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oa9e 1 <br /> Work Activity Wo��k �rder 5�1,� :�1, ,.a:5., <br /> ISSUBd By SJT2 � SPOONER,JAMES T. <br /> Issued Cepartment aw PUBLIC WORKS <br /> Datelssued 12nonoi� <br /> Fund 40� Account o Program »o Function �is Activity 6�5 <br /> Program <br /> TitIB CONV'?RT]5 INCH 2314 B LOMBARD AVE 710119675 <br /> Work Order No 20133841 PfOJQCt Activity Type CORRECTIVE MAINTENANCE SZ8fl1S CL <br /> Status izno�zois Timeos:3a Ori�inalWO_________Billing__ _ _ __ ___ <br /> Customer Infnrmation <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�p <br /> Subdivision Change Map YIN <br /> Phone No ( ) - Ext <br /> - - - <br /> Second Phone ( ) • Ext <br /> E-Mail Address — -- ----- - - ----- - <br /> Problem Information <br /> Address 23�4 g Street LOMBARD AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTNER <br /> Requested By Date Requested <br /> Agenc�� 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 /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> I Action Taken REPLACE.75 WCH CURBSTOP WITH 751NCH SETTER,�dETER AND BOX.FLAT TO METER <br /> OWNER REQ. <br /> ` Recommended Action <br /> Approved By wo� WEAVER,DEAN L. JOb COSI Ifl(Of�t18i10�(Y/N) <br /> --- ------._ .--�- - - <br /> --- -- °ermit No <br /> Start Date � i Time Date Com leted v2sno�a __ ___ _ <br /> -- - <br /> Cempleted By Time Follow Up? <br />