVE UT3477-6-3 <br /> Work Order No 20152258 PfOJ2Cf ACflVity Typ@ COFRFCiIVE MNNTEMANCE StatuS CL <br /> Staws �o�izizo�s Time ozs� Origina11N0 Billing _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No � 1 - Ext <br /> Second Phone ( > • Ext - <br /> E-Mail Address <br /> — – -- -- <br /> Problem Information <br /> Address �gpy Street LOMBARD AVE <br /> From Cross Street <br /> To Cross Street <br /> ciry z�p <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requesled By Dale Requesled <br /> Agency Related Request <br /> Initialed From <br /> Utility Locate (USA) No Called Date Expiratinn Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Coniracror <br /> Assigned To <br /> Assigned B�- <br /> � <br /> Assigned Date __ __ . To Be Comp Date r',�� � .P�„�;�;� ,i yt.; a; � <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP T0.751NCH SETTER WITH METER AND BOX.FLA7 TO METER <br /> PROG'AM. <br /> Recommended Action <br /> Approved By EAL ERICKSON,ANDREW L Job Cost Information(Y/N) <br /> Start Date i i Time Date Completed �on2izo�s Permit No _ <br /> Completed By Time Follow Up? <br />